基于脾升胃降理论辨治儿童厌食的研究进展

Research Progress on the Treatment of Pediatric Anorexia Based on the Theory of Spleen Ascending and Stomach Descending

摘要: 儿童厌食是儿科临床常见疾病，以长时期食欲不振、食量减少、厌恶进食为主要特征，严重影响患儿的生长发育与免疫功能。脾升胃降理论是中医学核心理论之一，脾主升清，胃主降浊，二者升降相因，共同完成食物的消化吸收。近年来，基于脾升胃降理论辨治儿童厌食的临床研究日益丰富，形成了健脾助升、消导助降以及升降同调三条主要治法路径，方药、推拿、穴位贴敷等干预手段多样，其机制研究亦在胃肠动力、脑肠肽调控和肠道菌群等领域取得初步进展。本文系统梳理该领域的研究进展，总结三条路径的适用指征与组方规律，分析现有不足，并展望未来方向，以期为临床实践与后续研究提供参考。

Abstract: Pediatric anorexia is a common clinical condition in pediatrics, characterized primarily by long-term loss of appetite, reduced food intake, and aversion to eating, which severely impairs the growth, development, and immune function of affected children. The theory of spleen ascending and stomach descending is one of the core theories of traditional Chinese medicine. The spleen governs the ascending of the clear, while the stomach governs the descending of the turbid; their ascending and descending functions are mutually dependent and together accomplish the digestion and absorption of food. In recent years, clinical research on the syndrome differentiation-based treatment of pediatric anorexia grounded in this theory has become increasingly abundant, giving rise to three main therapeutic pathways: invigorating the spleen to assist ascending, promoting digestion and removing stagnation to assist descending, and concurrently regulating both ascending and descending. The intervention methods are diverse, including herbal formulas, tuina, and acupoint application. Mechanistic studies have also made preliminary progress in areas such as gastrointestinal motility, brain-gut peptide regulation, and gut microbiota. This article systematically reviews the research progress in this field, summarizes the applicable indications and prescription patterns of the three pathways, analyzes existing shortcomings, and outlines future directions, with the aim of providing a reference for clinical practice and further research.