目的 观察综合性干预措施与常规4∶2∶1保健指导对营养不良儿童的干预效果。方法 选取99名低体重营养不良儿童为干预对象,根据家长知情自愿参与原则分干预A组、干预B组、对照组,分别进行一年的西医综合干预措施、中西医结合综合干预措施或单一措施(常规4∶2∶1保健指导)的干预效果评价。结果 儿童营养状况好转率干预A组为62.5%、B组为71.9%,对照组为37.1%,A、B两组均明显高于对照组,且B组效果优于A组(χ²=17.00,P=0.03)。采用儿童饮食行为干预问卷(Identification & Management of Feeding Difficulty,IMFeD)对干预组儿童进行干预后,A组、B组胃口差分别减少25%及47%,挑食偏食分别减少50%及53%,不良饮食习惯分别减少46.9%及56.2%,两组间差异均有统计学意义(P＜0.01)。 结论 采取健康讲座、膳食分析、饮食行为干预及中医治疗等合理的综合干预措施可有效降低营养不良患病率,是改善儿童营养状况的有效手段。

Objective To observed the effect of comprehensive intervention measures and routine the 4∶2∶1 care guidance malnourished children in the intervention. Methods 99 malnourished children whose parents were well informed the principle of voluntary participation points for the interventions of the object,were selected and divided into intervention group A,intervention group B,and comprehensive group.Intervention effect evaluation of interventions was finished after one year,with the methods of intervention measures,intervention measures combining traditional chinese and western medicine,and single measures(the conventional 4∶2∶1 care guidance). Results The improved rate of group A was 62.5%,group B was 71.9%,and the control group was 37.1%.Nutritional status improvements of children in both intervention group A and group B were obviously higher than that in comprehensive group,and group B got the fastest improvement(χ²=17.00,P=0.03).After the intervention of Identification & Management of Feeding Difficulty(IMFeD),Group A,group B appetite respectively decreased by 25% and 47%,picky eaters partial eclipse decreased by 50% and 53%,a decrease of bad eating habits by 46.9% and 56.2%. Conclusion The intervention combined with health talks,dietary analysis,reasonable eating behavior intervention and Chinese medicine treatment can effectively reduce the prevalence of malnutrition and it is an effective means to improve the nutritional status of children.