Tamura Fumiyo, Kikutani Takeshi, Machida Reiko, Takahashi Noriaki, Nishiwaki Keiko, Yaegaki Ken
The Nippon Dental University, School of Life Dentistry, Tokyo Dental Hospital, Japan.
Int J Orofacial Myology. 2011 Nov;37:57-68.
Disabled children suffer not only from their primary disease, but also from other complications, including food refusal. The purpose of this study was to elucidate the relationship between these conditions and food refusal in disabled children. The effectiveness of feeding therapy in treating food refusal was also examined. The study subjects were 67 disabled children (35 boys and 32 girls; mean age at initial examination: 6.5 years, SD: 6.0 years) who attended the Nippon Dental University Hospital between April 2004 and August 2008. Of them, the 13 subjects who were diagnosed as those who refused food received feeding therapy combined with desensitization therapy for hypersensitivity. Approximately 20% of the subjects showed food refusal symptoms. Primary disease, respiratory impairment and gastroesophageal reflux were not causes of food refusal in this population. There was a significant relationship between food refusal and hypersensitivity (p = 0.021). After receiving feeding therapy, six of the seven subjects with hypersensitivity but without dysphagia at initial examination recovered from food refusal. Food refusal did not significantly correlate with tube feeding. Hypersensitivity and/or tube feeding may induce food refusal. For subjects with these conditions, feeding therapy combined with desensitization therapy is effective in achieving recovery from food refusal.
残疾儿童不仅遭受原发性疾病的折磨，还会出现包括拒食在内的其他并发症。本研究的目的是阐明这些情况与残疾儿童拒食之间的关系。同时也考察了喂养治疗对治疗拒食的有效性。研究对象为2004年4月至2008年8月期间在日本齿科大学医院就诊的67名残疾儿童（35名男孩和32名女孩；初诊时平均年龄：6.5岁，标准差：6.0岁）。其中，13名被诊断为拒食的受试者接受了喂养治疗并结合了针对过敏的脱敏治疗。约20%的受试者表现出拒食症状。原发性疾病、呼吸功能障碍和胃食管反流并非该群体拒食的原因。拒食与过敏之间存在显著关系（p = 0.021）。在接受喂养治疗后，初诊时7名有过敏但无吞咽困难的受试者中有6名从拒食中恢复。拒食与管饲无显著相关性。过敏和/或管饲可能诱发拒食。对于有这些情况的受试者，喂养治疗结合脱敏治疗对从拒食中恢复有效。
