这个病没见过，不过有资料介绍。
什么是神经性贪食症
此症为周期发作不可控制的多食，可出现于神经性厌食中，但并非必然伴有此症状。此症状群包含两大主要成分，其一是不可抗柜的强迫自己多食，其二是自己设法进行呕吐以避免体重增加，有时则是滥用泻药。此类患者的体重常保持在正常范围之内，女性患者月经仍可正常。女性较为常见。
本症以反复发作性暴食和强烈的控制体重的愿望为特征，为防止暴食对体重的影响患者采用各种措施，如呕吐、导泻、增加活动量等，致使体重反低于正常范围。本症多见于年轻女性。
据国外报道，该症女性患病率约为1％～3％。男性患病率大约为女性的1/10。世界各地患病率相似。
该症常在青少年后期或成年早期起病，可持续数年。多为慢性或周期性病程。长程预后情况尚不明确。
什么原因引起神经性贪食症
病因尚不明确，与神经性厌食症有重叠处。
神经性贪食症有什么症状
（1）有暴食史，进食量远远超过正常，患者常常是吃到难受为止。
（2）暴食后马上采取不恰当补偿措施以防止体重增加，发生次数平均1周至少2次，且持续3个月以上。
（3）在初期，患者对自己的暴食行为感到害羞，常是秘密进行。
（4）暴食行为可为以下因素引发：情绪烦躁，人际关系不良，节食后感到饥饿，或对体重、身体外形不满等。暴食可暂缓烦躁情绪，随后不久病人便对自己不满而情绪低落。
（5）发病初时，患者对进食行为控制能力变弱，疾病后期自控能力完全破坏。
（6）控制体重的方法最常见是诱呕，可用手或其他器械刺激咽喉部，也有服用催吐剂致吐，一段时间后不用催发，患者想到呕吐便会呕吐，即使仅进少量食物亦能呕出。
（7）有1／3左右患者使用导泻剂减轻体重，极少数患者甚至使用灌肠法。
（8）有的患者不采用直接清除食物的方法，而是增加体能消耗，如快速活动，增加体育锻炼等，活动量大大超过正常，且影响生活正常进行。
（9）患者过分重视自己的身体外形，常感到不满意。
(10）可伴有抑郁或焦虑症状，内容多数与体重或身体外形有关。
（11）病情严重者，可出现水电解代谢紊乱，表现为低血钾、低血钠等。呕吐致使胃酸减少而出现代谢性碱中毒，导泻则可导致代谢性酸中毒。
（12）疾病后期，因食道、胃肠道、心脏等并发症而有致命危险。
神经性贪食症需要做哪些检查
（1）诊断要点：
1）发作性不可抗拒的摄食欲望或行为，一次可进大量食物。每周至少发作2次，且持续至少3个月。
2）有担心发胖的恐惧心理。
3）常采用引吐、导泻、增加运动量等方法，以消除暴食引起的发胖。
4）不是神经系统器官性病变所致的暴食，也非癫痫、精神分裂症等继发的暴食。
（2）鉴别诊断：
1）神经性厌食。若已明确诊断为神经性厌食，或交替出现的经常性厌食与间歇性暴食症状者，均应诊断为神经性厌食症。
2）Klein－levin综合征。又称周期性嗜睡贪食综合征，表现为发作性沉睡（不分日夜）和贪食，持续数天。患者醒了就大吃，吃了又睡。一次患病后体重增加明显。无催吐、导泻等控制体重行为，亦无对身体外形或体重不满的表现，故与神经性贪食症易于鉴别。
3）重性抑郁症。患者可出现过量饮食，但没有为减轻体重不恰当的补偿行为，如催吐、导泻等，故与神经性贫食症不同。
4）精神分裂症。该症患者可继发暴食行为，患者对此视之默然，无任何控制体重的行为，且有精神分裂症的其他症状。
5）癫痫等器质性疾病。可出现暴食行为，病史、体检和各项实验涉及EEG等功能检查，均有器质性病变基础，则不考虑神经性贪食症，而且这类病人缺乏控制体重的不恰当行为。
如何治疗
（1）多数病人要住院治疗，严重者需强制入院。
（2）心理治疗。最多采用的是行为治疗中的厌恶疗法或阳性强化法，制定与控制也含有联系厌恶刺激（如被约束、电针刺激等）或奖励方法（精神或药物奖励、与家人来往、自由活动等），视患者临床症状变化程度逐级治疗。
（3）药物治疗。较常采用两类药物，抗精神病药物和抗抑郁剂，前者最多采用舒必利，后者视患者躯体承受情况尽量选择不良反应少的药物，如氟西汀，氯米帕明。
（4）躯体支持治疗。规定患者进食量，尽量减少或制止呕吐行为，禁用导泻药物。水电解质代谢紊乱者予以对症处理。营养差者予营养支持治疗，必要时可用鼻饲。
（5）个别难治病例，可应用胰岛素治疗。
What is bulimia nervosa?
Bulimia is an eating disorder characterised by repeated episodes of overeating and a preoccupation with the control of body weight.
Studies have shown that up to 1 per cent of the population is suffering from bulimia nervosa at any one time, and this may well be an underestimate.
Other studies show that up to 7 per cent of young women consulting their GP have the symptoms of bulimia nervosa.
What are the symptoms?
According to the World Health Organisation, the criteria for a diagnosis of bulimia nervosa include the following:
* persistent preoccupation with eating and an irresistible craving for food.
* episodes of overeating in which large amounts of food are consumed in short periods of time.
* excessive exercise, induced vomiting after eating, starving for periods of time or taking medicines such as laxatives or diuretics to counteract the bingeing.
* fear of obesity, which is also seen in people with anorexia nervosa, and there is some overlap in the symptoms of these two diseases.
What is the cause of the disease?
The cause of bulimia nervosa is unknown. Factors in the patient's social environment are important, including the cultural pressure for women in the Western world to aspire to an unnaturally slim body weight. However, most people with bulimia nervosa maintain a normal body weight. Patients with bulimia nervosa often suffer from low self-esteem.
What are the symptoms of bulimia nervosa?
Often the person feels too fat and generally dissatisfied with their physical appearance.
They may decide to eat less and avoid fattening foods. The patient with bulimia nervosa becomes preoccupied with food and eating.
They will have episodes of craving for food and bingeing, which may take place in secret. After bingeing, sufferers feel guilty, and may make themselves sick.
What can people with bulimia nervosa do to help themselves?
Recognise that you are suffering from bulimia nervosa and seek help from your family doctor. There are also several good self-help books available.
What is the course of the disease?
While some cases of bulimia nervosa are short-lived, usually the symptoms will be present for some months or years before a sufferer seeks help. The disease can persist for years, and in some people the symptoms may be present all their lives.
Bingeing and vomiting can cause physical problems including damage to teeth from stomach acid, and heart problems due to the body being depleted of salts.
How is bulimia nervosa treated?
Treatment is aimed at the bulimia nervosa and any associated problems such as low self-esteem or depression.
Research suggests that cognitive behavioural therapy, a form of psychological therapy, is an effective treatment for many patients. Further research is being carried out into other forms of psychological therapy that may also be helpful.
Antidepressant medication can also be effective at treating the symptoms of bulimia nervosa. Sometimes a combination of psychological therapy and drug therapy is used.
References
Hay PJ, Bacaltchuk J. Psychotherapy for bulimia nervosa and bingeing (Cochrane Review) In: The Cochrane Library, Issue 1, 2000. Oxford: Update Software.
