| ObjectiveTo observe the clinical effect of Fuzheng Jiedu Recipe and Bear bile powder on children with persistent and chronic immune thrombocytopenia(ITP)combined with Mycoplasma pneumoniae(MP)infection.Based on the fact that children with ITP are prone to MP infection,and combined with Professor Yu Huiping’s effective clinical experience in the treatment of this kind of disease,this paper studies the clinical efficacy of Fuzheng Jiedu Recipe and Bear bile powder in the treatment children’s ITP combined with MP infection and the improvement of their clinical symptoms,and analyzes the mechanism of Fuzheng Jiedu Recipe and Bear bile powder,in order to provide a wider and safer treatment of traditional Chinese medicine using in children with ITP combined with MP infection.MethodA total of 60 children of persistent and chronic ITP combined with MP infection who were treated in the Pediatrics Department of Dongzhimen Hospital from From October 2018 to October 2019 were randomly divided into group A and group B with 30 cases in each group.Through the examination of complete blood test,recording TCM syndrome score scale and bleeding grading scale,as well as the indexes of each group were statistically analyzed for 2 weeks,4 weeks,6 weeks and 8 weeks,to study the clinical effect of Fuzheng Jiedu Recipe and Bear bile powder;through the observation of the changes of indexes and symptoms before and after treatment,in group A and B,to explore mechanism of Fuzheng Jiedu Recipe and Bear bile powder.ResultThere were 30 cases in the experimental group and 30 cases in the control group,a total of 60 cases.1、There were 30 cases in the experimental group,14 males and 16 females,aged 1 to 10 years,with an average of(5.57±2.57)years.The duration of disease was(6-36)months,with an average of(18.57±7.83)months.The average platelet count before treatment was(37.80±16.35)×109/L,and the bleeding grade was(1.87±0.346).There were 17 males and 13 females in the control group,aged(2-13)years,with an average of(5.47±3.00)years.The duration of disease was(6-40)months,with an average of(19.13±10.00)months.The average platelet count before treatment was(42.03±20.35)×109/L,and the bleeding grade was(1.94±0.183).The baseline data such as gender,age,duration of disease and platelet count were compared between the two groups,and the difference were not statistically significant(P>0.05),which was comparable2、The clinical effect of Fuzheng Jiedu Recipe and Bear bile powder was positive,and with the increase of treatment course,the total effective rate gradually increased.The effective rate of the experimental group was 13.33%,30%,43.33%and 50%respectively in the two weeks,four weeks,six weeks and eight weeks;the total effective rate of the control group was 6.67%,20%,30%and 23.33%respectively in the two weeks,four weeks,six weeks and eight weeks.The effective rate of the experimental group was significantly higher than that of the control group.It shows that for ITP patients combined with MP infection,the therapeutic effect of Fuzheng Jiedu Recipe combined with Bear bile powder is better than that of Fuzheng Jiedu Recipe combined with Azithromycin.3、The curative effect comparison of Mycoplasma pneumoniae infection between the experimental group and the control group:the curative effect rate of the experimental group is significantly higher than that of the control group,the difference is significant(Z=-3.377,P=0.001<0.05)4、Comparison of the negative rate of MP-IgM between the two groups after treatment After 8 weeks of treatment,19 cases of Mycoplasma pneumoniae antibody in the test group turned negative,2 cases of weak positive,4 cases of positive,the rate of turning negative was 63.33%;13 cases of Mycoplasma pneumoniae antibody in the control group turned negative,6 cases of weak positive,2 cases of positive,the rate of turning negative was 43.33%.The rate of turning negative in the test group was higher than that in the control group.There was a significant difference between the two groups(Z=-2.12,P=0.034<0.05).5、Before and after the treatment,the changes of blood routine indexes of the experimental group and the control group.There was no significant difference between the experimental group and the control group in terms of leukocyte count,platelet count,neutrophil percentage,lymphocyte percentage and C-reactive protein before treatment(P>0.05).After 8 weeks of treatment,compared with the control group,the platelet count of the experimental group was significantly different(P<0.05),and there was no significant difference in other blood routine indexes(P>0.05).In the 8-week course of treatment,with the extension of treatment time,the platelet count of the experimental group showed a gradual upward trend,and the platelet count of the control group showed a significant fluctuation and a downward trend,indicating that the combination of Fuzheng Jiedu Recipe and Bear bile powder can not only effectively improve the platelet count,but also steadily and orderly improve the platelet count compared with the control group.However,this treatment was not obvious in the improvement of blood routine infection index.6、Comparison of the therapeutic effects of two groups of TCM syndromes:The therapeutic efficiency 73.33%in the experimental group and 56.67%in the control group.The difference between the two groups was statistically significant(Z=-2.232,P=0.026<0.05)There was no significant difference between the experimental group and the control group before treatment(P>0.05).The two groups were comparable.After 8 weeks of treatment,the scores of TCM symptoms in the experimental group were lower than those in the control group,with significant difference(P<0.05).which indicated that for the treatment of ITP with MP infection,the treatment of Fuzheng Jiedu Recipe combined with Bear bile powder had a significant effect on the improvement of children’s symptoms such as purple spot,fatigue,bleeding,five heart trouble heat,cough,complexion,night sweat and constipation.7、Comparison of the improvement of bleeding grade between the experimental group and the control group before and after treatment:There was no significant difference between the two groups before treatment(P=0.167>0.05).After treatment,there was significant difference between the two groups(P=0.024<0.05).After two weeks,four weeks,six weeks and eight weeks of treatment,the level of bleeding in the experimental group was significantly lower than that in the control group,which showed that compared with the treatment of Fuzheng Jiedu Recipe combined with Azithromycin,Fuzheng Jiedu Recipe combined with Bear bile powder was more effective in improving the skin and mucous membrane bleeding symptoms of children with ITP and MP infection.Conclusion1、The clinical effect of Fuzheng Jiedu Recipe combined with Bear bile powder in the treatment of children with persistent and chronic ITP and MP infection is positive.It can not only improve the clinical symptoms of children with ITP,steadily increase the platelet count,reduce the bleeding grade of children,but also improve the clinical symptoms related to MP infection for children with Mycoplasma pneumoniae infection.With the extension of treatment time,the clinical effect is more and more obvious Obviously,the combination of Fuzheng Jiedu Recipe and Bear bile powder has no obvious adverse reactions and can be used in clinical application2、In this study,we want to explore the efficacy of Fuzheng Jiedu Recipe combined with Bear bile powder in the treatment of Mycoplasma pneumoniae infection.The results show that the conversion rate of Fuzheng Jiedu Recipe combined with Bear bile powder is higher than that of Fuzheng Jiedu Recipe combined with Azithromycin in the treatment of Mycoplasma pneumoniae antibody.However,due to the small sample test and the influence of drug course,laboratory sample test,parents’ compliance and other factors,this result needs further clinical research to confirm. |
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