The Study On Therapy Of Refractory Purpura With Singie Glycyrrhizae Decoction

ObjectivesGlycyrrhizae is sweet in taste, mild in nature , and attributive to heart, lung, spleen and stomach channels . It can reinforce the function of the spleen and be beneficial to qi. It can also remove heat and toxicity, dispel phlegm and relieve cough, alleviate spasmodic pain , and regulate the actions of other drugs. Single dose can reinforce the function of the spleen and reconcile stomach, replenish qi and hemostasis, increase the levels of neutrophils and thrombocytes. The effectiveness of it is similar to prednisone, but it has no side effect of prednisone and more economical. In this study, a new therapeutical methods for a group of refractory ITP patients was observed. This group of patients concluded ITP patients complicated with Cushing'syndrome, ITP patients complicpated with Diabetus, old patients, relapsed patients, pregnant patients, Autoimmunity disease(AID) patients with thrombocytopenia; relapsed Henoch-Schonlein purpura(HSP) patients. The effectiveness and side effects of glycyrrhizae was observed when being applyed to treat these patients Methods10 ITP patients, 5 HSP patients, 4 AID patients, 4 pregnant patients with SAA or ITP were selected randomly. Among them, one more than 80 years old and one under 2 years old. The durations of illness of all patients were exceeded 6 months, as long as 15 years. All the patients had received adrenalcortical hormone and presented with side effects of adrenalcortica. Allthe patients received single glycyrrhizae decoction 30 g/d, bid orally without increasing the dosage of adrenalcortical hormone. The hemorrhage circumstance, megakaryocyte counts, platelet counts, immunological function and side effects of glycyrrhizae were observed. Results23 patients had shown good response, hemorrhage was improved even disappeared. The maintained dosage of triamcinolone in the 10 patients with relapsed ITP was 4 mg/d when combined with glycyrrhizae. The platelet counts could be maintained more than 50 x 109/L, the underlying blood hypertension, diabetes mellitus and Cushing'syndrome all got remission. 4 pregnant patients delivered smoothly, the fetus had no deformity. The platelet count could be maintained in AID patients when treated with triamcinolone( 8mg/d) combined with single glycyrrhizae decoction. Purpura and hematuria under microscope of the patients with HSP were disappeared. About side effect, a few patients can't accept glycyrrhizae decoction for its more sweet in taste, glycyrrhizae could be applied to them dilutely. Conclusions1 . Single glycyrrhizae decoction (30g/d, bid) could enhance or replace adrenalcortical hormone in hemostasis and increasing peripheral platelet that had a broad prospect.2 . When combined with single glycyrrhizae decoction in treating the older patients, the patients with AID and the chronic FTP patients with complications, the dose of adrenal cortical hormone could be decreased.3 . Glycyrrhizae was more safe in treating the pregnant patients than adrenalcortical hormone.4 . Patient with type pure HSP can be treated with single glycyrrhizae, while the patients with other type must be treated with glycyrrhizae combinedwith small dosage of hormone.5 . More patients showed good response to glycyrrhizae slowly. It needed about 3 weeks.6 . Glycyrrhizae with too sweet could be used dilutely.7 .Extracting the effective ingredient and studying the mechanism of it should be done in future.