Essential Thrombocythemia Syndromes Clinical Observation And Yiqihuoxuejiedu Law Intervention

Essential thrombocythemia, a type of myeloproliferative neoplasm (MPN), is characterized clinically by thrombocytosis which results from bone marrow megakaryocyte hyperplasia. Patients with ET are at increased risk for developing thrombosis, hemorrhage because of the change of hemorheology and platelet function,as well as transformation to myelofibrosis or acute myeloid leukemia. The fatality ratio of ET is keeping rising in these years. However, the disease in clinical practice has not been given enough attention because of the concealed clinical symptom and the distinct clinical characters. Misdiagnosis or missed diagnosis patients of ET were not uncommon, which may lead to serious complications or even life threat.However, there has been no agreement about the pathogensis of ET. The antiplatelet drug and the antineoplastic drug are the main types of the Western Medicine. Although there is an affirmative clinical efficacy in short term,the long term therapeutic effect have not received expected positive result. Furthermore, because of the dependence and side effects, The patients have less compliance of medication.There has been rich experience in treatment of ET by Traditional Chinese Medicine and achieved satisfactory effect to control symptoms and indexes,as well as improve hypercoagulable state and high blood viscous state. Therefore, Traditional Chinese Medicine has wide prospect on treatment of ET.Objective:1. To explore the TCM syndrome features of ET with retrospective study, in order to support an objective foundations for the reasonable TCM treatment in ET.2. Based on the Western Medicine therapy, observe the influence of symptoms and the effect on the indexs of blood routine tests hemorheology tests and coagulation function tests. Therefore survey the efficacy and advantages of Yiqijiedu formula on curing ET.Methods:Study I:The objects of the research are80patients who diagnosed definitely with ET in the Dongfang Hospital from Jan,2008to Jan,2014. They were studied retrospectively with their TCM syndrome features by descriptive statistics and factor analysis.Study II:The objects of the research are40patients who diagnosed definitely with ET in the Dongfang Hospital from Jan,2013to Jan,2014. They were given the Yiqihuoxuejiedu formula on the basis of original Western Medicine for eight weeks.1. Observe the change of the indexes and TCM syndrome.2. Compare the change of blood routine tests before and after TCM intervention.Choose SPSS17.0software for statistical analysis. Measurement data use t-test or non-parametric test. Enumeration date use chi-square test or non-parametric test.Results:Study I:1、Descriptive Statistics:(1) Signs and symptoms:Based on the frequency of occurrences, the top ten signs or symptoms were fatigue and lassitude, dark purple face, halitosis,coughing and phlegm, irritable, anorexia, spontaneous sweating, numbness, palpitation and insomnia,red eyes and faces. Fatigue and dark purple face were the most common symptom.(2) Tongue picture:Pale and dark tongue nature and white greasy tongue coating was the most common tongue condition, Swollen tongue with teeth-print was more common than other body of tongue.(3) Pulse conditions:The most common pulse conditions was stringy-thready pulse, rolling pulse and deep-thready pulse.2、Factor analysis:(1) Based on the frequency of occurrences,16original signs or symptoms variable were choosen.(2)4common factors were extracted by common factor analysis, the cumulative contribution rate reached to65.318%.(3) Choose the main indicators variables of4common factors based on the factor loading matrix.(4)According to TCM theory, the4factors represented qi deficiency and blood stasis syndrome, liver depression and spleen deficiency syndrome, phlegm syndrome and blood insufficiency syndrome.The result of the contribution rate shown that qi deficiency and blood stasis> liver depression and spleen deficiency syndrome>phlegm syndrome> blood insufficiency syndrome.Study Ⅱ:Based on the original Western Medicine therapy, the patients were given the Yiqihuoxuejiedu formula:1, Observe the influence of symptoms and the effect on the indexs of blood routine tests、hemorheology tests、coagulation function tests and TCM score:(1)The improvement of indexes:There was significant difference in PLT、whole blood viscosity、plasma viscosity、PTT、TT and FIB before and after treatment(P<0.05).(2)The improvement of the evaluation of symptoms:The total effective rate after the therapy of TCM and Western medicine reaches95%. There was significant decline on TCM score after treatment (P<0.05).2. Compare the change of blood routine tests before and after TCM intervention:Both the two periods had an very significant decline in the PLT level after treatment(P<0.01). However, there was no significant difference between the two periods(P=0.05).Conclusion:1. Qi deficiency and blood stasis was the major TCM symptoms characteristics of ET.Liver depression and spleen deficiency was the major symptoms of Zang-Fu disease. In addition, the rates of phlegm、 blood-insufficiency and heat syndrome were high in the ET.2. Based on the Western Medicine therapy,Yiqihuoxuejiedu formula has affirmatory curative effect in the treatment of ET.with the ability of decreasing the platelet count,impoving the change of hemorheology and coagulation function as well as relieving clinical symptoms Therefore,the method could be effective in preventing the occurrence of clinical symptoms,such as hemorrhage and thrombosis and impove the quality of life.