The Clinical Efficacy Analysis Of The Supplementing Qi, Nourishing Yin, Highlighting Spleen And Clearing Heat Decoction In The Treatment Of Chronic Immune Thrombocytopenia

Objective:To observe the clinical effects of the supplementing qi,nourishing yin,highlighting spleen and clearing heat decoction in the treatment of chronic immune thrombocytopenia(cITP).Methods:The 72 cases of cITP patients with hospital or outpatient were all involved from december 2015 to december 2016 in Jiangsu Province of TCM.There were 30 children in the 72 patients,15 patients in the chinese medicine group and 15 patients in the chinese and western:medicine group;There were 42 patients in the adult group,24 patients in the chinese medicine group and 18 patients in the western medicine group.Chinese medicine group were treated with the supplementing qi,nourishing yin,highlighting spleen and clearing heat decoction(including Huangqil5g,Shudihuangl5g,Shuiniujiaol5g,Xianhecaol5g,Zhongjiefengl5g,Yangtigenl5g,Puhuangtanl5g,Sanqifen3g,Fulingl5g,Jiaobaishul5g,Zhimu10g,Lianqiao10g,Zhishengma6g).The patients by the treatment of glucocorticoids effectively and taking the glucocorticoids before treatment continue taking glucocorticoids,and declining the doses step by step.The patients were treated with at least 3 courses.The peripheral blood platelet counts,clinical response rate and the dosage of glucocorticoids withdrawal were compared before and after treatment.Results:There were 30 patients in the pediatric group,the overall response rate in the 15 patients treated with chinese medicine decoction was total to 86.67%and the blood platelet counts increased from(29.40±20.22x109/L)to(59.33±38.31)x109/L.Among them,the response rate in the 15 patients treated by the glucocorticoids combined with the chinese herbal medicine was total to 80%,the blood platelet counts elevated from(39.60±29.09×109/L)to(67.67±29.34)×109/L.Platelet counts were significantly improved compared with the initial treatment,the difference was statistically significant in two groups(P<0.05).Between the two groups,the total effective rates of clinical treatment were no difference(P>0.05).In 42 adult patients,the response rate in the 24 patients treated with chinese medicine decoction was total to 87.50%and the blood platelet counts increased from(23.96±15.21)×109/L to(48.67±23.03)×109/L after treatment for 3 courses.The response rate in the 18 patients treated by the glucocorticoids combined with the chinese herbal medicine was total to 83.33%and the platelet counts increased from(44.72±29.81)×109/L to(77.28±45.04)×109/L.Platelet counts were significantly improved compared with the initial treatment,the difference was statistical significant(P<0.05).There was no significant difference in the total effective rates of clinical treatment between two groups(P>0.05).The overall response rate in the 39 patients treated with chinese medicine decoction was 87.18%and the platelet counts increased from(26.05±17.26)×109/L to(52.77±29.77)×109/L after treatment for 3 courses.The response rate in the 33 patients treated by the glucocorticoids combined with the chinese herbal medicine was 81.82%and the platelet counts increased from(42.391±29.14)×109/L to(72.91± 38.44)×109/L after 3 courses of treatment.The platelet counts of the two groups were significantly higher than the initial treatment(P<0.05).Total effective rates of the two groups were no significant difference(P>0.05).The average dose of glucocorticoid in children was reduced from the initial dose of 10.42 ±5.54mg to 3.17±3.12mg.The average dose of glucocorticoid in adult was reduced from the initial dose of 18.12±17.37mg to 4.38±3.44mg.The average dose of glucocorticoid in chinese and western medicine group was reduced from the initial dose of 14.62±13.75mg to 3.83±3.31mg.The changes of hormone levels in the three groups were significantly lower than the initial treatment,and the difference was statistical significant(P<0.05).Conclusion:The study shows that the supplementing qi,nourishing yin,highlight spleen and clearing heat decoction can effectively improve platelets counts and the total effective rate of clinical treatment,assist glucocorticoids withdrawal and release bleeding symptoms in children and adults cITP patients.