To Explore The Effect Of Fuzheng Jiedu Decoction On PLT And Platelet-associated Antibody Levels In Children With ITP

OBJECTIVE:Primary immune thrombocytopenia(primary immune thrombocytopenia,ITP)is the most common hemorrhagic disease in children.It is due to humoral and cellular immune abnormalities caused by the production of anti platelet antibodies,resulting in increased platelet destruction.Its incidence is 0.46/10 million,The 20%-30%of children with ITP will gradually evolve into persistent or chronic thrombocytopenia.Since there is no effective treatment for ITP,the main use of corticosteroids,intravenous immunoglobulin and other methods to treat it.The corticosteroids and intravenous immunoglobulin may cause osteoporosis,diabetes,renal failure,thrombosis and so on.Therefore,it is necessary to find effective treatment.Instructors use Decoction("Fuzheng Jiedu Decoction")for the treatment of ITP is relatively good.Therefore,we propose that Fuzheng Jiedu Decoction can regulate the hypothesis of multiple pathogenesis of persistent and chronic ITP in children,for example:Humoral and cellular immune dysfunction.Objective to evaluate the value of Fuzheng Jiedu Decoction in the treatment of persistent,chronic ITP and mechanism by means of platelet associated antibody as an entry point and the clinical study of blood cell subsets in early stage.This is also hoping to provide new ideas for ITP diagnosis and treatment.METHODS:Research object:The subjects of this study were 30 children with persistent and chronic ITP who were enrolled in the outpatient department of our hospital.And they must belong to the traditional Chinese medicine syndrome type of Qi does not take blood type.Observation period:All of the patients were observed for 12 weeks and were followed up for 12 weeks.Intervention measures:The 30 children who met the inclusion criteria were randomly divided into A group and B group.A was used as the control group,the patients were treated with Fuzheng Jiedu Decoction combined with Western medicine.B was used as the control group,The Traditional Chinese medicine simulator combined with Western medicine was used to interfere with it.Two groups of subjects had skin and mucosal bleeding obvious subjects will help to multidimensional,Compound Rutin Tablets treatment.Observation index:Group day:Participants had to sign informed consent and then undergo a physical examination.On the day of admission complete safety inspection(such as:blood routine,urine routine,liver function,renal function,ECG)and main outcome measures(such as:blood routine,platelet associated antibody).2/4/6/8/10 weeks:Physical examination on the subjects,and improve blood routine examination.12 weeks:Undergo a physical examination,complete safety inspection(such as:blood routine,urine routine,liver function,renal function,ECG)and main outcome measures(such as:blood routine,platelet associated antibody).RESULTS:1.The overall trend of PLT in the two groups was rising,while the PLT of the control group decreased.The average PLT value of the two groups before treatment was close,but with the expansion of the treatment period,the average value of PLT of the two groups was opened,Compared with the control group,the overall trend of the treatment group was significantly higher than that of the control group.2.The treatment group:total effective in 9 cases(64.3%),complete response in 8 cases(42.9%),effective in 3 cases(21.4%),ineffective in 5 cases(35.7%).The control group:total effective in 4 cases(28.6%),complete response in 0 cases(0%),effective in 4 cases(28.6%),ineffective in 10 cases(71.4%).There was significant difference between the two groups,the results were statistically significant(P<0.05).With the prolongation of the treatment period,the therapeutic effect of the treatment group was more obvious and more stable.There was no effect on liver,renal function and electrocardiogram in the treatment group and the control group,which indicated that the two groups had good clinical safety.3.The positive rate of platelet associated antibodies in the two groups was low,which may be related to the small sample size and the special research object,the specific reasons need to be further explored.Statistical analysis of the four antibodies,the most of the platelet associated antibodies have declined.Compared with the control group,the number of cases of treatment group decreased a bit more.However,there was no significant difference between the two groups after treatment in the treatment of the four antibodies(P>0.05).And the difference between the two groups in the absence of was not statistically significant.The results indicated that Fuzheng Jiedu Decoction could affect platelet related antibody to some extent,but the difference was not significant.Due to the limitation of time and funds,it is not possible to exclude the influence of the observation period and the number of monitoring on this study.The specific reasons still need to be further explored.In addition,there was a negative correlation between platelet associated antibody and platelet count and platelet life span.This study does not directly indicate that the relationship needs to be further explored.CONCLUSIONS:1.Fuzheng Jiedu Decoction can safely,stably and effectively increase the number of platelets in patients with chronic ITP children belong to the traditional Chinese medicine syndrome type of Qi does not take blood type.Its treatment effect is exact,it is worthy of further study and promotion.2.Fuzheng Jiedu Decoction to a certain extent will have an impact on platelet associated antibodies.However.The specific mechanism needs to be further studied and discussed.