Retrospective Analysis Of Treatment Of Immune Thrombocytopenia In Children With Traditional Chinese Medicine And Western Medicine

Objective:This study was conducted to retrospect and follow-up the efficacy and prognosis of different treatment regimens for the treatment of primary immunodeficiency thrombocytopenia in children,to evaluate the clinical efficacy and prognosis of ITP intervention in children,to further explore IVIG The effect of intervention therapy on the prognosis of ITP in children,and to provide the best clinical treatment plan from the aspect of improving the curative effect and improving the prognosis.Methods:This retrospective analysis was conducted from January 2014 to March 2017 in outpatient and inpatient of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine and the first Affiliated Hospital of Zhengzhou University.A total of 150 children with newly diagnosed ITP who met the inclusion criteria and exclusion criteria were selected.Patients were divided into 5 groups according to the different regimens of initial treatment: simple hormone group,simple gamma globulin(IVIG)group,hormone combined IVIG,Chinese medicine combined hormone,three drugs combined group,30 cases in each group,and follow-up 1 year.The differences in the age,sex,etiology,initial platelet level,and degree of bleeding before treatment were compared between groups,and the treatment effects and adverse reaction differences of different treatment protocols were compared.The recurrence rate of each group was compared with the difference in the number of recurrences within 3 months,3~6 months,and 6~12 months,the total disease course,the course of disease type,and the remission rate.Results:(1)The average age of 150 children was 3.56 years old,age ranging from 2 months to 16 years old.Of these,86 were male and 64 were female.The male-female ratio was 1.34/1.In terms of pathogenic factors,there were 30 cases of exogenous sensation,1 case of vaccination,and no obvious incentives.Hemorrhage scores were scored from 0 to 3 points in 62 cases(41.33%),4 to 5 points in 83 cases(55.33%),and ? 6 points in 5 cases(3.33%);(2)Statistical analysis of different treatment options in terms of gender,cause of etiology,platelet count and hemorrhage degree was no statistically significant difference(P>0.05),there was significant difference in the age of children in different treatment groups(P=0.012<0.05).The age of gamma globulin treatment group was younger,and the treatment group of hormones and Chinese herbs was older.Analysis of covariance of age,P were all greater than 0.05,showing early clinical efficacy,adverse reactions,recurrence,duration,and remission rate of different treatment groups did not change with age,indicating that each group had no difference in baseline data;(3)Through statistical analysis of different treatment options in early treatment efficacy and adverse reactions(P>0.05),it was suggested that there was no significant difference in early efficacy and adverse reactions after treatment in children with different treatment regimens.Among 150 children,with mild liver injury in 2 cases,1 case of recurrent infection,1 case of severe adverse reactions,all with hormone therapy;(4)statistical analysis of recurrence rate,number of relapses within 1 year,duration of disease and type of disease course in each group(P<0.05),indicating differences in recurrence rate,number of relapses within 1 year,duration of disease,and remission rate in each group.150 cases were classified according to the course of disease,and 99 cases(66%)were acute.There were 26 cases(17.3%)of persistent type and 25 cases(16.7%)of chronic type.The total response rate was 83.33%.There was a significant difference between the Chinese medicine intervention group and the non-Chinese medicine intervention group(P<0.05),suggesting that the intervention treatment of traditional Chinese medicine can reduce the recurrence rate,reduce the relapse of the disease,shorten the course of the disease,and improve the prognosis.The recurrence rate and relapse frequency of the hormone combined Chinese medicine group were the lowest,far lower than that of the simple hormone group,and the total disease course was the shortest.The children with chronic ITP were the least and the remission rate was the highest.There was no significant difference in the recurrence rate,number of recurrences,duration of disease,and course of disease classification between the IVIG intervention group and the non-IVIG intervention group(P>0.05),but the recurrence rate of the combination of hormone and traditional Chinese medicine group and three drugs combination was not significant.The number of recurrences,duration of illness,and remission rate were significantly different.It was shown that on the basis of hormone-combined Chinese medicine,the recurrence rate increased after IVIG intervention,the number of relapses increased,the course of disease was delayed,and the remission rate decreased;(5)Multivariate repeated measurements were made on the number of relapses within 3 months,the number of relapses within 3~6 months,and the number of relapses within 6~12 months,resulting in 4 statistics,P were all greater than 0.05,consistent with the results of the analysis of variance in Table 10,showing that the number of recurrences at different stages of the different treatment groups was significantly different,and showed a decreasing trend,suggesting that the disease can be gradually relieved over time.There was a significant difference in the number of recurrences within 3 months,and there was no significant difference in the frequency of relapses and recurrences within 6~12 months in 3~6 months.There were significant differences in the number of recurrences at different stages between the hormone combined Chinese medicine group and the pure hormone group,the hormone combined with the gamma sphere group,and the three-drug combination group.There was no significant difference between the other treatment groups..Conclusion:(1)The efficacy and adverse reactions of early intervention treatment of traditional Chinese medicine were not significantly different from those of Western medicine group;(2)Intervention treatment of traditional Chinese medicine can reduce the recurrence of the disease,reduce the recurrence rate,shorten the course of the disease,and improve the prognosis.In particular,the combination of hormones and traditional Chinese medicine treatment is more effective;(3)The use of gamma globulin is not significantly associated with the disease progression in children..