| PurposeObserve the clinical efficacy of Fuzheng Jiedu Decoction in treating children with persistent and chronic immune thrombocytopenia(ITP),At the same time,the positive rate of antinuclear antibody(ANA)in children with persistent and chronic ITP and its relationship with treatment outcome and prognosis were discussed.MethodsFrom February 2016 to February 2018,65 cases of children with persistent and chronic ITP diagnostic criteria were admitted to the pediatric clinic of dongzhimen hospital,no systemic lupus or other connective tissue disease,test for the ANA and ANAs,and the statistical ANA rate.Dynamic analysis was performed in 30 patients with persistent and chronic ITP that met the criteria for inclusion in the group,which was divided into ANA(+)group and ANA(-)group and 15 cases in each group.Both groups were treated with Fuzheng Jiedu Decoction.The indexes of hemorrhage and platelet levels before and after the treatment were analyzed.The treatment time was month,2 months,and 3 months.Follow-up was 6 months.Clinical efficacy of Fuzheng Jiedu Decoction and its influence of ANA.Results1 Statistical analysis of 65 cases of children with persistent and chronic ITP ANA total positive rate 33.8%(22/65),the male patients were 45.5%(10/22),women were 55.5%(12/22),no significant gender and age differences(P>0.005).One patient was diagnosed with SLE during the treatment.2 The total positive rate was 24.1%,35.5%and 80.0%,respectively,according to the age ratio of 1-6 group,6-12 group and 12-18 group.The male and female positive rates were 1-6 group,21.1%of men and 30.0%of females.6-12 group were 33.3%men and 36.8%female.12-18 group were 66.7%men and 100%female.The results showed that there was no gender difference in each group(P>0.05).3 The clinical efficacy of fuzheng detoxification was accurate.Treatment of 1 month,2 months,3 months,two groups of the total effective rate was 22.2%,44.4%,55.5%,among them the ANA(+)group effectiveness is 23.1%,23.1%and 30.8%respectively,the ANA(-)group effectiveness were 21.4%,64.3%and 71.4%respectively.There was no statistically significant difference between the ANA(-)group and ANA(+)group at 1 and 2 months of treatment(P>0.05).For three months,the ANA(-)group was significantly better than the ANA(+)group,and the difference was statistically significant(X2=6.238,P=0.021,P<0.05).4 Fuzheng Jiedu can significantly improve the bleeding of skin and mucous membranes in children with ITP.The improvement rate of skin mucosal bleeding in the ANA(+)group was 38.5%,ANA(-)group was 85.7%.The ANA(-)group bleeding improvement than the ANA(+)group,the difference was statistically significant(P<0.05).5 After three months of treatment,both groups showed significant improvement in TCM syndromes,and the difference was statistically significant(P<0.01),But there was no statistically significant difference between the two groups(P>0.05).6 The PLT of ANA(+)and ANA(-)groups at different time points was compared,and the data at each time point showed statistically significant differences(P<0.01).There was a cross-over between time and groupings,but no significant difference between the two groups(P>0.05).7 Follow-up to 6 months of clinical efficacy:ANA(+)group efficiency of 50%,ANA(-)group efficiency of 83.3%,the efficiency between the two groups was not significant difference(P>0.05).ConclusionFuzheng Jiedu Decoction is effective in treating persistent and chronic ITP children,and with the extension of treatment time,the total effective rate is steadily increasing.ANA is associated with persistence and chronic ITP.It has an auxiliary role in evaluating clinical efficacy,improvement of bleeding symptoms,and prognosis of the disease.ITP clinical exclusion diagnosis,it is necessary to detect ANA and ANAs in the diagnosis of the disease,ANA positive patients should be followed closely. |
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