Meta - Analysis Of Immune Thrombocytopenia In Children Treated By Traditional Chinese Medicine And Report On Curative Effect Of "Cocktail"

Background Primary immune thrombocytopenia (ITP) is the most common acquired hemorrhagic disease in children, annual incidence of about 4/One hundred thousand, about 2/3 being recovered.20%-30% of children evolved into the persistent and chronic ITP. Because the pathogenesis is unknown, lack of targeted therapeutics, clinical children with persistent and chronic ITP recurrent disease is treated difficultly. After a systematic evaluation of therapeutic effect of effective stage Chinese medicine treatment of children with ITP, tutor Yu Huiping proposed cocktail therapy, based on years of clinical treatment of children with ITP. Cocktail therapy to Yu from "Fuzhengjiedu" as the basic, cooperates with small doses of hormones, a variety of nutrients. There is essentially a two meanings:first, multiple drugs in combination, comprehensive treatment; second, personalized, targeted therapy.Objective To review the curative effect and safety of Chinese medicinal in treatment of children’s primary immune thrombocytopenia,to summarize and analyze the effectiveness of cocktail therapy in the treatment of persistent and chronic ITP in children, there is explored new ideas for the treatment of chronic ITP with effective and low side effectsMethods The retrieval strategy was as follows:CNKI,VIP, Wanfang Date, CBM, PubMed, EMBASE and MEDLINE were retrieved. The deadline was Sep.30,2015.The inclusion was randomized controlled trials (RCT) of treating children’s primary immune thrombocytopenia in control of Chinese medicinal. Data were extracted by two persons independently and meta analysis by using RevMan 5.3 software. Statistics PLT of children with persistent and chronic ITP, Professor Yu Huiping take the cocktail therapy for the children after treatment for 3 months and 6 months from January 2013 to January 2015 in outpatient department of Pediatrics in Dongzhimen Hospital Beijing University of Chinese Medicine. There is to evaluate the efficacy of the treatment after 3 months and 6 months through the children’s ITP curative effect evaluation standard of diagnosis and treatment been put forward by the Hematology Society, Pediatrics Branch, Chinese Medical Association in 2013.Results There were 13 studies reviewed involving 945 children with primary immune thrombocytopenia. Experimental group (n=376) was allowed to use the Chinese medicines, control group (n=224) was allowed to conventional therapy of hormones. Another experimental group (n=174) was allowed to use the Chinese medicinal and conventional therapy of Western medicines, control group (n=171) was allowed to conventional therapy of Western medicines. In fully recovered, the group with Chinese medicinals had better results compared with the group with hormone therapy (OR:2.40 95%CI[1.67,3.34]). The group with traditional Chinese medicine and western medicine combining therapy had better results compared with the group with Western medicinals therapy (OR:2.92 95%CI[1.87,4.53]). In Effective treatment, the group with Chinese medicinals therapy had better results compared with the group with Western medicinals therapy (OR:3.78 95%CI[2.55,5.61]). The group with traditional Chinese medicine and western medicine combining therapy had better results compared with the group with Western medicinals therapy (OR:3.03 95%CI[1.59, 5.79]). After six months of cocktail therapy treatment, complete response rate is 46.70%, the total efficiency of 68.90%.Conclusion The current evidence shows that Chinese medicinals or traditional Chinese medicine and western medicine combining therapy have the latent curative effect in the healing of children’s primary immune thrombocytopenia, which needs to be confirmed through designing more rigorous clinical expreriment with larger sample. The treatment results are satisfactory. Cocktail therapy is accepted easily as mainly oral medication, and worthy of further promotion.