The KIT And Anxiety Scales Were Used To Explore The Correlation Analysis Between Emotional Factors And Immune Thrombocytopenia

ObjectivePrimary immune thrombocytopenia(ITP)is a clinically common acquired bleeding disorder in children,mainly caused by immune dysregulation,with clinical manifestations of bleeding in the skin,mucous membranes and internal organs.Because the pathogenesis of ITP is not fully understood and the western medical treatment for ITP is limited,the health-related quality of life(HRQoL)scores of children with ITP and their parents are generally low.In clinical practice,parents of children with ITP were found to be more worried and anxious about ITP than those reported abroad,and children with anxiety were found to have less favorable treatment outcomes.Therefore,it is suggested that anxiety affects the treatment outcome of children,and that there is a potential link between the anxiety of children and parents,and that parental anxiety affects the child’s mood and indirectly affects the treatment outcome of children.In this study,based on previous studies,we took emotional factors as an entry point to observe the influence of emotional factors on the illness of children with ITP,and focused on the HRQoL scores and anxiety of children and parents with chronic ITP to observe whether there is a correlation between the influencing factors,which is also important for the description of ITP symptoms and the assessment of treatment efficacy.MethodsA total of 31 children with persistent and chronic ITP and 6 children with clinically observed ITP(without medication)who visited the pediatric department with Dongzhimen from August 2020 to March 2021 were selected for the study.Among them,children with ITP treated with traditional Chinese medicine(Fu Zheng Detoxification Formula)were the experimental group,and the clinical observation group was the control group,using the ITP Child Quality of Life Scale(The Kid’s ITP Tools,KIT),the Screening Scale for Anxiety Emotional Disorders in Children(SCARED),the Hamilton The Kid’s ITP Tools(KIT),the Screening Scale for Anxiety Disorders in Children(SCARED),and the Hamilton Anxiety Scale(HAMA)were used to assess the quality of life scores of children and parents and the presence of anxiety.The demographic data,KIT scale(children’s volume),SCARED scale,and TCM evidence record form were recorded for all participating children with ITP,and the KIT scale(adult volume)and Hamilton anxiety scale were recorded for all participating parents of children with ITP.If the child had doubts about the contents of the scales,he or she should ask the investigator directly,and the parents could not participate in filling them out;children<7 years old could be filled out by a proxy if they could not fill out the scales by themselves;parents should fill out the parental questionnaire by themselves.The correlation analysis was done to investigate whether the anxiety of children and parents with ITP existed and whether the degree of anxiety correlated with the severity of ITP disease,and whether the anxiety of parents correlated with the child’s emotion.Results1.After comparing the TCM symptom scale scores of the children in the TCM treatment group and the clinical observation group by t-test according to the subgroups of time of diagnosis,time of treatment,age of the children,and the subgroups of the children’s PLT numerical categories,the P values were>0.05,and the differences were not statistically significant.The TCM symptom scale scores of the children in the TCM treatment group were grouped according to different lengths of time of diagnosis and treatment,different ages of the children,and the PLT numerical categories of the children,and the groups were compared between different subgroups by t-test,and the final P values were>0.05,which were not statistically significant.2.The difference analysis of the KIT quality of life scores of parents and children by t-test showed significant differences(P-value<0.05);the correlation analysis of the KIT quality of life scores of parents with the KIT quality of life scores of children by pearson correlation analysis showed that the correlation was not statistically significant(P>0.05).After comparing the KIT scale quality of life scores of children in the TCM treatment group and the clinical observation group according to the subgroups of time of diagnosis,time of treatment,and age of the children,the differences were not statistically significant(P value>0.05).The difference between the KIT scale quality of life scores of children in the TCM treatment group and the clinical observation group was statistically significant(P<0.05)when compared by t-test according to the subgroups of children’s PLT values,and the difference between the KIT scores of the TCM treatment group and the clinical observation group within the PLT value 30×109/L subgroup(P<0.05);PLT values 30×109/L to 80×109/L The differences in KIT scores between the TCM treatment group and the clinical observation group were not statistically significant(P>0.05);the differences in KIT scores between the TCM treatment group and the clinical observation group in the PLT values of 80×109/L to 100×109/L subgroup were statistically significant(P<0.05).The quality of life scores on the KIT scale for children in the TCM treatment group were grouped according to the time of diagnosis and treatment of different lengths,different ages of the children,and the PLT count categories of the children,and the groups were compared by t-test for different subgroups,and the final P values were>0.05,which were not statistically significant.3.After comparing the KIT scale quality of life scores of parents of children in the TCM treatment group and the clinical observation group by t-test according to the subgroups of time of diagnosis,subgroups of time of treatment,and subgroups of age of children,the differences were not statistically significant(all P-values>0.05)The t-test was used to compare the KIT scale quality of life scores of the parents of children in the TCM treatment group and the clinical observation group according to the subgroups of the children’s PLT values.The differences in KIT scores were statistically significant(P<0.05).The KIT scale quality of life scores of parents of children in the TCM treatment group were grouped according to different lengths of time of diagnosis and treatment,different ages of children,and PLT count categories of children,and the final P values were>0.05 for the comparison between groups by t-test,which were not statistically significant.4.After comparing the SCARED scale scores of the children in the TCM treatment group and the clinical observation group by t-test according to the subgroups of the time of diagnosis,the subgroups of the children’s age,and the subgroups of the children’s PLT numerical categories,the P values were>0.05,and the differences were not statistically significant.The SCARED scale scores of children in the TCM treatment group and the clinical observation group were compared by t-test according to the subgroups of children’s treatment time,and the differences between the scores of the TCM treatment group and the clinical observation group in the 1-3 years of treatment subgroup were statistically significant(P<0.05).The SCARED scale scores of the children in the TCM treatment group were grouped according to different lengths of time of diagnosis and treatment,different ages of the children,and the PLT count categories of the children,and the groups were compared between different subgroups by t-test,and the final P values were>0.05,which were not statistically significant.5.t-test was used to compare the HAMA scale scores of parents of children in the TCM treatment group and clinical observation group according to the time of diagnosis in each subgroup and the age of children in each subgroup,and the P-values were>0.05,and the differences were not statistically significant.The t-test was used to compare the HAMA scale scores of the parents of children in the TCM treatment group and the clinical observation group according to the subgroups of PLT values of the diagnosed children,and the difference between the scores of the TCM treatment group and the clinical observation group was statistically significant in the subgroups of PLT values below 30×109/L(P value<0.05).The HAMA scale scores of parents of children in the TCM treatment group were grouped according to different lengths of time of diagnosis and treatment,different ages of children,and PLT count categories of children,and the groups were compared among different subgroups by t-test,and the final P values were>0.05,which were not statistically significant.6.Intergroup comparison between the TCM treatment group and clinical observation group in terms of clinical symptom scores,children’s KIT quality of life scores,and psychological anxiety scores by Spearman correlation analysis yielded statistically significant(P value<0.05)in the correlation analysis between ITP symptom scale scores and children’s SCARED scale anxiety scores.Conclusion1.The severity of symptoms,quality of life,and anxiety of children with ITP were not related to the time of diagnosis,treatment time,age,and PLT values,and there were other factors that had an effect on children;the quality of life and anxiety of parents of children with ITP were not related to the time of diagnosis,treatment time,age,and PLT values of children.2.There were significant differences between parent and child quality of life scores,with parents having worse quality of life and mothers having lower mean quality of life scores than fathers.There was no significant correlation between child KIT quality of life score and parent KIT quality of life score,ITP symptom scale score,purpura item score,bleeding item score,and PLT value.3.When the children’s PLT values were below 30×109/L,the quality of life of the children in the group taking herbal medicine was significantly higher than that of the children without treatment,but when the children’s platelet counts fell within the range of 80×109/L to 100×109/L,the quality of life of the children without medication was significantly higher than that of the children with herbal medicine.4.When the children’s PLT values were below 30×109/L,the quality of life of the parents of the children taking Chinese herbal medicine treatment group was significantly higher than that of the parents of the children without Chinese herbal medicine treatment;when the children’s PLT values were in the range of 30×109/L～100×109/L,the quality of life of the parents of the children without Chinese herbal medicine treatment was significantly higher than that of the parents of the children with Chinese herbal medicine treatment.5.Among children with ITP who had been seen for 1-3 years,the SCARED scale anxiety scores of children in the TCM treatment group were significantly different from those in the clinical observation group,and the anxiety level of children in the TCM treatment group was significantly lower than that in the clinical observation group.6.When the children’s PLT values were below 30×109/L,the anxiety level of parents of children in the TCM treatment group was significantly lower than that of parents of children without drug treatment.7.The PLT value of ITP correlated with the anxiety level of the children,suggesting that the anxiety of the children may affect the PLT value.