Effect Of Nourish Yin And Clear Heat Method On Clinical And Autophagy Level Of Primary Immune Thrombocytopenia

Objective: By observing the clinical efficacy and effects on the level of autophagy of Nourish yin and clear heat method in patients with Primary immune thrombocytopenia(ITP)of Yin deficiency-induced internal heat pattern,this paper tries to excavate the scientific connotation between "Nourish yin and clear heat method" and "autophagy",to provide a useful reference for the study of the mechanism of traditional Chinese medicine in the treatment of ITP from the cellular and molecular levels.Methods: From November 2021 to August 2022,60 patients with ITP of ITP patients with Yin deficiency-induced internal heat pattern were enrolled in the outpatient department and ward of Hematology Department of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine(30 cases in the treatment group and 30 cases in the control group).The treatment group was treated with Xue-An-Ning granules which is a hospital preparation of Nourish yin and clear heat,and the control group was treated with Wei-Xue-Ning granules.The observation period was 6 months.Observe and compare the two groups of patients with general information,before and after treatment of TCM syndrome integral,peripheral blood PLT count,the efficacy of judgment and comparison;The levels of platelet autophagy proteins LC3-Ⅱ/LC3-Ⅰ,p62 and the percentages of ATG5 and ATG7 cells in peripheral blood were compared and statistically analyzed before and after treatment in the treatment group and the control group,and compared with the normal group(ten healthy volunteers).Results: 1.TCM syndrome integral and TCM syndrome total curative effect:After treatment,the scores of TCM syndromes in both groups decreased(P<0.05),and the improvement of TCM syndrome scores in the treatment group was better than that in the control group(P<0.05).The total effective rate was 90% in the treatment group and 79.31% in the control group(P<0.05).2.Peripheral blood platelet count and total clinical efficacy: After treatment,the PLT count in both groups was increased(P<0.05),and the PLT count in the treatment group was better than that in the control group(P<0.05).The total effective rate was 80% in the treatment group and 72.41% in the control group,but the difference was not significant(P>0.05).3.Peripheral blood platelet autophagy protein levels: Before treatment,the levels of LC3-Ⅱ /LC3-Ⅰ and the percentages of ATG7 and ATG5 cells were lower,and the level of p62 were higher in the two groups than in the normal group(P<0.05).After treatment,the levels of LC3-Ⅱ /LC3-Ⅰ and the percentages of ATG7 and ATG5 cells in both groups were increased,and the levels of p62 in both groups were decreased(P<0.05).The improvement of LC3-Ⅱ/LC3-Ⅰ and the percentages of ATG5 cells in the treatment group were better than that of the control group(P<0.05).There was no significant difference in the levels of 4 proteins between the treatment group and the normal group(P>0.05),and the percentages of ATG7 cells and the level of p62 in the control group were not significantly different from those in the normal group(P>0.05).Conclusion: 1.Nourish yin and clear heat method is effective in the treatment of ITP patients with Yin deficiency-induced internal heat pattern.2.Nourish yin and clear heat method can effectively improve the symptoms of ITP patients with Yin deficiency-induced internal heat pattern,improve the quality of life of patients,and increase the PLT count in peripheral blood.3.There is abnormal platelet autophagy in ITP patients.Nourish yin and clear heat method can improve the levels of platelet autophagy proteins LC3-Ⅱ/LC3-Ⅰ,ATG7,and ATG5 in the peripheral blood of patients,and reduce p62 level.