The Clinical Study Of Tiaoganfupi Interventing In Adult CITP Bleeding By ITP-BAT Assessment

ObjectiveMost adult immune thrombocytopenia have showed a chronic state. Bleeding is a major factor in its quality of life impact. The study used ITP-BAT to assess the clinical efficacy of tiaoganfupi interventing in adult CITP (chronic immune thrombocytopenia) bleeding, and TEG to assess platelet function before and after the treatment, helping to provide evidence of tiaoganfupi preventing adult CITP bleeding.MethodsThis non-randomized controlled study on the patients which were diagnosised of adults CITP in the department of hematology in the outpatient of Guangdong Provincial Hospital were from May 2015 to December 2015. There were 33 cases in the traditional Chinese medicine intervention group (treatment group) received yidianyin and maintenance dose (0～15mg/d) hormone therapy,27 cases in the western medicine intervention group (control group) received 1/10 dose yidianyin and maintenance dose (0～15mg/d) hormone therapy. Through the comparison of index to evaluate the clinical effects of tiaoganfupi before and after treatment by Platelet count, bleeding grade and bleeding symptom score、 the change of MA.Results(1) In general comparison:1. Bleeding before treatment:bleeding in the skin has happened 43 times (54.43%), mucosal bleeding has happened 15 times (18.99%), organ bleeding has happened 21 times (26.58%), indicating that the bleeding of CITP patients occured mainly in the skin.The mild bleeding in the treatment group and the control group were 33 cases (100%) and 25 cases (92.59%). The moderate bleeding were 0 cases (0%) and 2 cases (7.41%), indicating that CITP patients were mainly mild bleeding.2. The comparison of bleeding grade with gender, age, duration, platelet count and hormone dose:Bleeding grade were no significant differences in terms of gender、 age、 duration 、platelet count and hormone dose (P>0.05)(2) Platelet count change before and after treatment:The means of treatment group’s platelet count were 31.36±13.68× 109/L、35.37±9.21 × 109/L respectively before and after treatment. There were significant differences between them (P<0.05), the platelet count after treatment was higher than before. The means of control group’s platelet count were 25.59±12.89×109/L、 25.95±8.57 × 109/L respectively before and after treatment. There were no significant differences between them (P>0.05).The platelet count were no significant differences between the two groups before treatment (P>0.05), but differences after treatment (P<0.05), the platelet count of treatment group was higher than control group.(3) The bleeding before and after treatment:The proportion of treatment group’s mild bleeding was decreased, but the no bleeding group was rising. The proportion of control group’s mild bleeding was rising after falling, but no bleeding group on the contrary. Moderate bleeding has not changed. The bleeding grade were significant differences between the two groups at different platelet count stratification after the treatment. The no bleeding’s proportion of treatment group was higher than control group, but mild bleeding was lower. The frequency of treatment group’s skin, mucocutaneous and organ bleeding was decreased, bleeding in the skin was the most obvious. The frequency of control group’s bleeding showed a downward trend, but to a lesser extent, bleeding in the skin and mucocutaneous were rising after falling. It showed that the frequency of bleeding was more decreased after chinese medicine intervention than maintenance dose hormone. The bleeding symptom score were no significant differences between the two groups before the treatment (P >0.05), but was significant differences after the treatment (P<0.05). The treatment group was better than control group, that is skin bleeding better than organ, and organ better than mucocutaneous. The skin、 mucosal and organ bleeding were significant differences in the treatment group before after the treatment (P<0.05), but only skin bleeding was significant differences in the control group (P<0.05)。(4) Platelet function:The change of platelet function was no significant differences before and after the chinese medicine intervention by comparing MA (P>0.05).We considered it was affected by the sample size and a short observation time.(5) Adverse reactions:There were no significant adverse reactions during the treatment. ConclusionFor adults CITP, tiaoganfupi could improve grade bleeding and bleeding symptom score.reduce bleeding. Platelet function did not change significantly because of sample size and short observation time, but to a certain extent, it enhanced the platelet count.