| ObjectiveIn this study,a randomized controlled trial was conducted to observe the effects of Qingdesihuang powder application on PLT count,bleeding symptoms and TCM symptoms of adult CITP patients,and to objectively evaluate the clinical efficacy of Qingdesihuang powder application on adult CITP,so as to provide a new treatment method for CITP.MethodsThis randomized controlled study on 49 patients which were diagnosised of adults CITP in the department of hematology in the outpatient of Guangdong Provincial Hopital of Chinese Medicine from November 2019 to January 2020(during the treatment,4 cases were removed from the study group and the control group,and 45 cases were finally included in the study).Based on yidianyin and maintenance dose(0-15mg/d)hormone therapy,there were 23 cases in the study group received Qingdaisihuang powder applied to the spleen,each applying time was 6h-8h,once a day for 4 weeks,followed up at 2 weeks after treatment,while 22 cases in the control group were not.By comparing the changes of PLT count,TCM syndrome grade score and 2016ITP bleeding scale to evaluate the efficacy of treating CITP with qingdaisihuang powder applied to the spleen.Before and after treatment,patients in both groups were required to receive TCM syndrome score and 2016ITP bleeding score.Blood routine examination and platelet count level were required before treatment and at week 1,2,3 and 4 after treatment.Two weeks after the end of treatment,patients in both groups were followed up for blood tests and platelet counts.ResultsThere was no significant difference between the two groups in the basel ine data before treatment.(P<0.05)(1)Platelet count change before and afterIntra-group comparison:the platelet count in the study group before treatment were 29(24,34)×109/L,and after treatment was 40(37,69)X 109/L.The difference in platelet count before and after treatment was statistically significant(P<0.05),and the platelet count after treatment was higher than before treatment.The mean platelet count in the control group before treatment was 38.23±12.66×109/L,and after treatment was 45.32±16.81 X 109/L.The difference in platelet count before and after treatment was not statistically significant(P>0.05).Comparison between groups:There was no significant difference in platelet count between the two groups before treatment(P>0.05)and after treatment(P>0.05).During follow-up,the platelet count in the study group was 39(30,70)X 109/L,while the mean platelet count in the control group was 43.14±18.93×109/L.The difference in the study group was statistically significant(P<0.05),while the difference in the control group was not statistically significant(P>0.05).(2)comparison of TCM symptom scores before and after treatmentIntra-group comparison:the score of TCM symptoms in the study group was 6(5,9)points before treatment,and 3(3,5)points after treatment,with statistically significant difference before and after treatment(P<0.05).The average score of TCM symptoms in the control group was 5.27±2.334 points before treatment,and 4.55±1.993 points after treatment,with statistically significant difference before and after treatment(P<0.05).Comparison between groups:there was a significant difference between the two groups before and after treatment(P<0.05),and the symptom score decreased.The total effective rate of the study group was 73.9%,while that of the control group was 18.2%.(3)comparison of main single clinical symptoms between the two groups before and after treatmentThere were significant differences in purpura,fatigue and pale complexion between the study group and the control group before and after treatment(P<0.05).The improvement efficiency of purpura in the study group was 68.42%and the efficiency of mental fatigue was 42.86%and the efficiency of pale complexion was 62.5%,while the improvement efficiency of purpura in the control group was 6.67%and mental fatigue force improvement efficiency was 10%and the efficiency of pale complexion was 16.67%.(4)compasison of the efficacy of the 2016ITP bleeding scale between the two groupsIntra-group comparison:the bleeding score of the study group was 2(2,2)points before treatment and 1(1,2)points after treatment,with statistically significant difference before and after treatment(P<0.05),and the score decreased after treatment.The bleeding score of the control group was 2(1,6)points before treatment,and 2(1,4.25)points after treatment,with no statistically significant difference before and after treatment(P>0.05).Comparison between the two groups:there was a significant difference in the efficacy of the bleeding score scale before and after treatment between the two groups(P<0.05).The bleeding score of the two groups decreased after treatment,with the effective rate of 52.2%in the study group and 13.6%in the control group.(5)comparison of efficacy before and after treatmentThe efficacy of the two groups was determined and compared at different time points according to the changes in platelet values,and it was concluded that there was no statistically significant difference in efficacy between the two groups at week 2,week 4 and week 6(P>0.05).At week 2,week 4 and week 6,the effective rates of the study group were 21.7%,26%and 30.4%respectively,and those of the control group were 9.1%,9.1%and 13.6%respectively.Conclusion(1)In the treatment of adult CITP by applying qingdaisihuang powder to the spleen,the TCM symptoms of patients can be improved,especially the improvement of purpura,mental fatigue and pale complexion.And it can also improve the bleeding symptoms of patients and increase the platelet count to a certain extent,and it also helps stabilize the platelet count.(2)The operation of applying qingdai sihuang powder to the spleen is safe,with little side effects and strong repeatability;It is easy to use self-made dressing belt to apply the spleen,the medicine solution is not easy to exude,and the adhesive tape can reduce the skin caused by various discomfort,and can be reused.After improving the self-made dressing belt further,it can be popularized. |
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