A Preliminary Exploratory Study Of Traditional Chinese Medicine Syndrome Elements On Primary Immune Thrombocytopenia

ObjectiveTo explore the distribution and combination characteristics of TCM syndrome elements of primary immune thrombocytopenia(ITP),and to provide reference basis for establishing a more objective and quantifiable evaluation system of TCM syndrome differentiation and treatment of this disease.MethodsThis study collected the data of four-diagnosis information of TCM and the blood routine report of patients with primary immune thrombocytopenia who visited the outpatient and inpatient departments of hematology,Guangdong Provincial Hospital of TCM from July 2020 to April 2021.Through the establishment of a medical record database,the syndrome elements were extracted with reference to the syndrome differentiation scale and the syndrome element diagnostic criteria,and the general information of the case data,the distribution of syndrome elements,and the combination of syndrome elements were analyzed using SPSS25.0 statistical software.Results1.Among the 130 patients collected,102(78.5%)cases were female,28(21.5%)cases were,female:male were 3.64:1.and 24(18.5%)cases were newly diagnosed ITP,25(19.2%)cases were persistent ITP,81(62.3%)Cases were chronic ITP.2.The location of syndrome elements include spleen,liver,spirit and kidney.Their distribution characteristics are as follows:the spleen ranks first and liver is second,there is statistical difference compared with each other(P<0.05);the kidney ranks last,there is no statistical difference between kidney and spirit(P>0.05).3.The characteristic of syndrome elements are qi deficiency,blood deficiency,yin deficiency,qi stagnation,dampness,stirring blood,yang deficiency,yang hyperactivity and phlegm in order.Their distribution characteristics are as follows:there is statistical difference between qi deficiency and others(P<0.05);there is no statistical difference between blood deficiency and yin deficiency,qi stagnation and dampness(P>0.05).4.There is no statistical difference between the syndrome elements of newly ITP and persistent ITP(P>0.05).Compared newly diagnosed and persistent ITP with chronic ITP,there are statistical differences in the spirit,kidney,qi deficiency,blood deficiency,and yang deficiency(P<0.05);there is no statistical difference in other syndromes elements(P>0.05).5.The cluster analysis of syndrome elements in newly ITP and persistent ITP shows that:spleen,qi deficiency,and blood deficiency are classified into a small category,liver,qi stagnation,and yin deficiency are classified into a small category,and the two are clustered into a large category;phlegm,yang hyperactivity,spirit,and dampness are classified into a category,combined with kidney,yang deficiency,and stirring blood into a large category.It is suggested that the pathogenesis of this period is mainly spleen deficiency and blood insufficiency,liver yin deficiency,liver depression and qi stagnation,liver depression and spleen deficiency,and some patients may have both spirit yang hyperactivity,dampness(phlegm)clouding the spirit,and kidney yang deficiency.In the cluster of chronic ITP syndrome elements,yang hyperactivity,spirit,qi stagnation,liver,and stirring blood are classified as one category,and dampness,phlegm,yang deficiency,and kidney are classified as another one,and the two are clustered into a large category;qi deficiency,blood deficiency,spleen is one category,yin deficiency is one category,and the two are combined into a large category.It is suggested that the pathogenesis of this stage is mainly deficiency of both qi and blood,deficiency of both qi and yin,liver depression and qi stagnation,or both liver depression transforming into fire,liver yang hyperactivity and disturbing the spirit,and kidney yang deficiency.ConclusionThe location of syndrome elements of ITP is mainly the spleen and liver,which may involve the spirit and kidney.The main characteristic of syndrome elements are qi deficiency,blood deficiency,yin deficiency,and qi stagnation.There is no statistical difference between the newly and persistent ITP in syndrome elements,suggesting that the main pathogenesis of the two is the same,which are spleen deficiency and blood insufficiency,liver yin deficiency,liver depression and qi stagnation,liver depression and spleen deficiency.Chronic ITP has more obvious symptoms of qi deficiency and yin deficiency,combined with yin deficiency and fire,yin deficiency and yang hyperactivity.The main pathogenesis are deficiency of qi and blood,deficiency of qi and yin,liver depression and qi stagnation.