Observation On The Immune Mechanism Of Self-Made Purpura One Presciption For The Treatment Of Immune Thrombocytopenia

Objectve:By using the Self-made Purpura One Presciption to treat Xuere Fengsheng Syndrome of immune thrombocytopenia,observe the platelet count,T cell subsets(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+),bleeding,disease efficacy,TCM symptoms and clarify the clinical efficacy of Self-made Purpura One Presciption on immune thrombocytopenia and the mechanism of traditional Chinese medicine,to provide a new idea and data support for clinical treatment of ITP.Methods:Patients with ITP treated in the inpatient and outpatient departments of the Hematology Department of Traditional Medicine of Hospital were collected from November 2018 to December 2019.According to the inclusion criteria,70 ITP patients were selected and randomly divided into a combined group and a hormonal group of 35 cases each.The combined treatment group was given methylprednisolone and the Self-made Purpura One Presciption(Xi-anhecao 15g,Nvzhenzi 15g,Fangfeng 15g,Baizi10g,Qinghuo 15g,Chantui 15g,Jinyinhua 15g,Lianqiao 15g,Dihuang15g,Shuiniujiao 9g,Chenpi 15g,Houpo 15g,Gancao3g.),and the hormone control group was given methylprednisolone.For 3 months of treatment,data such as platelet count,bleeding,TCM clinical symptom scores,T cell subsets(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+)before and after treatment were recorded and entered into statistical software using SPSS20.0 for statistical analysis.Results:1.Comparison of TCM clinical symptom score,bleeding score,and platelet count before treatment between the two groups of ITP patients was not statistically significant(P>0.05).Compared with before treatment,the clinical symptom scores of traditional Chinese medicine decreased,the bleeding scores decreased,and the platelet count increased in both groups of ITP patients(P<0.05).Comparison of TCM clinical symptom scores,bleeding scores,and platelet counts between the two groups of ITP patients after treatment were statistically significant(P<0.05),suggesting that the Self-made Purpura One Presciption combined with methylprednisolone was able to improve clinical symptoms of TCM,reduce bleeding risk,and increase platelet counts than methylprednisolone,reflecting the advantages of traditional Chinese medicine treatment.2.According to the disease efficacy standards,the combined treatment group responded completely in 18 cases,13cases were effective,and 4 cases were ineffective,with a total effective rate of88.57%,and the hormone control group was completely responded in 8 cases,17 cases were effective,and 10 cases were ineffective,with a total effective rate of 71.41%.After chi-square test,P=0.031<0.05,the difference was statistically significant,indicating that the disease effect of the Self-made Purpura One Presciption combined with methylprednisolone was better than that of the control group.3.According to the TCM symptom efficacy standard,8 cases of clinical cure,10 cases of marked effect,14 cases of effect,and 3cases of ineffectiveness were achieved in the combined treatment group,with a total effective rate of 91.43%,and 0 cases of clinical healing of the hormone control group,5 cases of marked effect,20 cases of effective,and 10 cases of ineffective were achieved in the hormone control group,with a total effective rate of 71.41%.After rank sum test,P=0.000<0.05,the difference was statistically significant,suggesting that the efficacy of TCM syndromes of the Self-made Purpura One Presciption combined with methylprednisolone was better than that methylprednisolone.4.Comparison of T cell subsets(CD3~+,CD4~+,CD8~+,CD4~+/CD8~+)before treatment between two groups of ITP patients was not statistically significant(P>0.05),and T cell subgroups after treatment were statistically significant(P<0.05).The T cell subsets in the combined treatment group were statistically significant compared with those before treatment(P<0.05),and the T cell subsets in the hormone control group were not significantly different in CD3+after treatment(P<0.05),but the remaining T cell subsets(CD4~+,CD8~+,CD4~+/CD8~+)were statistically significant(P<0.05).The above hints that T cell subgroup disorder may exist in the development of ITP disease and the Self-made Purpura One Presciption may increase the number of CD4~+,CD4~+/CD8~+,and T cells by regulating the T cell subgroup disorder,and reduce CD8~+to play its role in treating ITP.Conclusion:1.The Self-made Purpura One Presciption with methylprednisolone is better than methylprednisolone in improving clinical symptoms of TCM,reducing the risk of bleeding,and increasing platelet count levels.2.The Self-made Purpura One Presciption combined with methylprednisolone is superior to methylprednisolone alone in terms of disease efficacy and TCM symptoms.3.As a clinically effective traditional Chinese medicine,the Self-made Purpura One Presciption increase the number of CD4~+and T cells by regulating the disorder of T cell subsets,reduce CD8~+to exert its role in treating ITP,and increase platelet count levels.