Adult primary immune thrombocytopenia (ITP) refers to a combination of humoral and cellular immune abnormalities mediated by increased platelet destruction, impaired megakaryocyte maturation in the bone marrow, and platelet An autoimmune disease characterized by abnormal production and bleeding of skin and mucous membranes, which is the most common clinical bleeding disorder. Traditional Chinese medicine classifies it in the categories of “blood blood”, “purpura” and “nvxue”. The Department of Hematology of our hospital adopts traditional Chinese medicine syndrome differentiation and treatment, and combined traditional Chinese and Western medicine treatment to achieve satisfactory results.
ITP has an insidious onset, manifested as scattered skin bleeding spots or other milder bleeding symptoms, such as epistaxis, bleeding gums, etc. Months or even years before the diagnosis, there is a history of prone to small bleeding spots and petechiae, menorrhagia and repeated epistaxis. Blood blisters may occur in the oral and tongue mucosa in severe thrombocytopenia, and petechiae may occur deep in the skin after injury. However, joint and retinal hemorrhages are rare, subconjunctival hemorrhage, genitourinary tract hemorrhage and gastrointestinal hemorrhage can also occur. In severe cases, visceral hemorrhage and even intracranial hemorrhage can occur.
According to the new diagnostic criteria, the first-line treatment of ITP western medicine is mainly adrenal glucocorticoid and gamma globulin, and the second-line treatment is mainly thrombopoietic drugs, anti-CD20 monotherapy. Cloning antibodies, splenectomy, etc.
The Five Elements of Traditional Chinese Medicine believe that the liver belongs to the wood, which is mainly responsible for dredging and discharging, and mainly for storing blood. Wood qi is the main growth, active, has the nature of vigor, has the tendency to grow and grow, and is the qi of growth in the human body. At the same time, the power of wood is bidirectional. It can not only produce all things, but also destroy and strip all things. “Su Wen·Wind Theory” says: Wind is the longevity of all diseases, and its changes are due to other diseases, impermanent prescriptions, However, there is also an atmosphere. ITP is mainly characterized by increased platelet destruction, megakaryocyte maturation disorder and abnormal platelet production in the bone marrow, which is the same as Muyuyinhuafengzao. Wood is born in water but grows in soil, and its pathology mainly involves the stagnation of wood qi itself, water deficit, and soil weakness. Therefore, in the specific treatment, it is necessary to take into account the strengthening of the kidney (water) and the spleen (soil).
The glucocorticoids used in conventional treatment are regarded as “pure yang” products in traditional Chinese medicine, which are easy to cause “invigorating fire and eating qi” and “energy”. The side effect of “Yang is strong and cannot be secreted” affects the introversion of yin essence and its nourishing effect, thus forming kidney yin deficiency. When glucocorticoids are in the process of reducing the dose, it is easy to form the manifestation of kidney yang deficiency, so in the treatment, it is necessary to take into account the conditioning of kidney yin and kidney yang.
ITP treatment is not only about the number of platelets itself, but more about restoring the patient’s constitution. Naizhi”. In life, we adjust from three aspects: diet, emotion, and daily life:
1 Eat a healthy diet and eat less cold food
The spleen and stomach belong to the earth and can transform into all things. Raw and cold food can easily damage the yang qi of the middle earth. At times, liver qi is easily suppressed and turned into wind. In terms of dietary structure, we can learn from a sentence from “Su Wen, Dirty Qi Law Time”: “Poisons attack evil, five grains for nourishment, five fruits for help, five animals for benefit, five Vegetables are the filling. The smells are combined with them to replenish the energy.”
2 Peace of mind
Emotions that are too low will affect health. We can learn from “Su Wen·Ancient Innocent Treatise” A mantra to self-cultivation. “The teachings of the ancient sages are also called, “Evil evil thieves the wind, avoid it sometimes, calm the emptiness, follow the true qi, keep the spirit within, and stay safe from the disease.”
3 daily routine, good sleep
Sleep at the right time is the best way to build up yang qi. We can refer to “Simple Questions and Four Qi Adjusting the Spirit”: ” Spring March…night bed early to get up, walk in the courtyard. Summer March…night bed early to get up, tireless in the sun. Autumn March…early bed early to get up, with chickens happy. Winter March…early bed and late rise, must stay Daylight.”
Guang’anmen Hospital, Chinese Academy of Chinese Medical Sciences
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Hematology, Guang’anmen Hospital, Chinese Academy of Chinese Medical Sciences The Department of Diseases was established in July 2014. It is a comprehensive specialty of hematology with integrated traditional Chinese and Western medicine integrating medical treatment, teaching and scientific research. The department adheres to the characteristic medical concept of “highlighting traditional Chinese medicine and emphasizing both Chinese and Western medicine”, follows traditional Chinese medicine theory, and introduces modern medical diagnosis and treatment techniques to treat aplastic anemia, hemolytic anemia, iron deficiency anemia, myelodysplastic syndrome, Myeloproliferative neoplasms, thrombocytopenia, malignant lymphoma, multiple myeloma, leukemia and myelosuppression after radiotherapy and chemotherapy have accumulated rich clinical experience.It is effective in improving the remission rate of the disease, reducing the recurrence rate of the disease, prolonging the survival period and improving the quality of life.
The author of this article is Zhang Minghui, attending physician, Department of Hematology, Guang’anmen Hospital, Chinese Academy of Chinese Medical Sciences