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Treatment of ITP using Western Medicine:

One method of treatment for ITP is by using hormone therapy e.g. the use of prednisone (强的松), prednisolone (强的松龙) or methyl-prednisolone (甲基强的松龙). However, this method has its disadvantages because it may worsen the situation of people at risk of or already with hypertension or diabetes. It may also increase
susceptibility to infections, and cause osteoporosis.

A better alternative would be the use of Immunoglobulin proteins (免疫球蛋白). Side effects as associated with use of hormones are not apparent. However, such treatment is costly. One treatment cycle would be 5 consecutive days of IVIg at 0.4g/kg — 20g is a typical dosage. One to two treatment cycles would
suffice for a start. For cases of substantial bleeding, hemostatic drugs as Etamsylate (酚磺乙胺) and (卡巴克络) should be used in tandem.

Chinese Herbs for ITP:

What kinds of Chinese herbal formulas are best suited to the treatment of bleeding? Let us look at some formulas and see how they fit into the picture. The first types of formulas to look at are hemostatic formulas and
hemostatic herbs.

[more on hemostatics]

How will the Herbs Help?

Looking at Idiopathic Thrombocytopenic Purpura (ITP), we see that it is characterized by purplish spots on the skin (皮肤瘀点或瘀斑), as well as bleeding in areas as the nose, the gums and the conjunctiva. Secondary to the loss of blood and subsequently reduced blood count (otherwise known as anemia) are symptoms as low fever (低热), fatigue (乏力), dizziness (头昏) and insomnia (失眠). Note that many of these are symptoms associated with deficiency (虚证) as understood in TCM terms — giving us a clue that tonics should at least be able to
take care of the symptoms of anemia associated with ITP, if not the root cause of ITP.

ITP in Children:

While adults are most likely to present with a chronic form of ITP, ITP when seen in children is expressed more frequently in the acute form. Hemorrhage symptoms as a result of a fall in PLT count are often preceded by some from of infection, most commonly upper respiratory throat infection (URTI).

Research:

According to Mr. Dong (董玉睿), as published in the Shaanxi Journal of Traditional Chinese Medicine, 226 patent formulas of good empirical standing were analyzed using statistical methods and of the 189 chinese herbs used, tonics and heat clearers were best represented. See website for more: http://d.wanfangdata.com.cn/Periodical_shanxzy200706031.aspx

The treatment principles then do not wander too far away from tonifying the qi and blood, tonifying yin and clearing heat, cooling the blood and stemming hemorrhage. Another common modifications include adding herbs to calm the spirit, stem hemorrhage and vitalize blood to remove stasis.

Further Reading:

• Western medicine treatment options: http://www.xxbkf.cn/post/200.html
• Three tcm herbal formulas that treat:http://www.xxbkf.cn/post/201.html
• Another two formulas (one for blood heat, one for yin def, blood dry: http://www.xxbkf.cn/post/209.html
• On what is megakaryocyte (巨核细胞): http://www.xxbkf.cn/post/205.html
• 药膳 for ITP: http://www.xxbkf.cn/post/208.html
• More on all kinds of blood diseases here: http://www.cnxueye120.cn/

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