[Treatment of Idiopathic Thrombocytopenic Purpura by Xiaoban Decoction: a Case Observation of 119 Patients].

Objective To observe the clinical effect of Xiaoban Decoction (XBD) in treating idio- pathic thrombocytopenic purpura (ITP). Methods Totally 119 ITP patients were treated by XBD. The he- mogram, bleeding symptoms, effective rate, and adverse reactions were observed before and after treatment. Patient condition was observed while taking XBD but with other treatment program withdrawal (including glucocorticoids). Results After 6 -18 months of treatment, WBC count, hemoglobin concen- tration, and platelet count were all increased, as compared before treatment. Complete relief (CR) oc- curred in 57 cases (platelet count≥100 x109/L) , response(R) in 27 cases (platelet count≥50 x109/L) , no relief (NR) in 35 cases (platelet count <50 x109/L). The total effective rate was 70. 6%. Bleeding symptoms were improved after one-month treatment. There were 70 patients using glucocorticoids before taking XBD. No withdrawal crisis occurred after rapid withdrawal. No adverse reaction occurred, except increased times of passing stool. Seven patients were pregnant during follow-up and gave birth safely lat- er. Conclusions XBD, independent of glucocorticoids, could rapidly improve bleeding symptoms and steadily elevate platelet count. It was an effectively long-lasting treatment of Chinese medicine.

[Clinical observation of treating 62 patients with severe aplastic anemia failing in immunosuppressive therapy by integrative medicine].

OBJECTIVE: To explore treatment methods for patients with severe aplastic anemia (SAA) failing in immunosuppressive therapy (IST). METHODS: Totally 62 SAA patients failing in IST were treated by integrative medicine (IM). The treatment course was divided into three stages: the critical emergency stage, the improvement stage, and the recovery stage. In the critical emergency stage, patients were treated with Lingyang Yigui Decoction (LYD, consisting of 1.2 g antelope horn, 6 g coptis chinensis, 12 g stir-baked Fructus Gardeniae, 30 g rehmannia rhizoma, 50 g lalang grass rhizome, 9 g amur corktree bark, 12 g Cortex Moutan, 9 g ass-hide gelatin, 30 g red date, 6 g prepared licorice root, etc.) and Erzhi Busui Decoction (EBD, consisting of 120 g glossy privet fruit, 100 g eclipta prostrata, 24 g prepared Gold Theragran, 12 g fructus lycii, 90 g rehmannia rhizoma, 60 g astragalus, 9 g Angelica sinensis, 9 g ass-hide gelatin, 30 g honeysuckle flower, 12 g lotus plumule, and so on) alternatively, one dose daily, decocted twice, taken in two portions. Meanwhile, 50 mg Testosterone Propionate was intramuscularly injected every other day to the improvement stage. Those with fever were treated with LYD by adding 60 g gypsum, 60 g common anemarrhena, 30 g dandelion, 30 g bittersweet herb, 30 g blackend swallowwort root and rhizome, 15 g hemsley rockvine root tuber, and so on. In the improvement stage patients were treated with Jixueteng Compound (Jixueteng Zhengyang Decoction was administered to those of Shen-yang deficiency syndrome: consisting of 100 g spatholobus suberectus, 60 g astragalus, 3 g red ginseng, 12 g psoralea corylifolia, 18 g dodder seed, 12 g angelica, 18 g Herba Epimedii, 6 g common fenugreek seed, 24 g Gold Theragran, 30 g glossy privet fruit, 30 g eclipta prostrata, 6 g dried human placenta, and so on). Meanwhile, 50 mg Testosterone Propionate was intramuscularly injected every other day. Jixueteng Yijing Decoction was administered to those of Shen-yin deficiency syndrome: consisting of 100 g glossy privet fruit, 100 g eclipta prostrata, 90 g rehmannia rhizoma, 30 g spatholobus suberectus, 12 g dodder seed, 6 g psoralea corylifolia, 30 g prepared Gold Theragran, 9 g ass-hide gelatin, 9 g fructus lycii, 24 g Salvia miltiorrhiza, 30 g astragalus, 6 g angelica, and so on), one dose daily, decocted twice, taken in two portions. The treatment lasted to the recovery stage. The medication was gradually reduced to the follow-ups of drug discontinuance. Results After 6 -57 months of treatment, 12 patients (accounting for 19.4%) were basically cured, 14 (22.6%) relieved, 8 (12. 9%) markedly improved, 28 (45.2%) ineffectively, with the total effective rate of 54. 8%. Totally 23 patients had the body temperature ranging 37.6-38.5 degrees C at the first visit to our hospital. They took 2 h- 6 days to have pyretolysis ( <37.5 degrees C) after treatment. Twenty patients with body temperature higher than 38.5 degrees C took 4 h - 5 days to have pyretolysis after treatment. Totally 26 patients suffering from IST induced abnormalities of liver and renal functions (ALT, AST, BUN, and Cr) at the first visit were treated by IM for 2 months. They were restored to the normal levels in 25 cases. CONCLUSIONS: The treatment of SAA failing in IST had its specificity. The staging targeted treatment is in line with its pathophysiology. The key points for its treatment might be lie in the improvement and protection of hematopoietic microenvironment of bone marrows. The antisepsis and anti-inflammation of Chinese herbs hindered its aggravating tendency.

[A 30-year follow-up study on effect of spatholobus composite in treating 66 patients with aplastic anemia].

OBJECTIVE: To assess the long-term therapeutic effect of Spatholobus Composite (SSC) for treatment of aplastic anemia (AA). METHODS: A follow-up study was carried on 110 AA patients, who were successfully treated by SSC and testosterone propionate from 1976 to 1994, by correspondence, the information regarding blood cell count, condition of health and labor, as well as incidence of relapse and complications were collected, and the data from 66 patients response to the correspondence were compared with those of 36 healthy persons and 13 recently visited AA patients. RESULTS: In the 66 AA patients, the average blood cell counts were WBC: 4.7 x 10(9)/L, hemoglobin 121.2 g/L, platelet 109.5 x 10(9)/L, neutrophilic granulocytes 2.5 x 10(9)/L, and their mean hemopoietic tissue in bone marrow 72.7%, all were significantly different to those in the recent visitors (P < 0.01); SF-36 scoring showed insignificant difference between the patients and the healthy person (P > 0.05). Out of the 66 patients, 17 of the 30 school-aged (56.7%) have schooling; the family consummative rate was 87.9% (58/66), including 24 got married after curing, 26 had already married before illness and 8 at school students; 43 (65.2%) have got job; 4 died. The incidence of recurrence was 10.6% (7/66), and the complication occurred in 7.6% (5/66). CONCLUSIONS: The AA patients could be cured by SSC and testosterone propionate, which is a remedy with safety. Cured patients could go into society harmoniously and have their own regular life and job.

[Observation on treatment of post-remission acute myeloid leukemia patients by lingxiong piaoling powder and longchan cigu decoction].

OBJECTIVE: To explore the effect of the treatment for long-term disease-free survival (DFS) of post-remission patients with acute myeloid leukemia (AML). METHODS: Twenty-nine AML patients with completely remission (CR) and 17 with partial remission (PR) were treated with Chinese medicine, Longchan Cigu Decoction 1 dose per day and Lingxiong Piaoling Powder 7 doses per month, and combined with DA or HA regimen of chemotherapy one course per year. Patients peripheral blood picture, bone marrow smear, biopsy and human leukocyte antigen DR (HLA-DR) cells were examined before and after treatment, and their disease-free survival (DFS) was followed up. RESULTS: After treated with above mentioned treatment for 2 months, percentage of patients with normal peripheral blood count increased, including patients with WBC > or = 4.0 x 10(9)/L raised from 46% to 70%, with Hb > or = 120 g/L from 17% to 46% and with PLT > or = 100 x 10(9)/L from 63% to 85%; nucleated cell volume in bone marrow increased from 35.83 +/- 28.42% to 60.46 +/- 17.73% (P < 0.01); HLA-DR cell was also increased significantly from 10.55 +/- 4.95% to 14.84 +/- 4.94%, (P < 0.01); while the residual leukemia cells were not increased in one year, from 5.90 +/- 5.09% before and 5.82 +/- 2.42% after treatment (P > 0.05). The maximal DFS in patients was 123 months. The 3-year survival rate was 64.15 +/- 1.96% and 5-year survival rate was 51.19 +/- 16.25%. CONCLUSION: The integrative Chinese and western medicine treating program used in this study is beneficial for the long-term treatment of AML patients after complete remission.