Idiopathic Thrombocytopenic Purpura
Idiopathic thrombocytopenic purpura (ITP) is an acquired bleeding disorder of unknown cause, characterized by thrombocytopenia, a normal or increased number of megakaryocytes in the bone marrow, and the absence of an identifiable cause, including exogenous or secondary factors. It is now widely accepted that most cases of ITP result from immune-mediated platelet destruction; the condition is therefore also known as immune thrombocytopenia.
TCM Pattern Differentiation and Medication Reference
|Common Symptoms
Clinical description:
Acute onset and severe bleeding; dry throat and mouth with a preference for cold drinks; dry, hard stools; scant, dark urine; a crimson-red tongue with a dry, yellow coating; and a floating, rapid or slippery, rapid pulse.
In plain language:
- The condition begins suddenly and develops quickly.
- Bleeding is heavy and severe.
- The throat and mouth feel dry, and cold drinks are preferred to relieve thirst.
- Stools are dry and hard, and bowel movements may be difficult.
- Urine is scant and yellow.
- The tongue is deep crimson-red.
- The tongue coating is yellow and dry.
- The pulse feels superficial and fast, or smooth and fast.
|Treatment Approach
Clinical description:
Clear heat and resolve toxins; cool the blood and stop bleeding.
In plain language:
- May help clear internal heat and resolve pathogenic factors, easing symptoms such as fever, sore or swollen throat, and red, swollen sores.
- May help cool the blood and stop bleeding, easing signs such as vomiting blood, nosebleeds, or spots of bleeding under the skin.
|Related Products
The products listed below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Purple, dark purpuric spots; a dark complexion; possible chest tightness and pain in the flanks; a dark purple tongue with purplish spots; and a wiry or choppy pulse.
In plain language:
- Purple spots appear on the skin and look dark.
- The face looks dark or dull, with a poor complexion.
- There may also be a feeling of chest tightness and pain along the sides of the torso.
- The tongue looks dark purple, with purplish spots on its surface.
- The pulse feels tense or rough and uneven under pressure.
|Treatment Approach
Clinical description:
Resolve stasis and unblock the collaterals; invigorate the blood and stop bleeding.
In plain language:
- May help disperse blood stasis and open the meridians and collaterals, easing discomfort such as numbness, joint pain, or obstruction.
- May help promote blood circulation and stop bleeding, easing signs such as bruising, persistent bleeding, or heavy menstrual bleeding.
|Related Products
The products listed below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Bright-red bleeding; heat in the palms and soles; possible tidal fever and night sweats; thirst without much desire to drink; a red tongue with little coating; and a fine, rapid pulse.
In plain language:
- Bleeding is bright red in appearance.
- The palms and soles feel hot, often with a sense of internal heat and discomfort.
- There may be episodes of feeling feverish and sweating at night, especially during sleep.
- The mouth feels thirsty, but there may be little desire to drink.
- The tongue is reddish with very little coating.
- The pulse is fine and fast.
|Treatment Approach
Clinical description:
Nourish yin and reduce fire; cool the blood and stop bleeding.
In plain language:
- May help nourish yin and reduce internal deficiency heat, easing discomfort such as dry mouth and throat, restlessness, night sweats, or heat in the palms and soles.
- May help cool the blood and stop bleeding, easing signs such as vomiting blood, coughing up blood, nosebleeds, or spots of bleeding under the skin.
|Related Products
The products listed below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Dull purplish spots; a pale, lackluster complexion; dizziness and palpitations; fatigue and weakness; abdominal bloating and loose stools; a pale tongue with a thin white coating; and a fine, weak pulse.
In plain language:
- The purplish spots on the skin look dark and dull rather than bright.
- The face lacks a healthy glow and looks pale and washed out.
- Dizziness and a fluttering or pounding heartbeat may occur.
- There is fatigue and low energy, and it is easy to feel weak during activities.
- The abdomen feels bloated, and stools are loose or poorly formed.
- The tongue is pale in color.
- The tongue has a thin, white coating.
- The pulse is fine and weak, with little force under pressure.
|Treatment Approach
Clinical description:
Strengthen the spleen and supplement qi; nourish the blood and help contain it.
In plain language:
- May help support spleen function and replenish qi, easing discomfort such as poor appetite, fatigue, shortness of breath, abdominal bloating, or loose stools.
- May help nourish the blood and support its containment, easing signs such as a pale complexion, dizziness, palpitations, or increased bleeding.
|Related Products
The products listed below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Long-lasting condition with recurrent bleeding, fatigue, aversion to cold, lower back soreness, a pale and enlarged tongue, and a deep, slow pulse.
In plain language:
- The condition has lasted a long time and is slow to resolve.
- Bleeding recurs, with periods of improvement followed by flare-ups.
- It is easy to feel tired and weak, with little energy for activities.
- There is a marked sensitivity to cold, and the hands and feet may feel cold.
- The lower back feels sore or uncomfortable.
- The tongue is pale and enlarged.
- The pulse feels deep and slow.
|Treatment Approach
Clinical description:
Warm and tonify the spleen and kidney; replenish essence and nourish the blood.
In plain language:
- May help warm and support spleen and kidney function, easing discomfort such as aversion to cold, cold limbs, poor appetite, soreness and weakness in the lower back and knees, or low energy.
- May help replenish essence and nourish the blood, easing signs such as dizziness, ringing in the ears, a pale complexion, palpitations, or fatigue.
|Related Products
The products listed below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
|Common Symptoms
Clinical description:
Long-lasting condition; dark-red bleeding; heat in the palms and soles; night sweats; dizziness and blurred vision; soreness and weakness in the lower back and legs; a red or crimson-red tongue with little or no coating; and a fine, rapid or wiry, fine, rapid pulse.
In plain language:
- The condition has lasted a long time, and symptoms persist.
- Bleeding is dark red rather than bright in appearance.
- The palms and soles often feel distinctly hot and uncomfortable.
- Sweating occurs during sleep at night.
- Dizziness and blurred vision may occur.
- The lower back and legs feel sore and weak.
- The tongue is red or crimson-red, with little or almost no coating.
- The pulse is fine and fast, or fine, tense, and fast.
|Treatment Approach
Clinical description:
Nourish yin and clear heat; cool the blood and stop bleeding.
In plain language:
- May help nourish yin and clear deficiency heat, easing discomfort such as dry mouth and throat, restlessness, night sweats, or heat in the palms and soles.
- May help cool the blood and stop bleeding, easing signs such as vomiting blood, coughing up blood, nosebleeds, or spots of bleeding under the skin.
|Related Products
The products listed below are provided for informational purposes only and do not constitute medical advice or a prescription. Refer to the product packaging and instructions, and use under the guidance of a physician or pharmacist.
References
- Yang R，Han ZC. Pathogenesis and management of chronic idiopathic thrombocytopenic purpura: an update[J]. Int J Hematol，2000，71(1)：18-24.
- Zhou B，Zhao H，Yang RC，et al. Multi-dysfunctional pathophysiology in ITP[J]. Crit Rev in Oncol Hematol，2005，54(2)：107-116.
- Rodeghiero F，Stasi R，Gernsheimer T，et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group[J]. Blood，2009，113(11)：2386-2393.
- Hou Ming. Standardized diagnosis and treatment of adult idiopathic thrombocytopenic purpura[J]. Journal of Clinical Hematology，2008，21(1)：3-4.
- Chen Haozhu. Practical Internal Medicine[M]. 12th ed. Beijing: People’s Medical Publishing House，2005：711.
- George JN. Idiopathic thrombocytopenic purpura in adults: current issues for pathogenesis, diagnosis and management[J]. Hematol J，2004，5(Suppl 3)：S12-14.
- Zhang Zhinan，Hao Yushu，Zhao Yongqiang，et al. Hematology[M]. 2nd ed. Beijing: People’s Medical Publishing House，2013：1273-1277.
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People’s Republic of China: Clinical Medication Guide, Volume on Chinese Patent Medicines[M]. Beijing: China Medical Science Press，2011.