There are 100 cases all belong to outpatient, lab examination showed they are not primary thrombopenic purpura.
Treatment according to type:
1. Exterior wind-heat attack: sudden outbreak, fever, slightly aversion to cold, the purpura is generally found on four limbs and severely on lower limbs, the color is cardinal red, the size and figure are different, it may permeate to large patch or has the sensation of itching, its distributing appears symmetrically on both sides, red tongue with thin coating, superficial and rapid pulse. The treatment should be dispersing wind and clearing heat, cooling blood and resolving stasis. We can use Powder of Honeysuckle and Forsythia combining with Antiphlogistic Powder of Schizonepeta and Ledebouriella with modification.
2. Damp heat in stomach-intestine: cutaneous purpura, combined with severe abdominal pain, especially around navel and in lower abdomen, nausea, poor appetite, constipation or
Diarrhea, or bloody stools, red tongue with yellow greasy coating, slippery pulse, the treatment should be draining intestine and cooling blood, dispersing wind and resolving dampness, the prescription is Si Miao Powder or Decoction of Pueraria, Scutellaria and Coptis with modification.
3. Excess heat attacking blood circulation: cutaneous purpura, dispersed distributing or permeating to large patch, generally combined with sthenic fever, extreme thirst, nasal bleeding, bloody stools, yellow urine, deep red tongue with yellow coating, rolling and rapid pulse, the treatment should be clearing heat and relieving toxicity, cooling blood and stopping bleeding, we use Decoction of Rhinoceros Horn and Rehmannia with modification.
4. Yin deficiency of liver-kidney: slow onset, cutaneous purpura with wine color, coming and going alternately, soreness sensation on lumbar region and knees, feverish sensation on five centers, tidal fever, night sweating, dry mouth and throat, dizziness, tinnitus, or hematuria, red tongue with yellow coating, thready and rapid pulse. The treatment should be nourishing yin to lower the fire, cooling blood and stoping bleeding. The prescription is Great Yin-Replenishing Pills combining with Qian Gen Powder with modification.
5. Dysfunction of spleen to control blood: cutaneous purpura with light color, pale face, poor appetite, watery stools or darkish stool, fatigue, severe palpitation, shortness of breathing, lazy speech, pale tongue, weak pulse. The treatment method should be tonifying spleen and nourishing heart, replenishing qi and controlling blood, we use Decoction for Invigorating the Spleen and Heart with modification.
6. Blood obstruction blocking the meridians: cutaneous ecchymosis or petechia with deep purple color, or hematoma, combined with swollen pain on joints, abdominal pain, deep and hesitant pulse. The treatment method should be removing stasis to promote generation, we use Tao Hong Si Wu Decoction with modification.
Modification according to syndrome: adding Mu Gua, Niu Xi, Fang Ji if there is joint pain; adding Qing Pi, Yuan Hu, Bai Shao Yao, Gan Cao if there is abdominal pain; adding Bai Mao Gen, Qian Cao Tan if there is nasal bleeding; adding fry Shan Zhi, Ou Jie Tan if there is teeth bleeding; adding Da Ji, Xiao Ji, Bai Mao Gen if there is hematuria; adding Di Yu Tan, Huai Hua if there is bloody stools; adding Zong Lu Tan, Xue Yu Tan, Xian He Cao, Zi Cao if there is severe hypodermal bleeding; adding Lu Rong, Ba Ji Tian, Shan Yu Rou if there is kidney deficiency manifested by soreness sensation on lumbar region and knees; adding more Mu Li if there is night sweating; adding Yin Chai Hu, Qing Hao, Di Gu Pi if there is long time low fever; adding Tian Men Dong, Mai Dong, Shi Hu etc if there is severe dry mouth.
Result: 81 cases are cured, 15 cases get improved, 4 cases without effect, the total effective rate is 96%.
Key Words: anaphylactoid purpura, differentiation
Writer: De Chun Xing
Song Yuan city hospital, Jilin province (138001)
Comments: