Objective To explore the therapeutic effect of Yiqi Tongyang Granule in the treatment of immune thrombocytopenia mice and the underlying mechanism.Methods BALB/c mice were treated with anti-mouse platelet serum from guinea pig to establish an immune thrombocytopenia mouse model. Model mice were randomly devided into the model group, the prednisone group, the Yiqi Tongyang Granule group, and the Jinshuye group; 10 unmodeled mice as the control group. The mice were treated with Yiqi Tongyang Granule（17.4 g/kg）, prednisone（9.1 mg/kg）, and Jinshuye Styptic Mixture（3.9 mL/kg） by gavage for 11 days, and the platelets（PLT）, white blood cells（WBC）, and hemoglobin（Hb） counts in the mice were measured. Bone marrow megakaryocyte counts were compared by bone marrow smears and bone marrow pathology, and the proportions of different types of megakaryocytes in bone marrow were analyzed. The organ coefficients and pathological changes of the spleen and thymus were observed in mice. Lymphocyte subsets were detected using a flow cytometer.Results Compared with the control group, the number of PLT in immune thrombocytopenia mice was reduced（P＜0.05）, and after treatment with Yiqi Tongyang Granule, prednisone, and Jinshuye Styptic Mixture, the number of PLT was increased（P＜0.05）. Compared with the control group, the number of bone marrow megakaryocytes was increased and the proportion of PLT-producing megakaryocytes was decreased in immune thrombocytopenia mice（P＜0.05）. The number of megakaryocytes was decreased after treatment with Yiqi Tongyang Granule（P＜0.05）, the ratio of primitive and naive megakaryocytes was decreased, and the proportion of PLT-producing megakaryocytes was increased in the immune thrombocytopenia mice（P＜0.05）. The spleen was observed to be enlarged in the immune thrombocytopenia mice based on the spleen organ coefficient and pathology, and extramedullary hematopoiesis was found to be common in the spleens of immune thrombocytopenia mice. Thymus atrophy was very obvious in immune thrombocytopenia mice treated with prednisone based on the thymus organ coefficient and pathology. The percentages of Tc, Th, and Treg cells of immune thrombocytopenia mice were reduced, and these percentages were increased after treatment with Yiqi Tongyang granules（P＜0.05）.Conclusion Yiqi Tongyang Granule could regulate the immune state of immune thrombocytopenia mice by regulating the lymphocyte subpopulations and increase the PLT levels in peripheral blood by affecting the number of bone marrow PLT-producing megakaryocytes. The therapeutic effect of Yiqi Tongyang Granule was similar to that of prednisone and clearly superior to that of Jinshuye Styptic Mixture.

Purpose: Primary immune thrombocytopenia (ITP) is an immune disease with a diagnosis of exclusion, since no validated biomarkers have been identified. In this study, we explored biomarkers associated with the development of ITP from an immune perspective to inform the clinical diagnosis.Patients and Methods: Differentially expressed genes (DEGs) between normal and ITP samples were analyzed using limma package. Random forest algorithm and LASSO regression were further used to screen for DEGs associated with ITP. The expression of these hub genes was validated by PCR. The relationship between DEGs and immunity was explored by enrichment analysis. Immune cell infiltration in ITP was analyzed by CIBERSORT and ssGSEA, and the relationship between DEGs and infiltrating immune cells was analyzed by Spearman's rank correlation analysis. Finally, a diagnostic model related to DEGs was constructed by the neural network, and its efficiency was detected by the ROC curve.Results: After screening the GEO database and validation by PCR analysis, The expression of CTH and TAF8 were higher and while OSBP2 expression was lower in ITP patients compared to normal subjects (P<0.05). GO enrichment analysis showed that these DEGs were associated with inflammatory immune-related diseases, and KEGG analysis showed that they mainly regulated signaling pathways such as JAK-STAT. CIBERSORT and ssGSEA analyses showed that these DEGs were mainly associated with macrophage M1 polarization. The expression of CTH and TAF8 were positively correlated with M1 expression, while OSBP2 was negatively correlated with M1 expression. The ROC curve showed high accuracy of the neural network model [AUC= 0.939, 95% CI (0.8-1)]. Conclusion: Our results suggest that CTH, TAF8, and OSBP2 can be used as effective diagnostic biomarkers of ITP.

免疫性血小板减少性紫癜(ITP)属于中医"血证""发斑"范畴.基于扶阳思想,麻柔教授认为其基本病机乃素体阳虚为本、阳郁为标,治疗上提出"次第治疗"原则,初期、中期宜清通太阳阳明郁热,以通阳为原则,使邪有所出,同时恢复中焦枢转之机;后期宜温扶坎中元阳,以温阳为原则,旨在恢复阳气宣通温补,达到阴平阳秘状态.