[Introduction]

Primary thrombocytopenic purpura, also known as spontaneous immune thrombocytopenic purpura, is a com-monly seen disease in hematopathy. The clinical manifes-tations are spontaneous ecchymoses and hemorrhage from mucus and viscera. It is either acute or chronic. Acute primary thrombocytopenic purpura is usually self-limited and often seen among children. Chronic primary thrombo-cytopenic purpura is usually seen among young women. This disease is similar to macules and blood syndrome in TCM. Acute primary thrombocytopenic purpura is caused by interior accumulation of heat-toxin that drives blood to flow abnormally; while chronic primary thrombocytopenic purpura is often caused by asthenia-damage of the liver, spleen and kidney, asthenia-fire scorching the collaterals or failure of qi to check blood.

[Syndrome differentiation]

1. Interior accumulation of heat-toxin

Sudden onset, purplish patches on the skin, often ac-companied by hemorrhage, hematuria and hematochezia with fresh red color, or fever, feverish sensation over the palms, soles and chest, yellow and brown urine, deep-red tongue with thin and yellow or yellow and dry fur, slip-pery and rapid pulse.

2. gin asthenia and fire exuberance

Slow onset, purpura with frequent changes of aggra-vation and alleviation, especially on the lower limbs, or epistaxis, dental bleeding, profuse menstruation, often accompanied by tidal fever, flushed cheeks, dysphoria, night sweating, dizziness, amnesia, aching and weakness of loins and knees, red tongue with scanty fur, thin and rapid pulse.

3. Failure of qi to check blood

Prolonged duration, sparse and light-colored purpu-ra, recurrence, aggravation after overstrain, or accompa-nied by epistaxis, dental bleeding, hematuria, hematoche-zia, profuse menstruation, pale complexion, spiritual las-situde, insomnia and anorexia, dizziness, light-colored tongue with white fur, thin and weak pulse.

[Treatment]

1. Body acupuncture

Prescription: Xuehai (SP 10), Geshu (BL 17) and Sanyinjiao (SP 6).

Modification: For interior accumulation of heat-toxin, Quchi (LI 11) and Neiting (ST 44) are added; for yin asthenia and fire exuberance, Taixi (KI 3), Taichong (LR 3), Ganshu (BL 18) and Shenshu (BL 23) are add-ed; for failure of qi to check blood, Pishu (BL 20), Shen-shu (BL 23), Qihai (CV 6) and Zusanli (ST 36) are added.

Performance: For interior accumulation of heat-toxin, reducing needling technique is used; for yin asthe-nia and fire exuberance, reducing needling technique is used first and then reinforcing technique is applied, or mild reinforcing and reducing technique is resorted to; for failure of qi to check blood, reinforcing needling technique is used and moxibustion can also be applied.

2. Ear acupuncture

Prescription: Adrenal Gland ( TG2p ), Endocrine (CO18), Lung (CO14), Heart (CO15), Spleen (CO13), Liver (CO12) and Middle Ear (HX1).

Performance: Embedment of needles is used. Or ear pressure with Wangbuliuxingzi (Semen Vaccariae) is applied, pressing three times a day and 3 minutes each time. Two ears are pressed in alternation.

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