Leukemia is a critical disease with a high incidence and extremely high fatality rate.Immune escape by leukemia stem cells(LSC)is the main factor for recurrence and progression after remission.Clinical diagnosis and treatment by Traditional Chinese Medicine(TCM)have distinct advantages of syndrome differentiation and treatment.Based on the purpose of diagnosis and treatment,leukemia treatment by TCM emphasizes the harmony of yin and yang to restore human functions,which is conducive to improve autoimmunity and conforms to the mechanism of intervention for tumor cell immune escape.This article discusses the mechanism and research progress of TCM interventions in LSC immune escape based on literature and TCM theory.

Objective Through bibliometrics and visual analysis of the related studies on traditional Chinese medicine (TCM) treatment of immune thrombocytopenia (ITP), this study aims to sort out the overall research progress, hotspots, and trends in this field, and provide reference for further research in ITP. Methods The articles on ITP treated by TCM were retrieved from China National Knowledge Infrastructure (CNKI), Wanfang Database, China Science and Technology Journal Database (VIP), Web of Science Core Collection (WOSCC), and PubMed. The retrieval time was from the establishment of the databases to July 31, 2022. VOSviewer, CiteSpace, Carrot2, and NoteExpress were used for data analysis of the articles in terms of their quantities, types, and journals, and for visualization of research hotspots, authors, institutions, and keywords. Results 1 493 Chinese articles and 40 English articles were included. The articles in Chinese mainly focus on clinical trial research and clinical experience summary, while the English articles mainly focus on clinical trial research and animal research. The Chinese articles were published in 317 Chinese journals, while English articles were published in 29 English journals. Research hotspots include the clinical syndrome differentiation of ITP, the therapeutic effect of TCM compounds on ITP, and the mechanism of ITP treatment. Keyword analysis shows that there are many research achievements in integrated traditional Chinese and western medicine treatment, clinical research, famous doctors’ experience, TCM treatment, cellular immunity, and humoral immunity. The authors with the most articles in Chinese and English are Professor CHEN Xinyi and Professor MA Rou, respectively, and the research institutions with the most articles are Dongzhimen Hospital of Beijing University of Chinese Medicine and Xiyuan Hospital of China Academy of Chinese Medical Sciences. Chinese herbs often used to treat ITP clinically include Xianhecao (Agrimoniae Herba), Nvzhenzi (Ligustri Lucidi Fructus), Mohanlian (Ecliptae Herba), Zhongjiefeng (Sarcandrae Herba), etc., and the prescription usually used to treat ITP include Guipi Decoction (归脾汤), Xijiao Dihuang Decoction (犀角地黄汤), Bazhen Decoction (八珍汤), Erzhi Pill (二至丸), and Xiaochaihu Decoction (小柴胡汤). The main development trends toward retrospective study, TCM treatment mechanism, and data mining. Conclusion The research on TCM treatment of ITP has progressed steadily, but in-depth studies and close cooperation between research institutions are necessary for the modernization of TCM in treating ITP.

Objective To observe the effect of expelling wind, cooling blood and invigorating kidney prescription on the marrow megakaryocyte differentiation maturity and TGF-β1 in patients with chronic idiopathic thrombocytopenic purpura (CITP). Methods Fifty CITP patients were randomly divided to three groups, including 20 patients administrated with the expelling wind, cooling blood and invigorating kidney prescription as TCM group, 15 patients with the same decoction and prednisone as combine group, and 15 patients with prednisone as western medicine group, 4 weeks as one treatment course. After 3 courses, the change of platelet counts, marrow megakaryocyte amount, platelet-produced megakaryocyte proportion and TGF-β1 level in the marrow were observed. Results The fine efficiency of TCM group (55.0%, 11/20) excelled western medicine group (20.0%, 3/15) significantly and close to that of combine group (60.0%, 9/15). Platelet counts of TCM group was raised obviously after treatment (P<0.01), better than that of western medicine group (P<0.05), and was similar to that of combine group. The marrow megakaryocyte amount of TCM group was effectively decreased and the platelet-produced megakaryocyte proportion was increased greatly (P<0.01), similar to that of combine group, which of western medicine group had no significant difference between pre-therapy and post-therapy. TGF-β1 of TCM group and combine group degraded obviously (P<0.05) compared with that before treatment, and was significant deviation compared with that of western medicine group (P<0.05). Conclusion The expelling wind, cooling blood and invigorating kidney prescription can effectively degrade the value of TGF-β1 of CITP patients, facilitate the maturity of the marrow megakaryocyte amount and raise the platelet counts.