To explore the mechanism of tripterygium wilfordii polyglycoside tablets for elderly patients with relapsing refractory immune thrombocytopenic purpura(ITP), and to seek the theoretical basis for Chinese medicine treatment of this disease.

The clinical data of 79 patients with relapsing refractory ITP were retrospectively analyzed.According to whether the combined use of tripterygium wilfordii polyglycoside, they were divided into the control group(35 cases) and the observation group(44 cases). The control group was treated with platelet and tranexamic acid, sulfasalazine, sulforaphane sodium, hemagglutinin and other symptomatic hemostasis treatment.The observation group in symptomatic hemostasis support on the basis of treatment with tripterygium wilfordii polyglycoside tablets.The CD₄⁺ /CD₈⁺ ratio and CD₄⁺ CD₂₅⁺ Treg expression were compared between the two groups.

The CD₄⁺ /CD₈⁺ ratio, CD₄⁺ CD₂₅⁺ Treg and platelet count in the control group before treatmentwere (0.96±0.36), (1.21±0.67)%, (13.14±6.92)×10⁹/L, respectively, which of the observation group were (0.92±0.37), (1.19±0.59)%, (11.51±6.21)×10⁹/L, respectively, there were no statistically significant differences between the two groups(all P>0.05). The CD₄⁺ /CD₈⁺ ratios in peripheral blood of the observation group at 2 weeks, 3 weeks and 4 weeks after treatmentwere (1.04±0.56), (1.55±0.34), (1.59±0.41), respectively, there were statistically significant differences between the two groups(t=9.994, 9.797, all P<0.05). The CD₄⁺ CD₂₅⁺ Treg proportions in the observation group at 2 weeks, 3 weeks and 4 weeks after treatmentwere (1.01±0.61)%, (1.06±0.57)%, (5.92±0.65)%, respectively, there was statistically significant difference between the 4 weeks after treatment and before treatment(t=5.378, P<0.05). The CD₄⁺ /CD₈⁺ ratios in the peripheral blood of the control group were (1.01±0.60), (0.89±0.50) and (0.96±0.51), respectively, and the CD₄⁺ CD₂₅⁺ Treg in control group at 2 weeks, 3 weeks and 4 weeks after treatment proportions were (0.99±0.72)%, (1.15±0.66)%, (1.22±0.56)%, respectively, there were no statistically significant differences between before and after treatment(all P>0.05). There were statistically significant differences in the CD₄⁺ /CD₈⁺ ratio and CD₄⁺ CD₂₅⁺ Treg expression between the observation group and control group at 4 weeks after treatment(t=8.589, P<0.01; t=2.369, P<0.05). There was no statistically significant difference in the platelet count between the two groups(P>0.05), but the symptoms of bleeding of the observation group was lighter at 3 weeks after treatment.

Tripterygium wilfordii polyglycoside improves the expression of CD₄⁺ /CD₈⁺ and CD₄⁺ CD₂₅⁺ Treg in peripheral blood of elderly patients with relapsed or refractory ITP.It is an ideal drug for the treatment of relapsed and refractory ITP in the elderly, it is worth further study.

Tripterygium; Purpura, thrombocytopenic, idiopathic; T-Lymphocytes, regulatory; Aged