Experience Treating a Patient with Thrombocytopenia After Chemotherapy

This is a gynecological tumor patient diagnosed in 2000; the patient has survived for 21 years. After chemotherapy at the end of 2020, her platelets remained difficult to raise. The author tried various methods with no significant effect. Because of her low platelets, she frequently had nosebleeds; I worried that if her condition continued to deteriorate, she would develop serious bleeding problems.

The patient came to me again last week seeking help, while she herself was trying taking wall-broken red peanut skin and Five-Red Soup powder (both products she purchased online). I also decided to try a single-herb remedy: I instructed the patient to use Xianhecao (Agrimonia) 100g and Dazao (Jujube) 10 pieces daily, decocted as a tea. I also told the patient that if she could buy Fengweicao (Pteris Herb), to add 100g to the above formula (but she was unable to find Fengweicao, so this herb was missing). The main reason I use Xianhecao and Fengweicao is that these two herbs have good hemostatic functions and are inexpensive. The relatively large dose is because the patient's thrombocytopenia was severe and long-standing; too light a dose might be ineffective.

At the same time, the patient was also taking Jianwei Shengxue Tang (Stomach-Nourishing Blood-Generating Decoction) (prescription in link) made into pills, as well as the Chinese patent medicine Diyu Shengbai Pian (Sanguisorba White-Blood-Cell-Raising Tablets). After one week on this regimen, the patient's platelets unexpectedly returned to normal values. In fact, in the weeks before this, the patient had also used Jianwei Shengxue Tang and Diyu Shengbai Pian, but her platelets had not risen — they had actually been falling, so the platelet recovery should be unrelated to these two medicines.

As an aside, around August or September of last year, the patient also had low platelets, low red and white blood cells, and severe anemia; at that time she took Jianwei Shengxue Tang as I had designed it, and her blood counts recovered quickly. So during this period, when chemotherapy caused poor blood counts, we naturally thought Jianwei Shengxue Tang might help her. But when actually used, the effect was not good, even though Jianwei Shengxue Tang also contains red peanut skin.

So this time the patient's platelets returning to normal may be related to two factors: first, the dose of red peanut skin was increased; second, the large-dose use of Xianhecao. Xianhecao, also called Tuoli Cao (Fatigue-Relieving Herb), is commonly used in rural southern China to treat bodily weakness; folk medicine often uses Xianhecao alone to treat debility. Xianhecao also has strong hemostatic functions and treats various bleeding disorders. Xianhecao is also a commonly used anti-tumor herb in oncology, which is why I used it in large doses here.

The standard dose of Xianhecao is generally 10-30g. But in folk use, the dose is larger: fresh herb is often used in quantities of half a kilo, and dried herb is used at least 100g — different from the standard dose in TCM textbooks.

Is this an isolated case or a repeatable treatment regimen? I will need to further verify this in future practice. But this patient's thrombocytopenia had troubled both me and her Western doctor for a long time, and it was not easy to get her platelets to recover this time. So I share this treatment experience for other doctors and patients to reference.