Adult primary thrombocytopenic purpura (ITP) is a common immune bleeding disorder, and commonly used treatments include hormones, immunosuppressants, spleen cutting, and herbal medicine. In China, due to insufficient clinician education and many incorrect concepts, or overtreatment is common, or patients are often resistant to the above treatments, the compliance of treatment is poor, the effect is not very satisfactory, there are many refractory and relapsed cases, and patients often lose confidence in treatment. In fact, many refractory and relapsed patients remain effective again after the above treatment, and even in complete remission and recovery. The key is for doctors and patients to correct misconceptions, establish the concept of correct treatment and confidence, and adopt individualized treatment plans in order to achieve the best results. Common misconceptions include: (a) “unexplained” thrombocytopenia is ITP. At present, the diagnosis of ITP lacks a “gold standard” or specific diagnostic indicators, and is basically an exclusionary diagnosis. The diagnosis is basically exclusionary and must be made by combining the patient’s medical history, physical examination, multiple platelet counts (and sometimes manual counts), peripheral blood smears, platelet autoantibodies, and even bone marrow smears and biopsies to exclude other thrombocytopenic conditions, such as pseudo-thrombocytopenia (mostly caused by the application of the anticoagulant EDTA during blood collection), secondary thrombocytopenia such as lupus erythematosus, anaphylaxis, dry syndrome, antiphospholipid syndrome, and pharmacological thrombocytopenia (aspirin, anti-inflammatory pain, penicillin, cephalexin, and other drugs). In addition, response to hormone therapy is also an important basis to support the diagnosis of ITP. In addition, response to hormonal therapy is also an important basis for the diagnosis of ITP. Therefore, the diagnosis of ITP should not be made after seeing a low platelet count and not finding the “real cause” for a while, without conducting the appropriate investigations to avoid misdiagnosis and wrong treatment. It is recommended that the patient be diagnosed and treated in a regular hospital with the right conditions! (ii) Overtreatment ITP is an autoimmune, benign disease for which there is no cure, and the goal of ITP treatment is to raise the platelet count to a safe range to prevent severe bleeding and reduce the death rate, not to bring the platelet count to a normal range. Therefore, in clinical practice, if the platelets are greater than 30x10e9/L, there is no bleeding, and the patient is not engaged in work or activities that increase the risk of bleeding, the patient may not be treated, but should be followed up and observed. If the platelets are below 30x10e9/L, or if there are bleeding symptoms, or if the patient is older, has had the disease for a long time, or if there are coagulation disorders, platelet function defects, or if there are factors such as hypertension, infection, trauma, or if the patient is taking anti-platelet accumulation drugs, therapeutic intervention is required. For patients who do not require therapeutic intervention, overtreatment can increase the incidence of complications such as infections, which can be life-threatening in severe cases. For patients who need treatment, it is also necessary to combine bleeding risk, efficacy, side effects, patient compliance, etc., to take into account, weigh the pros and cons, and use appropriate individualized treatment to minimize drug side effects without affecting efficacy. (iii) Inadequate treatment Glucocorticoids (hereinafter referred to as hormones) are the drug of choice for the treatment of ITP. Prednisone tablets usually start at 1 mg/kg, and methylprednisolone tablets can also be applied in an equivalent conversion method. Generally, platelets rise in 7~10 days of application and reach the peak value in 2~4 weeks. After the platelets are stabilized, the hormone dosage can be gradually reduced and the treatment can be maintained with prednisone 5~10mg per day or equivalent amount of methylprednisolone for 3~6 months or longer. If the platelets are still not elevated after 4-6 weeks of hormone therapy, it means that prednisone therapy is ineffective and should be rapidly reduced to discontinued. In clinical practice, three conditions are often encountered that lead to inadequate treatment: First, the hormone is reduced too quickly, starting to reduce the dose when the platelets are not yet stable, or reducing the dose too quickly after stabilization. Secondly, the drug is stopped too early without maintenance therapy. Third, the hormone dosage is insufficient, including the starting dose and maintenance dose, mainly because of the many side effects after long-term application. The importance of adequate initial treatment (hormone dosage can be calculated based on body weight), appropriate and individualized dosage reduction, and longer maintenance treatment (see above for the amount of hormone for maintenance treatment) should be emphasized in clinical treatment. Patients should also be educated to use the medication according to medical prescriptions, and not to stop the medication on their own and give up the previous work, nor to reduce the hormone dosage on their own and affect the efficacy. (iv) Treatment of refractory and relapsed patients Treatment of refractory and relapsed patients is more difficult, and hormone + propecia, hormone + danazol, vincristine, etc. can be used. Patients should overcome pessimism, actively cooperate with treatment, and have patience and confidence during treatment. Common cases include frequent change of doctors or specialists, inattention to life and living, overexertion, cold triggering, etc. Furthermore, it is necessary to properly cooperate with Chinese medicine treatment. Chinese medicine has certain characteristics and advantages in cooperating with the reduction of hormones, alleviating side effects and reducing bleeding, especially for relapsed and refractory patients.