Chronic immune thrombocytopenic purpura (CITP) occurs mostly in adults and may have no obvious signs and symptoms except for the finding of thrombocytopenia, which makes clinical identification and treatment more difficult. Chronic ITP is characterized by recurrent disease, easy relapse and difficulty in maintaining platelet count at normal physiological level. The key to chronic ITP is to grasp the main pathological mechanism and location of the disease and to identify the evidence accurately, which is the basis for good clinical results. Chronic ITP has its own etiological and pathological characteristics, the acute phase is characterized by “fire” and the chronic phase is characterized by “qi injury”. In chronic ITP, Chinese medicine has the advantage of “qi injury”, which means qi deficiency, and qi deficiency means insufficient biochemical and regulatory power of qi and blood, which means blood overflows outside the veins. In other words, “Jing Yue Quan Shu? Blood evidence” is recorded: “damage is mostly due to qi, qi injury, then blood can not be stored.” The clinical manifestation of chronic ITP is mainly qi deficiency at the early stage or when the condition is mild, the condition is repeatedly prolonged for a long time, and gradually loses its yang, which eventually leads to the depletion of yang, and the clinical evidence can be seen in the signs of yang deficiency, such as the lack of warmth in the limbs, the preference for hot drinks, the fatty tongue with teeth marks on the side, and the sunken pulse, or the poor appetite, drowsiness, fatigue and weakness, and the light tongue with white greasy coating, such as yang deficiency and dampness. The color of purpura at this stage is light red and sparse or there is no obvious bleeding point. The main line of treatment should be to benefit qi and warm yang. In the acute exacerbation of chronic ITP and recurrent patients, most of them show deficiency and deficiency to the cherry pregnancy mistletoe. The symptoms are not only weakness and other signs of qi deficiency, but also the lack of warmth in the extremities, cold, hot drinks, a light and fat tongue with teeth marks on the edge, a sinking pulse and other signs of yang deficiency, or yang deficiency and dampness. The treatment is to strengthen the spleen, benefit the qi and warm the yang. The formula is as follows: 30g of princely ginseng, 10g of fried atractylodes, 20g of poria, 10g of roasted licorice, 30-60g of roasted astragalus, 10g of cinnamon stick, 10g of white peony, 10g of locking the yang, 20g of Xianling spleen, 15g of Chuan Dioscorea Z, 10g of ginger, and 10 jujubes. In patients with chronic ITP with recurrent disease, low peripheral platelet levels and more obvious bleeding symptoms, the amount of Yang tonic and Yang-aiding products should be appropriately reduced, and the amount of heat-clearing and blood-clearing and detoxifying products, such as fine Radix et Rhizoma, Dangpi, Radix et Rhizoma, Scutellaria, Phellodendron, Radix et Rhizoma, etc., should be increased. Adding and subtracting the following products: with pharyngeal discomfort and itchy throat, add Fu Ling, Gong Ying and Forsythia to clear the throat and detoxify heat; for excessive menstrual flow, add Yi Mu Cao, Radix Rehmanniae, Dry Lotus Grass, Angelicae Sinensis, Dang Pi and Phellodendron Leaf to nourish Yin and nourish blood, cool blood and stop bleeding; for new purpura, add Dang Pi, Phellodendron Leaf and Cyperus Grass to cool blood and stop bleeding; for blood in urine, add Dang Pi, Ze Xie Di and Phellodendron Root to cool blood and stop bleeding and remove turbidity; for long-term hormone dependence, add Radix et Rhizoma Ligustrum, Phellodendron Leaf and Phellodendron Root. For long-term hormone dependence, add Radix et Rhizoma, Radix et Rhizoma, and Radix et Rhizoma. 3, the clinical evidence to keep the prescription is also key CITP slow onset of action, the treatment cycle is long, some up to 1 year or more. In addition, patients or family members are eager to cure the disease, hoping to see significant results in the short term, and arbitrarily reduce the amount of hormones used, which brings interference to clinical treatment. Doctors should give patients an account of their condition and treatment process so that they can cooperate with the treatment. It is not easy to change the prescription frequently when the patient is in the clinic, and it is generally appropriate to adjust the medication in 1-2 months. It is worth noting that people with long-term hormone dependence often have concomitant symptoms brought about by hormones, such as yin deficiency and fire or even yang deficiency, which can easily interfere with or conceal the main symptoms of the disease in clinical practice and should be treated with discretion. 4. Case example: Patient Guan X, female, 25 years old, had bleeding spots on her skin in August 2008, and her blood count at that time was 6.8×109/L WBC, 130g/L Hb, 10×109/L Plt, and the platelet-associated antibody (PAIg) titer was significantly increased: PAIgG: 2683ng/107; PAIgM: 156ng/107. PAIgA: 126 ng/107, bone marrow image: active proliferation, 259 megakaryocytes in the whole film, few platelet-producing giants, indicating impaired maturation of megakaryocyte lineage, diagnosed as idiopathic thrombocytopenic purpura. He was treated with prednisone, cyclosporine and intermittent platelet transfusions, but his condition was recurrent and his platelets were maintained at 20×109/L -30×109/L. He stopped western medicine treatment on his own. The symptoms were: obvious weakness, fear of cold, preference for hot drinks, pale fat tongue with tooth marks and thin white coating, sunken pulse, Plt:23×109/L, 13-carbon breath test (-). The evidence was identified as deficiency of both spleen and kidney. Prescription: Radix et Rhizoma Polygoni 30g, Atractylodes Macrocephala 10g, Poria 10g, Radix et Rhizoma Glycyrrhizae 10g, Cinnamomum Cassiae 10g, Radix et Rhizoma Paeoniae 10g, Fructus Cunninghamiae 20g, Radix et Rhizoma Spleen 10g, Radix et Rhizoma Chuanxiang Z15g, Radix et Rhizoma Pleurisy 15g, Radix et Rhizoma Ginger 10g, Jujube 10. A total of 28 doses were taken with water decoction, one dose per day, morning and evening in two divided doses on an empty stomach. Follow-up diagnosis: May 12, 2009, no significant changes in symptoms, pharyngeal discomfort, no cough and sputum, skin scattered small bleeding spots, light fat tongue with teeth marks on the side of thin white coating, smooth pulse. plt:25×109/L. Poria changed to Tu Fu Ling 30g, clear heat and detoxify, plus 20g of pieris longan, soothe the tendons and promote the absorption and dissipation of blood stasis, followed by 1 month. Follow up II: June 16, 2009, weakness reduced, no obvious fear of cold, light fat tongue with thin white coating, sunken pulse. plt:45×109/L. Continue to take the front for 2 months. Follow-up examination III: August 15, 2009, no obvious weakness and fear of cold, light fat tongue with thin white coating, sunken pulse. plt:98×109/L. Continued to take the first 2 months. This patient’s platelets returned to normal afterwards and have been maintained since then, and then stopped taking Chinese medicine. The patient’s platelets were maintained at about 20×109/L after stopping western medicine, and his condition was stable. The treatment was based on strengthening the spleen and the kidney and benefiting the qi, and adding poria, Chuan Dioscorea Z and warm tonic products to help the yang and dampness. The whole treatment process grasped the pathological mechanism of both spleen and kidney, and the patient’s platelets returned to normal after more than 6 months of treatment and have remained so far.