Leukopenia exists whenever the number of the white blood cells in the peripheral circulation is continually lower than 4¡Á10⁹/L, and the percentage of neutrophilic granulocytes is normal or slightly decreased. In most cases, the disease is related to the decrease of neutrophilic granulocytes, and granulocytopenia is defined as the absolute number of granulocytes is reduced below 1.8¡ª2¡Á10⁹/L. In TCM, this disease is grouped into the categories of "xuan yun" (vertigo), "xu lao" (consumptive diseases), etc.  

Main Points of Diagnosis

1. There must be a history of facilitating the result of leukopenia, e.g. contact with X-ray or radioactive materials, administration of drugs that affect leucocytes ,such as Amidopy-rine, Butazolidin, Thiouracil, Sulfonamides and antitumor agents, etc. Virus infection, desmosis and hepersplenism may also cause leukopenia.

2. The patient may be sick with such symptoms as dizziness, fatigue, mild fever, amprexoa and insomnia. The disease is chronic and is frequently accompanied with infections.

3. Leukocyte count ranges 2¡ª4¡Á10⁹/L, with normal or slightly reduced percentage of granulocytes. The picture of bone marrow shows no specific change.

4. The provocative test of adrenalin is helpful for identifying the false leukopenia. Hydrocortisone test can be used to test the reserving energy of bone marrow, indicating treatment and prognosis.  

Differentiation and Treatment of Common Syndromes     

1. Deficiency of Both Qi and Yin

Main Symptoms and Signs: Dim complexion, dizziness, blurred vision, lassitude and weakness, dysphoria with feverish sensation in the chest, palms and soles, pink tongue with little fur, thready and weak or thready and rapid pulse.

Therapeutic Principle: Supplementing qi and nourishing yin.

Recipe: Pulse-Activating Powder with additional ingredients.

pseudostellaria root

ophiopogon root

schisandra berry

astragalus root,

siberian solomonseal rhizome

spatholobus stem

tortoise plastron

prepared licorice

All the above herbs are to be decocted in water for oral administration.

In addition to the above ingredients, drugs of prepared rehmannia root 15g, dogwood fruit 12g and wolfberry fruit 15g are needed for cases with severe deficiency of the liver-yin and kidney-yin marked by amnesia, tinnitus, soreness and weakness in the loins and knees, tidal fever, night sweat, etc.

2. Insufficiency of Both the Spleen and Stomach

Main Symptoms and Signs: Vertigo, emaciation, lassitude, anorexia, indigestion, abdominal distension and fullness, sallow complexion, loose stool, pale tongue with whitish fur, thready and weak pulse.

Therapeutic Principle: Strengthening the spleen and replenishing qi.

Recipe: Modified Prescriptions of Decoction of Four Noble Herbs and Astragalus Decoction for Tonifying the Middle-Warmer.

codonopsis root

white atractylodes rhizome

poria

prepared licorice

astragalus root

cinnamon twig

white peony root

Chinese date

hyacinth bean

Chinese yam

amommum fruit

chicken's gizzard 

All the above herbs are to be decocted in water for oral administration.

3. Deficiency of the Spleen-Yang and Kidney-Yang

Main Symptoms and Signs: Dizziness, tinnitus ,fatigue and weakness, deficiency of qi ,disinclination to talk, intolerance of cold, cold limbs, aching pain and weakness in the loins and knees, poor appetite, loose stool, or puffy face and edema of limbs, pale and tender tongue with thin and whitish or whitish and greasy fur, deep, thready and weak pulse.

Therapeutic Principle: Warming and replenishing the spleen and kidney.

Recipe: Modified Prescriptions of Aconite Decoction for Regulating the Function of Middle-Warmer and Kidney-Yang Reinforcing Bolus.

prepared aconite root

dried ginger

codonopsis root

white atractylodes rhizome

poria

eucommia bark

antler glue (melted in boiling water)

dodder seed

astragalus root

prepared licorice

All the above herbs are to be decocted in water for oral administration.

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