Tehran University of Medical Sciences Iranian Journal of Allergy, Asthma and Immunology 1735-1502 0 0 2026 06 16 Immune Thrombocytopenia and Treatment-associated Changes in Platelet-associated Antibodies and Cytokine/T-cell Profiles: A Retrospective Case-control Study with Modified Gui Pi Decoction 1 12 Yan Yang Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China Sunwanqi Yu Anhui University of Chinese Medicine, Hefei, China Dongyu Guo Heilongjiang University of Chinese Medicine, Harbin, China Fanshun Meng Heilongjiang Academy of Chinese Medicine Sciences, Harbin, China Antao Sun Department of Hematology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China Weizheng Sun Department of Hematology, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China 2026 01 25 2026 02 14   To evaluate whether adjunctive Modified GuiPi Decoction provides additional benefit to standard immunosuppressive therapy in adult patients with chronic immune thrombocytopenia (ITP). This retrospective cohort study included 120 adult patients aged 18–65 years, diagnosed with ITP according to the 2016 Chinese Expert Consensus. Patients received either standard therapy (cyclosporine A plus prednisone; comparison group, n = 60) or standard therapy plus Modified GuiPi Decoction (treatment group, n = 60) between July 2022 and July 2024. After 12 weeks of treatment, the treatment group showed significantly greater improvement in fatigue severity score (mean reduction: 3.2 vs 1.8) and quality-of-life index (mean increase: 15.4 vs 9.1) compared to the comparison group. However, no significant between-group difference was observed in platelet count recovery (mean increase: 45.3 × 109/L vs 53.1 × 109/L), with the comparison group showing a numerically larger rise. Mild ALT/AST elevations were more pronounced in the treatment group. In adult ITP patients, adjunctive Modified GuiPi Decoction may offer symptomatic and quality-of-life benefits beyond standard therapy, but did not demonstrate superior hematological response. Caution is warranted regarding potential hepatotoxicity. https://ijaai.tums.ac.ir/index.php/ijaai/article/view/4739 https://ijaai.tums.ac.ir/index.php/ijaai/article/download/4739/2358