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Objective: To investigate the biological basis of qi, blood and vessel in immune thrombocytopenia (ITP) patients with syndrome of qi failing to govern blood (SQFGB) based on traditional Chinese medicine. Methods: A total of 52 ITP patients with SQFCB were enrolled and divided into bleeding group (38 cases) and non-bleeding group (14 cases). Bleeding group was further divided into mild qi deficiency group (25 cases) and moderate/severe qi deficiency group (13 cases) based on Chinese Medicine syndrome score. 20 healthy volunteer were recruited as control group. The count of platelet (PLT) was taken as the blood related indicator. The expressions of cytokines including IL-1β, IL-17A, TNF-α, CD40L, and TGF-β, detected by Aim Plex Multiple Immunoassays for Flow, were taken as the qi related indicators. The expressions of VEGF-A, detected by Aim Plex Multiple Immunoassays for Flow and NO, NOS, and ET-1 detected by ELISA, were taken as the vessel related indicators. Results: As compared to the control group, the count of PLT, taken as the blood related indicator, was significantly lower in ITP group patients with SQFCB (P<0.05). The expression levels of IL-17A and TNF-α, taken as the qi related indicators, were significantly higher, while those of CD40L, IL-1β, and TGF-β, also taken as the qi related indicators, were significantly lower in ITP patients with SQFCB, respectively (P<0.05). The expression levels of NO and ET-1, taken as the vessel related indicators, were significantly higher, while the expression levels of NOS and VEGF-A also taken as the vessel related indicators, were significantly lower in ITP patients with SQFCB, respectively (P<0.05). The count of PLT, taken as the blood related indicator, was significantly lower in moderate/severe group than those in mild group (P<0.05). The expression levels of CD40L and TGF-β, taken as the qi related indicators, were also significantly lower in moderate/severe group than those in mild group, respectively (P<0.05). Conclusion: The count of PLT might be the biological basis of blood. The expressions of NO, NOS, ET-1 and VEGF-A might be the biological basis of vessel. The expressions of IL-1β, IL-17A, TNF-α, TGF-β, and CD40L may be the biological basis of qi. The expressions of CD40L and TGF-β could reflect the degree of qi deficiency in ITP patients based on the theory of qi and blood.