Cheng Yu-Chen, Tsai Ming-Yen, Chen Chung-Jen, Hung Yu-Chiang
1 Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan .
J Altern Complement Med. 2015 May;21(5):304-6. doi: 10.1089/acm.2014.0145.
To illustrate the potential for clinical improvement and regimen decrement in treating a patient with a refractory case of polymyositis (PM) with a combination of Western medicine and traditional Chinese medicine (TCM).
A 40-year-old man diagnosed with steroid-resistant PM in January 2011 demonstrated a poor response to immunosuppressants. Complementary TCM treatments were applied to treat his weakness at a clinic integrating TCM and rheumatology in February 2012. He was treated with herbal formula powders named "Bu-Zhong-Yi-Qi-Tang" and "Si-Jun-Zi-Tan." Within 1 month of treatment, the patient seemed to show significant improvement in the grade of disability. Daily doses of methotrexate and methylprednisolone were tapered to 25% and 95.8% after TCM treatments, respectively. Creatine phosphokinase also decreased from 6655 to 718 U/L until December 2013.
In our experience, weakness related to PM can be improved by invigorating the spleen-Qi with TCM treatments. This might indicate that TCM treatments can not only play a role in symptom control but also accelerate steroid tapping for refractory cases. Long-term follow-up and future experimental studies are warranted to examine the efficacy and explore the mechanism of TCM treatments for PM.
阐述中西医结合治疗难治性多发性肌炎（PM）患者临床改善及方案减量的可能性。
一名40岁男性于2011年1月被诊断为对类固醇耐药的PM，对免疫抑制剂反应不佳。2012年2月，在一家中西医结合的诊所采用辅助中医治疗来改善其肌无力症状。给他服用名为“补中益气汤”和“四君子汤”的中药配方粉剂。治疗1个月内，患者残疾程度似乎有显著改善。中医治疗后，甲氨蝶呤和甲泼尼龙的每日剂量分别减至25%和95.8%。直到2013年12月，肌酸磷酸激酶也从6655降至718 U/L。
根据我们的经验，中医通过健脾益气可改善与PM相关的肌无力。这可能表明中医治疗不仅能在症状控制中发挥作用，还能加速难治性病例的类固醇减量。有必要进行长期随访和未来的实验研究，以检验中医治疗PM的疗效并探索其机制。
