The Third Affiliated Hospital of Zhejiang Chinese Medical University, 219 Moganshan road, Hangzhou, Zhejiang Province 310000, PR China.
The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province 310000, PR China.
Explore (NY). 2024 Jul-Aug;20(4):588-591. doi: 10.1016/j.explore.2024.05.004. Epub 2024 May 10.
Myasthenia gravis (MG) is a rare autoimmune neuromuscular disorder with significant morbidity and mortality. Traditional Chinese medicine (TCM) offers an alternative approach to standard pharmacological and surgical interventions, which are often associated with adverse side effects. This case report details the clinical remission of a 50-year-old male with moderate generalized MG following exclusive treatment with a modified Buzhong Yiqi decoction (BYD), a TCM formula, without the use of immunosuppressive agents.
The patient presented with diplopia, bilateral ptosis, weakness in chewing, limb weakness, and other symptoms indicative of spleen and stomach qi deficiency. Modified BYD was prescribed, focusing on strengthening the spleen, nourishing qi and blood, and enhancing immune response. The treatment included ingredients such as Radix Astragali, Angelica sinensis, Atractylodes macrocephala, and others, aiming to restore balance and improve the patient's condition. After two weeks of TCM treatment, the patient showed significant improvement in symptoms of myasthenia. By the second month, all clinical symptoms had disappeared. The patient continued to receive the TCM regimen until the thirtieth month of treatment. At the time of writing this report, the patient has no clinical symptoms and has experienced no relapse. Notably, no obvious adverse effects were reported throughout the treatment.
The success of this case suggests that TCM may serve as an independent treatment option for moderate MG, offering a steroid-free alternative, which would be particularly valuable for patients who are intolerant of or refuse steroid therapy, potentially with significant clinical implications. However it needs a randomized clinical trial comparing TCM to conventional Western medicine treatment to validate it.
重症肌无力（MG）是一种罕见的自身免疫性神经肌肉疾病，具有较高的发病率和死亡率。中医药为标准药物和手术干预提供了一种替代方法，而这些方法往往伴有不良反应。本病例报告详细介绍了一位 50 岁男性患者，在单独使用补中益气汤（BYD）治疗后，临床症状缓解，该患者为中度全身性 MG，且未使用免疫抑制剂。
患者出现复视、双侧眼睑下垂、咀嚼无力、四肢无力等脾胃气虚的症状。予补中益气汤加减治疗，重在健脾益气、养血生肌、增强免疫反应。处方包含黄芪、当归、白术等，以恢复机体平衡，改善病情。经两周的中医药治疗，患者肌无力症状显著改善。至第二个月，所有临床症状均消失。患者继续接受中医药治疗，直至治疗第 30 个月。截至本报告撰写时，患者无临床症状，未复发。治疗过程中未出现明显不良反应。
本病例的成功治疗提示，中医药可能作为一种独立的治疗方法，用于中度 MG 的治疗，提供一种无激素替代方案，这对不能耐受或拒绝激素治疗的患者可能具有重要的临床意义。然而，需要进行中医药与常规西药治疗的随机临床试验来验证其疗效。
