[Clinical study of strengthening pi and nourishing shen therapy combined with Western medicine on patients with glucocorticoid resistant myasthenia gravis].
OBJECTIVE
To study the effect of strengthening Pi and nourishing Shen therapy (SPNST) in treating patients with glucocorticoid resistant myasthenia gravis (GR-MG).


METHODS
Twenty-seven patients with MG were enrolled, who were relapse cases after treated by cholinesterase inhibitor with systemic glucocorticoid treatment and showed resistance to glucocorticoid. All were treated by Western medicines, methylprednisolone (MP) and pyridostigmine bromide (PSB), together with Chinese medicine (CM) given according to their syndrome types, namely, for the 15 patients of Pi-Shen qi-yin deficiency type, Buzhong Yiqi Pill and Liuwei Dihuang Pill, and for the 12 patients of Pi-Shen yang-deficiency type, Buzhong Yiqi Pill and Zishen Yutai Pill. The dosages of medicines were reduced gradually in MP-PSB-CM order along with the progressing of the therapy in 4 stages (symptom curing, choline receptor restoration, immune regulation, and functional strengthening). Muscle strength and overall state of patients were re-examined before and after each of the 4 stages.


RESULTS
After 1-year treatment, the therapeutic effect in 9 patients was judged as completely remitted; in 7 as remitted with continuous medication; in 5, 1 and 3 as significantly improved, moderately improved and unchanged respectively, while 2 patients died.


CONCLUSIONS
Integrative medicine shows definite effects in treating GR-MG, and it is worthy of further studying.
Liu
Xiao-yun
XY
Department of Chinese Medicine, the First Hospital Affiliated to Sun Yat-sen University, Guangzhou 510080.
Chen
Song-lin
SL
Zhang
Wei-xi
WX
D000293:Adolescent; D000328:Adult; D000368:Aged; D004351:Drug Resistance; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D055048:Integrative Medicine / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000188:drug therapy*; D016710:Yin Deficiency / Q000188:drug therapy*; D055815:Young Adult
D004365:Drugs, Chinese Herbal; D005938:Glucocorticoids; C042579:Liuwei Dihuang Decoction