title: Combination therapy of traditional Chinese medicine and Western medicine to treat refractory polymyositis: a case report.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital , Kaohsiung, Taiwan .
authors.forename: Yu-Chen
authors.initials: YC
authors.lastname: Cheng
authors.forename: Ming-Yen
authors.initials: MY
authors.lastname: Tsai
authors.forename: Chung-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Yu-Chiang
authors.initials: YC
authors.lastname: Hung
mesh_terms: D000328:Adult; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008516:Medicine, Chinese Traditional; D008727:Methotrexate / Q000008:administration & dosage; D008775:Methylprednisolone / Q000008:administration & dosage; D017285:Polymyositis / Q000188:drug therapy*
chemical_list: D004365:Drugs, Chinese Herbal; C402943:bu-zhong-yi-qi-tang; C403259:si-jun-zi-tang; D008775:Methylprednisolone; D008727:Methotrexate