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Please note that this version is a deprecated revision. To access the current version, please click here Table of Contents 1 Overview 2 Etiology 3 Diagnosis 4 Diagnosis 5 Therapeutic Measures 1 Overview

It is an autoimmune disease characterized by a disorder of conduction at the neuromuscular junctions of the transverse muscle.

It is an autoimmune disease characterized by muscle fatigue that is mild in the morning and severe in the evening and decreases after rest. It often involves the extraocular muscles, masticatory muscles, swallowing muscles and respiratory muscles. In severe cases, the ball is paralyzed.

Myasthenia gravis is a chronic disease that affects muscle contraction due to neuromuscular transmission dysfunction, and is one of the most common neuromuscular diseases, characterized by weakness of the involved transverse striated muscles. To date, there is no specific treatment, and its etiology and pathogenesis are not fully understood. Currently, there is a relatively unanimous understanding that it is an autoimmune disease.

The symptoms of this disease and the ancient Chinese medical books contained in the "sheath", "impotence", "Suimu", "cellular drooping The symptoms are similar to those of "sheath", "impotence", "plagiocephaly", "cystic droop", "eyelid wastage" and so on. As early as in the "Huang Di Nei Jing", there is a clearer description: "If the stomach is not solid, then all the veins are weak; if all the veins are weak, then the tendons and veins are slack; if the tendons and veins are slack, then the line of the yin exerts itself, and the gas can not be restored, and so it is a society." ("Spiritual Pivot - Mouth Question") Sui Dynasty "The Source of All Diseases - Sui-Mei候" Cloud: lining if the blood and gas is weak, then the skin and the coupling are open to the wind, and the wind is guest in the eyelid between the skin, ...... so its skin is slow and long, hanging over the eyes, then it can't be opened, and the world is called as Sui-Mei." The etiology, pathogenesis and symptoms of eye-type myasthenia gravis were clarified in detail. In the Ming and Qing dynasties, there were also discussions on this, such as Jingyue Quanshu, which said that "the cells are hanging down", and Yinhai Guanqi Disease Theory, which diagnosed it as "eyelids are wide and long". Muscle type myasthenia gravis, seems to be impotence, the Ming Dynasty, "evidence of treatment quasi" recorded that: "impotence, hand and foot impotence and weakness, hundreds of joints relaxed and not collected." The above shows that Chinese medicine has a considerable knowledge of this disease.

Modern medical practitioner Zhang Xichun has described the experience of applying strychnine to treat impotence. And clear clinical reports on the treatment of this disease with traditional Chinese medicine began to see in 1958. 50 ~ 60 years the treatment of this disease to the individual, test case data. Some people also tried to use acupuncture and strychnine to treat the disease, and achieved certain efficacy.In the 70's, the large sample report gradually increased, the identification and typing became more and more perfect, and most of the doctors believed that the disease was caused by the weakness of the spleen and kidney, and the legislation of tonifying the spleen and kidney. From 1980 to 1990, there have been more than 30 reports in the literature, with 1,727 cumulative cases. According to the statistics, the number of cases treated with the method of tonifying the spleen and kidney accounted for 83.3%, and the total effective rate was 92%. In addition, there are also combining the method of dispelling wind, warming yang, and clearing collaterals with the method of tonifying the spleen and kidney, and the results are also good. In addition to evidence-based treatment, acupuncture with traditional Chinese medicine or anticholinesterase drugs for the treatment of this disease has also been reported, purely with acupuncture for the treatment of this disease is most often reported in the eye, but also with auricular acupuncture cure reported.

There are few studies on the mechanism of Chinese medicine in the treatment of this disease. It is worth pointing out that in recent years, the combination of Chinese and Western medicine has successfully saved many patients with myasthenia gravis. Some doctors use the method of cultivating the spleen and kidney to carry out immunological observation on myasthenia gravis, and the result confirms that the method of cultivating the spleen and kidney can regulate the body's immune function; some doctors found that astragalus, atractylodes macrocephala, poria, xianling spleen, seaweed and other medicines used in the treatment of this disease can improve the function of humoral immunity and cellular immunity. In the future, if we can strengthen the clinical and mechanistic experimental research of this disease and the pharmacological research of effective prescription drugs, it will help to further improve the efficacy.

2 Etiology and pathogenesis

The onset of myasthenia gravis is mostly due to the lack of innate endowment and the deficiency of the body after a long period of illness, which leads to the depletion of essence and blood, the loss of qi and blood operation, and the blockage of meridians and channels and the emergence of a series of symptoms, which are closely related to the spleen, kidneys, liver, lungs and other organs.

Weakness of the spleen, the spleen is the main muscle, eyelids of the spleen, the spleen for the nature of this, if the body of the spleen and stomach weak, or due to disease caused by the deficiency, the source of qi and blood biochemistry is insufficient, the muscles and veins of the loss of nourishment, and gradually lead to the impotence of the limbs, eyelid ptosis, and even muscle atrophy.

Kidney essence deficiency The kidneys store essence, and essence and blood are born together. The first thing you need to do is to get rid of the problem. If you can't irrigate the blood, the blood can't be nourished, and the sinews and sinews are not nourished and moisturized, resulting in limb weakness and weakness, waist and leg impotence and weakness.

Liver blood deficiency The liver stores blood, the main tendon. Insufficient liver blood, sinews and sinews are not nourished and moisturized, then the sinews are relaxed and the joints are unfavorable, resulting in weakness and weakness of the limbs.

3 identification and typing

Comprehensive treatment experience of medical doctors around the world, the identification of this disease is often divided into the following five types:

1. Spleen and stomach qi deficiency This disease is mostly seen in the simple eye muscle type, one or both eyelids drooping, morning and evening, accompanied by a lack of appetite, stools rotting soft and insubstantial, tiredness and fatigue, low voice, shortness of breath, yellow face, thin and weak. The tongue is fat and the moss is thin, and the pulse is fine.

2. Spleen and kidney qi and yin deficiencies are mostly seen in the systemic type, the symptoms are generalized weakness, difficulty in swallowing and chewing, accompanied by diplopia, in addition to the spleen deficiency witnessed, can be seen in shortness of breath and dry throat. The tongue is red and the moss is peeling, and the pulse is fine.

3. Spleen and kidney yang deficiency is mostly seen in generalized or medullary type. There is a significant cold fear of cold, loose stools, lumbago, swallowing obvious difficulties, generalized extreme weakness. There are teeth marks on the edge of the tongue, thin and pale moss, and the pulse is sunken and weak.

4. Yin deficiency of the liver and kidney In addition to the symptoms of muscle weakness, there are diplopia, strabismus, fixed or inflexible rotation of the eyeballs, accompanied by dizziness and tinnitus, insomnia and dreaminess, soreness and weakness of the waist and knees, zygomatic redness and fire, dryness of the day and night, heat in the hands and feet and the heart, night sweating or spontaneous sweating. The tongue is reddish, with little or light peeling of the moss, and the pulse is fine.

5. Qi and blood deficiency In addition to the symptoms of muscle weakness, accompanied by yellow or pale thin face, dietary taste, less food, fatigue, low voice, shortness of breath, dizziness and fatigue. The tongue is pale and tender, the moss is thin and white, and the pulse is weak or dull.

4 Diagnosis

I. History and Symptoms:

It is common in adolescents and children, and is often seen with ptosis, diplopia, difficulty chewing and swallowing, or weakness of the limbs aggravated by activity.

Second, physical examination findings:

Extraocular muscle paralysis, limb muscle endurance, positive fatigue test, repeated the same action on the affected muscle or continuous percussion of a reflex, the response can be seen gradually weakened or can not.

Third, auxiliary examination:

1. Neostigmine test: Neostigmine methyl sulfate 0.51mg muscle injection, muscle strength within 0.51h marked improvement is positive, can be confirmed. To prevent muscarinic reaction of neostigmine, atropine 0.51mg should be injected at the same time.

2. Immunologic function tests may be abnormal.

3. Serum cholinesterase, immunoglobulin, and acetylcholine receptor antibody potency are elevated.

4. Chest X-ray or CT may show thymic enlargement or tumor.

5. Electrocardiogram may be abnormal.

6. Electrophysiological examination: induced electricity continuous *** affected muscle response quickly disappeared. EMG: repetition frequency ***, low frequency *** there is a wave amplitude decreasing, high frequency *** there is a phenomenon of wave amplitude increasing, such as decreasing more than the starting amplitude of more than 10% or increasing more than 50% of the positive.

Differentials:

It is necessary to exclude hyperthyroid myopathy, polymyositis, Guillain-Barre syndrome, periodic paralysis, and carcinomatous myasthenia gravis.

I. Anticholinesterase drugs, pyridostigmine 60240mg/dose,35 times/d orally.

Second, immunosuppressant:

After the cholinesterase inhibitors treatment is ineffective, according to the immune function of the choice, oral prednisone 3060mg times / d, for 35 months, or cyclophosphamide 200mg added to 25% dextrose 20ml plus vitamin B6100200mg static injection, once every other day, 20 times for a course of treatment.

Third, high-dose propecia drip:

100200mg/kg, saline 500ml diluted drip, 12 times a week.

Fourth, plasma exchange therapy:

Hospitals with conditions can be used, each exchange of 10001500ml, twice a week.

V. Thymoma in combination with ineffective medical treatment:

Radiotherapy or tumor removal.

5.1 Therapeutic efficacy standards

Because the clinical process of this disease is slow, there can be a natural remission period, although the disappearance of symptoms, but also may not be able to be cured, and the course of treatment is too short, the effect of treatment is not easy to consolidate. Therefore, the efficacy of this disease should not be less than three months, the cured cases must be observed for one year before judging the current Chinese medicine treatment of myasthenia gravis efficacy assessment has not been unified. Now, according to the opinions of various schools of thought, the synthesis is as follows:

Clinical cure: all clinical symptoms and signs disappear, return to work or engage in light work electromyography to return to normal or after random contraction muscle action potential amplitude and frequency of gradual reduction of phenomenon is obvious, follow-up one year without recurrence.

Significant effect: clinical symptoms or signs have largely disappeared, and life is self-care. The patient still needs to take anti-acetylcholine enzyme, and the hormone has been reduced by more than one-half. The electromyogram has improved significantly.

Effective: clinical symptoms or signs have improved. Antiacetylcholinesterase agents and hormones have been reduced by 1/3 to 1/5, and the electromyogram is slightly improved or unchanged.

Ineffective: after 3 months of treatment, there is no change in clinical symptoms, signs and drug dosage before and after treatment.

5.2 Types of treatment

(1) Spleen and stomach qi deficiency:

Treatment: tonifying qi and strengthening the spleen

Prescription: 15-30 g each of Codonopsis pilosulae and Astragalus membranaceus, 9-12 g each of Shengma and Chaihu, 15 g each of Rhizoma Atractylodis Macrocephalae and Radix Angelicae Sinensis, 9 g each of Pericarpium Citri Reticulatae, 6 g each of Jujubes and Glycyrrhiza Uralensis.

Dosage: 1 dose per day, decocted in water, served in 2 times.

Addition and subtraction: add Huang Jing, Chinese yam, lentil and other drugs.

Commonly used prescriptions: Liu Jun Zi Tang, Ginseng Ling Bai Zhu San.

(2) Spleen and kidney qi and yin deficiency

Treatment: benefit qi and nourish yin.

Dosage: 1 dose per day, decocted in water, served in 2 times.

Addition and subtraction: Ophiopogon, Schisandra, Paeonia lactiflora, Colla Corii Asini, Placenta tablets and other drugs can be added as appropriate.

Commonly used prescriptions: Shengmanshan, Zuoguiwan.

(3) Spleen and kidney yang deficiency

Treatment: warming yang and benefiting qi.

Prescription: 15-30 grams each of Radix Codonopsis pilosulae and Radix Astragali, 9 grams each of Radix Polygoni Multiflori and Cinnamon, 15 grams each of Cornu Cervi Pantotrichum, Radix Rehmanniae Praeparata, Radix Polygoni Multiflori, Radix Polygoni Multiflori, Cornu Cervi Pantotrichum.

Dosage: 1 dose per day, decocted in water, served in 2 times.

Addition and subtraction: can be added lock Yang, Morinda citrifolia, bone marrow, eucommia, Sang Sheng, placenta tablets and other optional drugs.

Commonly used prescriptions: Jin Gui Ren Qi Pill, You Gui Pill, Si Shen Pill.

(4) Yin deficiency of the liver and kidney

Treatment: nourish the kidney and tonify the liver

Prescription: 15 grams of Radix et Rhizoma Shengdi, 10 grams of Chinese yam, Poria, Codonopsis, Maitake, Cuscuta, Paeonia lactiflora, Radix Angelicae sinensis, 6 grams of Cornu Cervi Pantotrichum, Zelda, Dampy, Lycium Chinense.

Dosage: 1 dose per day, decocted in water, served in 2 times.

Addition and subtraction: add Zhimu, Huangbai, Xuanshen for Yin deficiency and fire exuberance; add floating wheat, ephedra root, calcined oyster for spontaneous sweating.

Commonly used formulas: Qi chrysanthemum dihuang pill, six flavors of dihuang pill, pulse powder.

(5) Qi and blood deficiency

Treatment: tonifying Qi and generating blood.

Prescription: 10 grams each of Radix Codonopsis, Rhizoma Atractylodis Macrocephalae, Poria, Radix Angelicae Sinensis, Radix Paeoniae Alba, 15 grams of Radix Rehmanniae Praeparata, 3 grams of Radix et Rhizoma Glycyrrhizae, Rhizoma Ligustici Chuanxiong.

Dosage: 1 dose per day, decocted in water, divided into 2 doses.

Add and add: you can take Zihechuan powder, or placenta tablets and other medicines.

Commonly used prescription: ten complete tonic soup.

Therapeutic effect: 803 cases of different types of myasthenia gravis were treated with the above parties***, results: 463 cases were cured, 94 cases were effective, 128 cases were effective, 118 cases were ineffective, and the total effective rate was 85%.

5.3 Specialized treatment

(1) Beneficial qi and Yang-raising soup

Composition: 15-30 grams of Astragalus, Codonopsis, 15 grams of Atractylodes macrocephala, Angelica sinensis, 12 grams of Zihechuan, 6 grams of Pericarpium Citri Reticulatae, Chaihu, Glycyrrhiza glabra.

Add and subtract: add ginseng and platycodon in the middle of the deficiency; add baji tian, cistanchiakis, antler gelatin in kidney yang deficiency; add liu wei dihuang pill in kidney yin deficiency; if yin deficiency is accompanied by deficiency heat, use xiyangshen to substitute for dangshen, and add zhi mou and sha shen.

Dosage: 1 dose per day, decocted in water, divided into 2 times.

Therapeutic effect: with the above **** treatment of this disease 51 cases; 21 cases cured, 26 cases effective, invalid 4 cases, the total effective rate of 92.2%.

(2) to protect the yuan soup

Composition: 12 grams of ginseng, astragalus 18 grams, chaihu, 9 grams of sesame, ginger, cinnamon 6 grams, wind, licorice 6 grams of red peony, white peony, 10 grams of dillon.

Add and subtract: photophobia, tearing, nausea, plus Cangzhu, Qiangwu; diplopia, strabismus, limited eye movement, plus Ligusticum chuanxiong, scorpion, centipede; bammy face, weakness, red ginseng, easy ginseng; long duration of the disease, recurrent episodes, lack of warmth of the extremities, plus the cooked epiphyllum, antler gelatin; irritable heat and thirst, red tongue, moss, yellow, go to Fangfeng, Ganzhi, plus Xianhecao, dry lotus herb.

Dosage: 1 dose per day, decocted in water, take 3 times warm. When the condition improves, followed by this formula made of punch for internal use, 2 times a day, 20 grams each time.

Therapeutic effect: with the above **** treatment of ocular myasthenia gravis 65 cases, 24 cases of clinical cure, 36 cases of improvement, ineffective 5 cases, the total effective rate of 92.5%.

(3) Strengthening the spleen and Yang Tang

Composition: 15-30 grams of ginseng, 12-18 grams of atractylodes macrocephala, 24-60 grams of astragalus, 9-12 grams of sesame, 9-18 grams of chaihu, 15-150 grams of cooked epiphyllum, 12-30 grams of Pueraria Mirifica, 12-24 grams of angelica, 9 grams of tangerine peel, 6-15 grams of ephedra, 6 grams of roasted licorice.

Add and subtract: kidney yang deficiency plus cinnamon, antler slices, wolfberry, bacopa monnieri, black sesame seeds; limb power is very plus chicken blood vine, dried dragon; breathlessness plus cinnamon sticks; excessive sweating, go to the ephedra; dry mouth and throat or skin burning after taking the medicine plus the land, maitake; local muscle twitching plus scorpion, centipede; tongue numbness and numbness of the limbs, as appropriate, to reduce the ephedra dosage.

Dosage: 1 dose per day, water decoction twice about 250 milliliters, both divided into 2 times warm. Cooked epiphyllum dosage should start from a small dose, and increase as appropriate. A small number of patients with mild dry mouth, dizziness, tongue numbness, numbness of limbs and burning sensation of the skin, or local muscle twitching, the above symptoms can be flexibly varied according to the above additions and subtractions.

Therapeutic efficacy: with the above **** treatment of this disease 41 cases, clinical cure 12 cases, 17 cases of apparent effect, 9 cases of effective, ineffective 3 cases, the total effective rate of 92.7%.

(4) tonify the middle and benefit qi soup flavor

Composition: 12 grams of ginseng, 12 grams of atractylodes macrocephala, 12 grams of poria, 5 grams of roasted licorice, 15 grams of astragalus, 10 grams of angelica sinensis, 5 grams of pericarp, 5 grams of sesame, 5 grams of platycodon grandiflorus, Coix seed 12 grams of silkworms sand 10 grams of Chinese wolfberry 12 grams of dodder seed 12 grams.

Addition and subtraction: abdominal distension, lack of taste in the mouth to remove angelica, add malt, radix et rhizoma, ji Nei Jin; strabismus, diplopia to remove the ascending flax, platycodonopsis, add Chinese yam, jujube skin.

Dosage: 1 dose per day, decocted in water, served in 2 times.

Therapeutic efficacy: the above treatment of 22 cases of ocular myasthenia gravis, cured 10 cases, 6 cases of apparent effect, 5 cases of effective, ineffective 1 case, the total effective rate of 95.5%.

(5) return to the astragalus is not a function of loose

Composition: 20 grams of ginseng (symptoms, with red ginseng 5-10 grams), 15 grams of atractylodes macrocephala, 15 grams of Poria cocos, 6 grams of pericarp, Astragalus 20 grams of angelica 15 grams of essence of the yellow 30 grams of glutinous rice 30 grams of grass, 30 grams of chicken poop vine, 5 grams of licorice.

Addition and subtraction: kidney yang deficiency, the symptoms of mild, discretionary addition of cuscuta, bone marrow, Morinda citrifolia; kidney yang insufficiency, the symptoms of severe addition of ripe sliced epiphyllum.

Dosage: 1 dose per day, decocted in water, served in 2 times.

Therapeutic effect: with the above **** treatment of this disease 10 cases, satisfactory results.

Attachment: myasthenia gravis crisis treatment

Clinical crisis occurs, mostly in myasthenia gravis type or ball type cases. Difficulty in breathing and swallowing, phlegm and saliva congestion, and even sweating, pulse is weak or large and weak as the main symptom. At present, the salvage mostly adopts the method of combining Chinese and Western medicine. Available below treatment.

Composition: Bie Zhi Sen (another decoction punch), hot licorice 9 grams each, mealybug tail (research punch) a pair, Kan Cheng 2, 30 grams of ripened earth (incense powder 1.5 grams with the pounding), calcined keel, calcined oyster, black tin Dan (package of decoction) 30 grams, 12 grams of light slices of adenium, 30 milliliters of fresh bamboo lee (punch), ginger juice 2 to 3 drops (punch).

Add: If you are delirious, add 1 Suhexiang Pill and take it.

Dosage: Decoction in water, administered nasally. In the application of the above basic prescription at the same time, actively cooperate with modern medicine rescue: respiratory muscle paralysis is mild, with suction to give oxygen, artificial respiration. If respiratory muscle paralysis is serious and sputum accumulates in the deep part of trachea, tracheal intubation or incision is performed, or population breathing is performed, and according to the degree of crisis, light intramuscular injection or static injection of neostigmine is performed, and heavy treatment is performed with a short course of high-dose hormone therapy. If the complication of colds, infections, penicillin as the first choice of drugs, can also choose to clear the heat and detoxification, promote lung phlegm Chinese medicine, to control the crisis has a good efficacy.

Boil effect: with the above **** rescue 10 cases of critical elephant patients, the results of the success of 8 cases, 2 cases of death, the total effective rate of 80%.

In addition, there is a unique ginseng soup Jun tonic qi, with bamboo lee, monkey jujube, swollen joints wind phlegm elimination of solid, the junction of the Western medicine measures, the treatment of 6 cases of myasthenia gravis critical incident author, the results, the effective 4 cases, the death of 2 cases. There are also doctors for acute exacerbation period or the emergence of crisis patients, traditional Chinese medicine to clear the lungs and moisten the dryness of the main, supplemented by the liver and kidney; the recovery period is to be supplemented by the spleen and kidney, regulating the internal organs, this method with Western medicine measures, rescue 2 cases were successful.

5.4 Experiences of old Chinese doctors

The case of Zhang Jin San

Zhou × ×, female, 24 years old. She suffered from generalized myasthenia gravis with onset of 10 months. The onset of the disease was 10 months ago. It started with diplopia and drooping of both eyelids with difficulty in purging, and gradually generalized weakness and difficulty in mastication, which required neostigmine support. In the morning she could still get up, but in the afternoon she was limp and weak. The face was emaciated, with an unnatural expression, very little food and drink, and the stools were sometimes dry and sometimes loose. The diagnosis was that the essence, qi and spirit were all deficient. The first is to benefit the qi and generate fluids to help the spirit.

Prescription: 15 grams of Radix Codonopsis, 24 grams of Radix Rehmanniae Praeparata, 6 grams of Radix et Rhizoma Glycyrrhizae, 15 grams of Radix Astragali, 12 grams of Radix Angelicae Sinensis, 12 grams of Salviae Miltiorrhizae, 12 grams of Lycium barbarum, 9 grams of Pericarpium Citri Reticulatae, 5 grams of Ligusticum Chuanxiong, and 3 grams of powdered Zihechuan (swallowed).

The above medicines plus and minus take about 3 months, the condition is reduced, the whole body muscle strength has increased, but diplopia is still more serious, thin moss, pulse fine. The eye is the essence of the five viscera and six bowels of the collection, the pupil is the kidney, the essence of the dispersion of visual discrimination, or the liver and kidney *** insufficient. The treatment of kidney filler essence.

Prescription: 12 grams of ripened ground, 12 grams of wolfberry, 12 grams of chasteberry, 12 grams of cornelian cherry, 30 grams of tortoise plate, 9 grams of Colla Corii Asini (melting punch), the system of 12 grams of Shouwu, 12 grams of raw white peony, 12 grams of return to the body, 3 grams of Zihechuan powder (divided into swallowing).

The above medicines plus or minus and served for 3 months, the body gradually recovered, the face of the rich, the spirit is also good, the new Stimulus with a gradual decline, diplopia reduction, but not all removed. After taking the medicine for several months, the diplopia disappeared, and the patient was able to perform general labor, and the use of Synthroid was also stopped. The patient before and after the service Yiqi spleen, tonifying the kidney to fill the essence and other agents for about two and a half years, and finally cured, and is now working and married, with a follow-up of four years, physical strength is good, and gave birth to a boy.

Note: Zhang believed that the paralysis of myasthenia gravis is mainly due to the deficiency of qi. Difficulty in chewing and swallowing is due to the deficiency of the spleen and kidney, and if the Yang is not spread to the four ends, the limbs will be idle and not collected. The general principle of the treatment of this disease is based on the cultivation of the spleen and stomach, emphasizing that it is appropriate to regulate the spleen and stomach rather than urgency, and that it is appropriate to nourish and tonify the medicines rather than bitter and cold, and that it is appropriate to solidify and astringent rather than flu. The process of treatment should not be suitable for the regulation of interest, pay attention to the happy and free of mind, dietary regimen, can only be cured.

5.5 The law of medication

According to the eight literature summarized, the therapeutic effect is better (the number of cases of treatment is less than 14 cases, more than a hundred cases, the efficacy of the majority of more than 50%) of the drug **** more than 60 flavors, is now summarized in the following table:

Frequency of application (cases)

Literature (articles)

Drugs ? Substances

≥450

≥6

Astragalus, Radix et Rhizoma Ginseng, Radix et Rhizoma Glycyrrhizae, Rhizoma Atractylodis Macrocephalae, Rhizoma Pericarpium Citri Reticulatae, Radix Aspergillus, Radix Angelicae Sinensis.

50 to 449

3 to 5

Radix Pseudostellariae, Chinese yam, Radix Rehmanniae Praeparata, Cornu Cervi Pantotrichum, Fructus Lycii, Poria, Paeonia Lactiflora, Radix Bupleurum, Radix Bupleurum Chinense.

2

Cornu Cervi Pantotrichum, Cinnamon, Pueraria Mirifica, Fructus Jujubae.

10 to 49

1

Cuscuta chinensis, Semen ziziphi, Rhizoma Polygonati Odorati, Rhizoma Pinelliae, Rhizoma Pinelliae, Rhizoma Pinelliae, Ginseng, Radix et Rhizoma Polygonati, Radix et Rhizoma Polygonatiae, Radix et Rhizoma Polygonati Odorati, Radix et Rhizoma Polygonati Odorati, Radix et Rhizoma Polygonati Odorati, Semen Coicis, Radix et Rhizoma Polygonatiae, Radix Strychnos.

According to the analysis of the above table, the commonly used medicines were nearly more than 20 flavors, indicating that the use of traditional Chinese medicine for the treatment of this disease was relatively concentrated, in which the most application was made to the medicines of benefiting qi and strengthening the spleen, such as astragalus, codonopsis, atractylodes macrocephala, licorice, and ascorbic acid. Secondly, there are medicines that warm the spleen and kidneys, such as Radix Pseudostellariae, Cinnamomum Cassiae, Chinese yam, Radix Rehmanniae Praeparatae, Cornu Cervi Pantotrichum, etc., whereas medicines that dispel wind and clear the channels, nourish yin and cool the blood, and clear away the heat, such as Radix et Rhizoma Gastrodiae, Radix strychnos, Radix et Rhizoma Pantotrichum, Radix et Rhizoma Polygoni Multiflori, etc., are less frequently used. This suggests that the treatment of this disease is mainly to benefit qi and strengthen the spleen, warm the middle and tonify the kidney, but also need to pay attention to the different physique, the different circumstances of each stage of the disease, the flexible use, in order to improve the therapeutic effect.

5.6 Other therapies

(1) Acupuncture and moxibustion

①Body acupuncture (one)

Acupuncture points: main points: Zanzhu, Yangbai, Yuzhuan. Supporting points: foot Sanli, Sanyinjiao, sun, Hegu, Baihui, Sibai. Double vision plus eye, wind pool.

Operation: each time you choose the common points 3 points, spare points 1 point. Light and shallow ***, each point alternately, can also be pierced through the point, such as Yang Bai through the fish waist, etc., each time the needle half to 1 minute, do not leave the needle. Hundred points with rice cones for scarless skin moxibustion 3 strong. Once a day, 7 to 10 days for a course of treatment. Foot Sanli, Sanyinjiao needle after adding moxibustion.

Efficacy: with the above method **** treatment of eye muscle type myasthenia gravis 43 cases, 35 cases cured, 1 case of apparent effect, 6 cases, ineffective 2 cases, the total effective rate of 95.3%.

② body acupuncture (bis)

Acupuncture points: main points: Zanzhu, Sizhukong, Yangbai, fish waist, Taichong, Taixi, Manxi. Supporting points: Hegu, Dudu, Spleen Yu, Baihui, Ashigaru, Zhongshu, Yinlingquan, Sanyinjiao.

Operation: each time the player foot meridian on the main points of a pair, according to the symptoms of the selection of 1 to 2 points, stay in the needle for 20 minutes. Out of the needle and then use the skin needle to take the affected side of the head foot sun, foot Shaoyang meridian line and the orbicularis oculi muscle, from top to bottom, from the inside to the outside of the percussion, the method of complementary method of light stabbing, treatment once a day, 10 times for a course of treatment, the interval between courses of treatment for 3 days.

Therapeutic efficacy: with the above method **** treatment of 365 cases of this disease, clinical cure 311 cases, 41 cases of significant effect, 11 cases of improvement, invalid 2 cases, the total effective rate of 95.5%.

(2) single formula prescription

① strychnine capsule

Composition: strychnine. Each capsule contains 0.2 grams of strychnine powder.

Dosage: 1 capsule 3 times a day, after meals. Every 2 to 4 days to take 1 additional capsule, and gradually increase to 7 capsules. In the process of increasing the drug, such as self-conscious body localized transient muscle throbbing, twitching feeling; cut not to increase, muscle strength is basically normal to reduce the dosage of strychnine until the termination of treatment.

Efficacy: with the above with the identification of medication **** treatment of 8 cases, 4 cases of significant effect, 1 case of improvement, 3 cases of ineffective, the total effective rate of 62.5%.

② Wujin wear tablets

Composition: 20 grams of raw grass, 10 grams of flowers, 170 grams of perforated dragon.

Usage: the above three drugs crushed through a 100-mesh sieve, with 1% starch material, baked static dry with 1% magnesium stearate tablets, *** pressure 1000 tablets. Oral 3 times a day, each time 2 to 4 tablets.

Therapeutic effect: with the above **** treatment of this disease 9 cases, 5 cases of significant effect, 4 cases of improvement, the total effective rate of 100%.

5.7 Other measures

Avoid overwork, emotional fluctuations, prevention and treatment of various infections.