| 中文摘要 |
背景：重症肌無力的患者若未具有乙醯膽鹼接受器抗體通常被認為為血清陰性型之重症肌無力。患者因西藥副作用所產生的不適而尋求中醫藥的協助。臨床表現及治療結果：一位57歲女性因於一個半月前同事突然發現她右側眼皮下垂而至西醫神經肌肉科就診，經檢驗及檢查後診斷為血清陰性型重症肌無力。但患者服用西藥（pyridostigmine）後出現頭暈、口乾、汗出等副作用，因此尋求中醫治療。經過以補中益氣湯為主方加減治療後，患者眼瞼下垂開始逐漸改善。在效不更方的情況下，每次依患者之臨床症狀略作加減治療。在經過五個星期治療後，患者眼瞼已無明顯下垂，在誘發試驗下（provocation test），患者眼瞼雙眼均未出現下垂現象。結論：重症肌無力一症患者可能因服西藥的副作用轉而尋求中醫藥的幫助。在中醫辨證施治的思路下，並配合現代醫學對疾病的認識，對患者臨床疾病改善可以有良好的療效。中醫藥在輔助醫學及臨床症狀治療上，值得深入研究及發展。objective: The patients with myasthenia gravis (MG) who do not have acetylcholine receptor (AChR) antibodies are considered as seronegative type. There are some side effects associated with the treatment who could not tolerate for the patients with MG. This report presented a patient with seronegative finding looking for Chinese medical treatment due to serious side effect of western medical treatment. Clinical feature, intervention and outcome: A 57-year-old female went to neurologic clinic due to right eyelid dropping one and half months ago. She was diagnosed seronegative myasthenia gravis after examination and inspection. However, the patient suffered from dizziness, dry mouth, and sweating after medication with pyridostigmine. She looked for Chinese medical treatment with Bo-jung-i-kki-Tang for five weeks. Gradually, she improved eyelid dropping with the negative finding of provocation test later. Conclusion: In this report, we demonstrated that the patient with myasthenia gravis improved under Chinese medical treatment based on the theory of Traditional Chinese Medicine (TCM) along with modern medical technology. Long-term follow-up and further experimental studies could be helpful to realize the efficacy of TCM for myasthenia gravis. |
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