顾锡镇治疗重症肌无力经验总结

Gu Xizhen's experiences in the treatment of myasthenia gravis

重症肌无力(MG)是由体液免疫、细胞免疫、补体系统介导的一种自身免疫疾病,主要影响神经-肌肉接头的传递。表现为肌肉的波动性疲劳,活动后加重,休息后缓解,晨轻暮重,其发病有逐年增加的趋势。目前西医治疗主要以胆碱酯酶抑制剂、免疫抑制剂、肾上腺皮质激素等为主。常出现耐药,病情加重,严重的副反应等情况。中医药治疗MG疗效显著,具有独特的优势。顾锡镇主任对MG的中医治疗有着独到的见解,并取得了较好的临床效果。顾锡镇教授认为本病是由于先天不足,后天失养,肝、脾、肾不足所致,故治疗宜补脾益气,补益肝肾等,并从脾胃虚弱型、肝肾亏虚型、肾阳不足型、脾虚夹湿型等证型辨证论治,以补中益气汤为主,配以六味地黄丸、右归丸、参苓白术散等,同时兼顾疏肝理气,解毒消瘤,固护正气,利水消肿等。并对患者进行避风寒,调饮食,畅情志,慎起居等指导,对改善症状,延缓病情进展,减少复发以及西药不良反应有重要意义。

Myasthenia gravis(MG)is an autoimmune disease mediated by humoral immunity,cell immunity and complement system,which mainly affects the transmission of neuromuscular connectors.MG is manifested as the volatility fatigue of muscle,aggravated on exertion and alleviated on rest.It is mild in the morning and is getting worse in the evening.MG is in the tendency of getting worse by years.At present,Western medicine provides cholinesterase inhibitors,immunosuppressants and adrenocortical hormones in treatment,but these drugs lead to drug resistance and the aggravation of disease,as well as severe side effects.Chinese medicine has the unique advantages and significant effects on MG.Gu Xizhen,the chief physician has unique understanding on the treatment of MG with TCM.The satisfactory effects have been achieved.Prof.Gu Xizhen believes that MG is caused by the insufficiency of congenital foundation,malnutrition of the acquired qi and the insufficiency of liver,spleen and kidney.The treatment focuses on tonifying spleen qi,liver and kidney on base of the syndrome differentiations,such as spleen and stomach weakness,liver and kidney deficiency,kidney yang deficiency and mixture of spleen deficiency and dampness.Buzhong yiqi tang is the basic formula,combined with liuwei dihuang wan,yougui wan,shenling baizu san,etc.Additionally,regulating liver qi,detoxification,consolidating antipathogenic qi and promoting water metabolism for edema are considered.Besides medication,the patients are advised to avoid wind cold,regulate diet,keep good mood and have a healthy living style.The combined therapeutic methods are significantly important for relieving the symptoms,retarding the progress of sickness,reducing the recurrence and the side effects of western medicines.