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Xi-qian Yang [1] and Ling Liu [2; 3] and Wen-yu Yang [4] and Huan-huan Dong [3] and Yi-ran Yang [1] and Yun Li [3]

Academic Editor: Gioacchino Calapai

1, The TCM Clinical Institute, Hubei University of Chinese Medicine, Hubei 430065, China, hbtcm.edu.cn

2, The First Clinical Institute, Hubei University of Chinese Medicine, Hubei 430065, China, hbtcm.edu.cn

3, Encephalopathy Department, Hubei Provincial Hospital of TCM, Hubei 430061, China, hbhtcm.com

4, The Second Clinical Medical College, Wenzhou Medical University, Zhejiang 325000, China, wmu.edu.cn

Received Feb 12, 2017; Accepted Jul 27, 2017

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

1. Introduction

Myasthenia gravis (MG) is a chronic autoimmune disorder of the neuromuscular junction of the skeletal muscle that is characterized by fluctuating pronounced ocular, limb muscle, or bulbar weakness [1]. MG is a global public health problem due to its increasing incidence [2]. The reported incidence of MG has markedly varied across epidemiological studies, and the pooled annual incidence of MG was calculated to be 5.3 per million persons based on 55 population-based epidemiological studies [3]. Notably, MG diagnosis is associated with increased risk of mortality [4, 5].

Current therapeutic strategies mainly include acetylcholinesterase inhibitors, immunosuppressive agents, and thymectomy [6]. Pyridostigmine is recommended as a first-line anticholinesterase inhibitor for acute exacerbations [7]. Long-term corticosteroids and azathioprine still remain the first choice for patients with severe or refractory disease [8]. Conventional treatment can effectively control symptoms in most patients. Unfortunately, a small proportion of cases still have poor disease control or require high-dose immunosuppressive agents [9, 10]. In addition, adverse effects induced by long-term use of steroids or other immunosuppressive agents remain an important concern [11]. Therefore, alternative therapies with better efficacy and fewer side effects are urgently needed.

MG is generally diagnosed as “flaccidity syndrome” in Traditional Chinese Medicine (TCM). According to the TCM theory, the syndrome is thought to be caused by Qi-deficiency [35]. Treatment with Qi-supplementing Formula in combination with the conventional Western medicine (WM) has achieved promising clinical effects in terms of better clinical efficacy and fewer adverse effects [36, 37]. However, the strength of this conclusion is limited by the small...
  

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