The Therapeutic Evaluation About The Reinforcing Spleen And Kidney Theory Used In The Treatment Of Myasthenia Gravis

Purpose: This research emphasized the use of the "The Reinforcing Kidney and Spleen" theory,one of the sub-theory of "The theory of Correlation of five Viscera" . Compared with traditional theory, via the use of the herbs which reinforce spleen and kidney expected the "The Reinforcing Kidney and Spleen" theory used in the treatment of MG disease has a batter efficacy .And multiple observation index were used in this work, especially the use of the QOL scale was introduced to evaluation the effect of the TCM treatment in the MG disease, we expect this would solve the defect of the therapeutic evaluation system of the TCM.Method:This research is a prospective study. Choose 60 patients which confirmed diagnosis were Myasthenia Gravis, combined with 40 patients whose type were spleen and stomach qi deficiency and 20 patients whose type were deficiency of spleen and kidney, and the group of spleen and stomach qi deficiency randomly divided into two groups, respectively given Buzhongyiqi Tang and Bupiyishen Tang, the group of deficiency of spleen and kidney given Bupiyishen Tang. We observe the symptom of the patients and fill the scales before the treatment, after 4 weeks treatments and after 8 weeks treatment. The observation index includes quantitative MG (QMG) score published by myasthenia gravis foundation of America (MGFA),SF-36 scale and MG-PRO scale. The collected data will process scientific statistical analysis at last.Result:All 60 patients finish the whole course of the treatment. After 4 weeks therapy, the group of spleen and stomach qi deficiency given Bupiyishen Tang compared with the group of spleen and stomach qi deficiency given Buzhongyiqi Tang has a significant improvement in the QMG scoring, the PF, RP, GH and VT domains of the SF-36 scale, the physiology and social psychotherapy domains of the MP-PRO scale, which mainly reflected the physical symptoms and the social adaptability of the MG patients, but the index which reflected the psychological symptoms of the MG patients have no statistical difference. After 8 weeks therapy, compared with 4 weeks ago, the result was similar, that mainly reflected the physical symptoms and the social adaptability of the MG patients, but the index which reflected the psychological symptoms of the MG patients have no statistical difference. No matter after 4 weeks or 8 weeks, he group of spleen and stomach qi deficiency given Bupiyishen Tang compared with the the group of deficiency of spleen and kidney given Bupiyishen Tang have a similar result. The QMG scoring form was efficient to reflect the body symptoms changes no matter 4 or 8 weeks treatment. The PF, RP, GH, VT and RE domains of the SF-36 scale could reflect the changes of QOL of the patients after the course of the therapy, but the BP, SF and MH domains had no significant differences. The physiology, social psychotherapy and psychology domains of the MP-PRO scale could reflect the changes of QOL of the patients after the course of the therapy, but the drug domains had no significant differences.Conclusion: In use of the theory of "Correlation of five Viscera" , emphasizing the use of the herbs which reinforce spleen and kidney in the treatment of MG disease, compare with the traditional method, have significant efficacy advantage. In use of objective symptoms scoring form and QOL scale as a brandnew therapeutic efficacy observation index, compared the treatment efficacy from symptons and QOL aspect, the three scales used in this research both reflect the treatment efficacy and have advantage reflecting the effect of TCM.