The clinical study of Myasthenia Gravis

중증근무력증(重症筋無力症)에 대(對) 임상적(臨床的) 연구(硏究)

  • Chae, Byung-Yoon (Dept of oph. & otolaryngology, college of oriental medicine, Kyung Hee Univ.)
  • Published : 1996.04.30

Abstract

Generally the Myasthenia Gravis is classified into two of hereditary factor and acquement. Aquired Myasthenia Gravis was Quite well known to be caused by the autoimmune mechanism. Not in accurateness, on the hereditary, acetylcholine receptor antibody was to be analyzed very high in their parents and brothers. Also Myasthenia Gravis is a chronic disease characterized by voluntary muscle weakness and fatigue. above all, ocular Myasthenia Gravis is characterized clinically by blepharoptosis and external ophthalmoplegia and to be showed abut 90% cases and so oriental medicine can not but deal with myasthenia gravis at blepharoptosis. Accordinglv 20 out patients with Myasthenia Gravis were clinical study and observation as to the sex, age, progress state of MG, blood type, history, main symptom, liking for warm and cool food and tepidity, state of pulse, treatment of acupuncture and administration of oriental medicine etc. The results were as follows. 1. There was investigaed on the frequency of attack for sex, age, oculus dexter, oculus sinister, oculus uterque. Among the 20 patients, the number of female were 60% with 12 cases and male were 40% with 8 cases, therefore it was the rate of 6 : 4. the patients under 10 ages and 40 ages were 20% with 4 cases, 10 ages and 50 ages were 15% with 3 cases, 20, 30, 60 ages were 10% with 2 cases. And then oculus uterque was 90% with 18 cases, oculus sinister was 10% with 2 cases and oculus dexter were none of them. 2. Stage I were 50% with 10 patients, stage $II_A$ were 30% with 6 patients and stage $II_B$ were 20% with 4 patients, on the clinical stage and too class I were 20% with 4, class II were 45% with 9, class III were 35% with 7, in the functional activity the patients with chest heavy were 15% with 3 and hyperthyroidism were 10% with 2. 3. Hospital which patients had used to before came to this hospital were 10 university hospital and 6 local clinic. 4. The duration of disease was from 3 months to 30 years, the patients suffering between 3 months and within 1 year were 25% with 5 cases, 1-2 years were 30% with 6 cases, therefore within 2 years were 55%. 4-5 years were 15%, over 7 years were appeared less than 10%. 5. In the main symptom, all of patients were appeared to be heavy in opening their eyes the patients with blephroptosis were 70% with 14 cases on the oculus uterque, oculus sinisterf and oculus dexter, there were 20% with 4 eases each other in the oculogyation incomplete. visual failing, ophthalmoxerosis, strabismus etc and indigetion, frequency of urine(feel hurt), mild stools(or diarrea), oversensitiveness etc. but in addition, all of the other were 10%. 6. In the distribution of blood type, 0 types were 45% with 9 cases, A types were 25% with 5 cases, B and AB types were 15% each other. 7. For the rates of patients of liking for warm and cool food or tepidity, patients of liking for warm food possess 45% with 9 cases, and cool food possess 35% with 7 and tepidity possess 20% with 4, and then most of patients liking for warm food were females and cool food were much more males than females. 8. Hyunsae(弦細) were 40% with 8 cases, Buhurl(浮滑) were 20% with 4 cases, Hyunsak(弦數) were 15% with 3 cases, and in addition, the others were 10%, among 7 types of pulses. 9. The patients with less than 1 week were 40% with 8 cases, and there were female most of them and over 4 weeks were 20% and 1-2weeks were 15%, in the duration acupuncture treatment. 10. 15 kinds of prescriptions were administrated with oriental medicine from 1 week to 20weeks 1_2 weeks were 25.71% with 9 cases, 3 weeks were 17.14% with 6 cases and 6 weeks were 11.42% with 4 cases and also Gamibaetaugunbitang(加味培土健脾湯) were 28.57% with 10 cases, Gamijeounyongtang(加味正容湯) were 14.28% with 5 cases, Gamibojoongyigitung (加味補中益氣湯), Gamiyinsamyangyoungtung (加味人蔘養榮湯) were 8.57% with 3 cases each other and also Gamisamgitung (加味蔘?湯), Gamisamuloajatung(加味四物五子湯) Gamigoudungum (加味鉤藤飮), etc were applied.

Keywords

References

  1. 대한신경과학회지 v.10 no.1 중중근무력중에서의 전신 방사선 요법 4예 강성수(외)
  2. 대한안과학잡지 v.29 no.6 Total External Ophthalpmoplegia가 초래된 Severe Ocular Myasthenia 1예 김동민(외)
  3. 대한신경외과학회지 v.10 no.4 한국인의 중증근무력증 환자에서 HLA type의 빈도에 대한 연구 서대원(외)
  4. 대한신경과학회지 v.10 no.2 중증근무력증에서 임상병세에 따른 아세틸콜린 수용채 抗體 역가의 변화 이광우(외)
  5. 대한신경과학회지 v.11 no.2 중증근무력증의 유형별 반복신경자극검사의 진단적 감수성 비교 이상암(외)
  6. 대한신경과학회지 v.10 중증근무력증에서 혈철 Anti-acetylcholine Receptor Antibody 역가와 임상양상과의 관계 조용원(외)
  7. 대한신경과학회지 v.10 no.4 중증근무력증 환자에서 Tensilon 주사 후 저율자극에 대한 반응연구 황선출(외)
  8. 最新診斷과 治療 金東輝(外)
  9. 眼科學 尹源植
  10. 內科學 李文鎬(外)
  11. 眼耳鼻咽喉科學 蔡炳允
  12. 醫學綱目 樓英
  13. 中醫眼科學 廖品正(外)
  14. 中醫眼科臨床實踐 龐贊襄
  15. 五官科學 上海中醫學院(編)
  16. 中醫眼科學 成都中醫學院(編)
  17. 巢氏諸病源後論 巢元方
  18. 眼科鍼灸治療學 會慶華(外)
  19. 證治準繩 王肯堂
  20. 張氏醫通 張璐玉
  21. Science v.186 Serum globulin in myasthenia gravis : Unbibition of a-bungarotoxin binding in acetylcholine receptors Almon, R.R.;Anderew, C.G.;Apple, S.M.
  22. Textbook of Medicine Cecil-loeb
  23. Arch. Ophthal. v.74 Myasthenia Gravis Cogan, D.G.
  24. Brain v.103 Clinical pathological HLA antigen and immunological evidence for disease hetrogeneity in myasthenia Compston, D.A.S.;Vincet, A.;Newsom-Davis, J.(et al.)
  25. Neurology v.30 Antibodies in acetycholine receptor in patients with thymoma but without myasthenia gravis Cuenoud, S.;Feltkamp, T.E.W.;Fulpius, B.W.;Oosterbuis, H.J.G.H.
  26. Ann NY Acad Sci v.274 The result to be expected from electrical testing in the diagnosis of myasthenia gravis Demir, C.;Young, R.R.
  27. New Engl. J Med. v.307 Functional activities of autoantibodies to acetiycholinereactors and the clinical severity of myasthenia gravis Drachman, D.B.;Adams, R.N.;Josifek, L.F.(et al.)
  28. Amer. J. Med v.19 Present Status of Thymectomy in Treatment of Myasthenia Gravis Eaton, L.M.;Clagett, O.T.
  29. Mayo Clinic Proceedings v.52 Immunecomplexes(IgG and C3) at the motor endplate in myasthenia gravis. Ultrastructural and light microscopic localization and electrophy siologic correlation Engel, A.G.;Lambert, E.H.;Howard, F.M.
  30. Ann Neurol v.16 Myasthenia gravis and myasthenic syndromes Engel, A.G.
  31. AnN NY Acad Sci v.183 Histometric analysis of the ultrastructure of the neuromuscular junction in myasthenia gravis and in the myasthenic syndrom Engel, A.G.;Santa, T.
  32. Brit. Med. J. v.1 Myasthenia Gravis Garland, H.;Clark, A.N.G.
  33. Neurology v.26 Electrophysiologic diagnosis of myasthenia gravis and the regional curare test Horowitz, S.H.;Genkins, G.;Kornfeld, P.;Papatestas, A.
  34. Historical aspects of the neurosciences Uber Myasthenia gravis pseudoparalytica. Berliner Klinische Wochenschrift Jolly, F.;Clifford, R.F(ed.);Bynum, W.F.(ed.)
  35. Arch Neurology v.39 Acetylcholine receptor antibody titer and HLA_b8 antigen in myasthenia gavis Kessey, J.;Naiem, F.;Lindstrom, J.(et al.)
  36. Int. Sym. Proc. Current status of the epidemiology and genetics of myasthenia gravis Kurland, L.T.;Alter, M.
  37. Immunologic mechanisms in myasthemia gravis-a model of a receptor disease : Clinical Immunology update-Reviews for physicians Lennon, V.A.
  38. Clin Immunol Immunopathol v.7 Anassay for antibodies to human acetylchoine receptor in serum from patients with myasthenia gravis Lindstrom, J.
  39. Muscle and Nerve v.1 Specificities of antibodies to acetylcholine receptors Lindstrom, J.;Campbell, M.;Nave, B.
  40. Neurology v.33 In vitro synthesis of antibodies to acetylcholine receptor by peripheral blood mononuclear cells of patients with myasthenia gravis Lisak, R.P.;Laramore, C.;Zweiman, B.;Moskovife, A.
  41. Amer. J. Med. v.50 Possible causative Factors in myasthenia gravis : Effects of Thymeotomy Matsuda, K.;Bauer, W.C.;Blumberg, J.M.
  42. New Engl J of Med v.294 Detetion of anti-acetylcholine receptor factors in serum and thymus from patients with myasthenia gravis Mittag, T.;Kornfeld, P.;Tormt, A.(et al.)
  43. Proc Soc Exp Biol Med v.105 Changes in serum complement activity in patients with myasthenia gravis Nastuk, W.L.;Plescia, O.J.;Osserman, K.E.
  44. Disease of the nervous system : Clinical neurobiology Newosom-Davis, J.
  45. Neurology v.30 Myasthenia gravis. Antibodies to acetycholine receptor with human and rat antigens Oda, K.;Gotol, Kuroiwa Y.;Onoue, K.;Ito, Y.
  46. Ann NY Acad Sci v.135 Clinical reappraisal of the use of edrophonium dichloride of (Tensilon) test in myasthenia gravis and significance of clinical classification Osserman, K.E.;Genkins, G.
  47. Ann NY Acad Sci v.274 The result to be expected from electrical testing in the diagnosis of myasthenia gravis Ozdemir, C.;Young, R.R.
  48. Myasthenia gravis : Merrit's Textbook of Neurology Penn, A.S.;Rowland, L.P.(ed.)
  49. J of neurol neursourg psychiatry v.39 Genetic associations between myasthenia gravis and HLA system Pirskanen, R.
  50. J. Nerv. Ment. Dis. v.39 Myasthenia Gravis Starr, M.A.
  51. Clinical Neuroophthalmology Waslh, F.B.;Hoyt, W.F.
  52. Brain v.81 An evaluation of thymectomy in myasthenia gravis Simpson, J.A.
  53. Scott Med J v.5 Myasthenia gravis : a new hypothesis Simpson, J.A.
  54. Clinical Neuroophthalmology Walsh, F.B.;Hoty, W.F.
  55. Myasthenia Gravis. A Clinical study With Special Reference to Prevalence and Prognosis Storm-Methisen, A.
  56. New Engl of J Med v.296 Myasthenia gravis. Study of humoral immune mechanusms by passive transfer to mice Tokya, K.V.;Drachman, D.B.;Griffin, D.E.
  57. JAMA v.153 A Historical review of myasthenia gravis from 1672 to 1900 Viets, H.R.
  58. Lancet Absence of anti-ace-tylcholine receptor antibodies in congenital myasthenia gravis Vincet, A.;Newsom-Davis, J.
  59. J Neurol Neurosurg Psychiatry v.48 Acetycholine receptor antibody as a diagnostic test for myasthenia gravis : Results in 153 valdated cases and 2967 diagnostic assays Vincet, A.;Newsom-Davis, N.
  60. J neurol Neurosurg Psychiatry v.43 Anti-acetylcholine receptor antibodies Vincent, A.;Newsom-Davis, N.
  61. Neurology v.33 Acetylcholine receptor antibody and clinical response to thymectomy in myasthenia gravis Vincent, A.;Newsom-Davis, N.;Newton, P.;Beck, N.
  62. Historical aspects of the neurosciences Willis, T.
  63. De anima brutorum : History of myasthenia gravis Aarli, A.;Clifford, R.F.(ed.);Bynum, W.F.(ed.)
  64. J Neurol Sci v.32 HLA antigens and myasthenia gravis in Japan Yoshida, T.;Tsuchiya, M.;Ono, A.(et al.)