What to do with myasthenia gravis, what to do with myasthenia gravis?

There are several methods of myasthenia gravis: first, drugs, which can use the cholinesterase inhibitor pyridostigmine bromide to improve symptoms, and use adrenocorticosteroids to suppress autoimmune responses, which can be used for various types of myasthenia gravis, and achieve the best effect by inhibiting the production of acetylcholine receptor antibodies; Immunosuppressants may also be used in patients who are inadequate, intolerant, or ineffective with adrenocorticosteroids. Second, thymus**, mainly used for patients with thymic tumors, thymic hyperplasia, and drug difficulties.

Third, plasma exchange, the first fast onset, good short-term efficacy, but not lasting, the effect is maintained for one to two months, and then with the gradual increase in antibody levels and symptoms recur, fourth, intravenous immunoglobulin, can make the binding function of acetylcholine receptor antibodies disordered and interfere with the immune response, to achieve the best effect, because the effect of immunoglobulin is good and not obvious, so it is currently widely used in myasthenia gravis.

Myasthenia gravis, myasthenia gravis is simply a chronic disease, an autoimmune disease, which produces antibodies, mistakenly believes that the acetylcholine receptors in their bodies are foreign invaders, destroys the receptors' ability to accept acetylcholine, makes the number of receptors insufficient, and the betacholine cannot function normally, resulting in weak muscle contraction. When the respiratory system is affected, a crisis of myasthenia gravis occurs. There are usually ophthalmosis types, such as simple ophthalmosis and generalized types, and the generalized type has ptosis, pupil covering, and a positive fatigue test.

More than 10% of people have tumors in the thymus, most of which are benign, and some people think that it is the immune center, and after surgical resection, they can receive good clinical results. Patients often have muscle weakness, swallowing weakness, weak and weak eyes with open and closed eyes, light in the morning and heavy in the afternoon, relieved after rest, including the movement of the muscles of the limbs, doing physical work is very difficult, gradually worsening, and finally affecting breathing and causing a crisis.

Myasthenia gravis is a series of complex diseases, due to the obstruction of nerve and muscle conduction pathways, patients show a series of related symptoms, relatively mild may have ptosis or blurred vision, which is called ocular deformity. In addition to ocular deformities, there are systemic ones that are more severe, and patients may have weakness in chewing, difficulty swallowing, and some patients may have dysarthria, that is, slurred speech and weakness in arthria. In more severe cases, there will be weakness in the limbs, lack of strength in the whole body, and in more serious cases, there may be weakness in breathing, chest tightness, wheezing and other related symptoms.

Generally, after myasthenia gravis occurs, the cause is first figured out, and most of them can be taken after the diagnosis of myasthenia gravis. After the use of neostigmine, it is called pyridostigmine bromide, and after using this drug, the symptoms can be gradually relieved. In addition to taking medications, surgery**, enlarged removal of the thymus, and myasthenia gravis can also be considered.

[**Policy].

Medications** and surgeries** are used as appropriate. Patients with thymic abnormalities should undergo thymectomy to effectively improve their symptoms.

Medications**] 1.Cholinesterase inhibitors are symptomatic drugs that should be given in small doses. Commonly used are neostigmine methyl sulfate and pyridostigmine bromide.

2.Immunosuppressants Commonly used immunosuppressants are: Adrenocorticosteroid hormones

prednisone, methylprednisolone, etc.; azathioprine; Circumferin A; cyclophosphosamine; Tacrolimus. 3.Plasmapheresis temporarily relieves the symptoms of patients with myasthenia gravis by removing acetylcholine receptor antibodies from the patient's blood, and the effect does not exceed 2 months if it is not supplemented by other ** methods.

4.Intravenous immunoglobulin Human immunoglobulin contains a variety of antibodies that neutralize autoantibodies and modulate immune function. Its effect is comparable to that of plasmapheresis.

5.Traditional Chinese Medicine** According to the theory of traditional Chinese medicine, adding traditional Chinese medicine to ** can reduce the *** caused by immunosuppressants, and can rebuild the efficacy of autoimmune function.

More than 90% of patients have thymus abnormalities, and thymectomy is one of the effective means of myasthenia gravis. It is indicated for patients with generalized myasthenia gravis with no contraindications to surgery and presents between the ages of 16 and 60 years, and most patients achieve significant improvement after thymectomy. Patients with thymoma account for 10% to 15% of patients and is an absolute indication for thymectomy.

Prognosis] A small number of patients can be completely relieved after **, most patients can be maintained with drugs to improve symptoms, and the vast majority of patients with good efficacy can carry out normal study, work and life.

It is recommended to use traditional Chinese medicine**, do not delay.

Patients with myasthenia gravis should pay more attention to their diet, in fact, there are many foods that patients can eat, which have a good warming effect on the body. Commonly used tonic foods: meat:

beef, pork, dog, rabbit, chicken, etc.; Fish, eggs, and milk are all important foods in the daily diet of patients with myasthenia gravis.

Myasthenia gravis (MG) is an autoimmune disease caused by dysfunction of transmission at the neuromuscular junction, which is clinically manifested as partial or systemic skeletal muscle weakness and fatigue, which worsens after activity and is relieved by rest. The prevalence is 77,150,100,000, with an annual incidence of 4,111,100 million. The prevalence is greater in women than in men, about 3:

2. It occurs in all ages, and children are mostly 1 to 5 years old.

Patients with myasthenia gravis often feel soreness and discomfort in the eyes or limbs, or blurred vision, fatigue easily, and fatigue worsens in hot weather or menstrual cramps. As the disease progresses, skeletal muscles become significantly fatigued and weak, which is characterized by muscle weakness that worsens after exertion in the afternoon or evening and decreases after getting up or resting, a phenomenon called "morning light and twilight heaviness".

Patients with myasthenia gravis can have systemic skeletal muscle involvement and may have the following symptoms:

1) Dropy eyelids, blurred vision, diplopia, strabismus, and inflexible eye movement.

2) Indifferent expression, wry smile, large tongue, difficulty in arthria, often accompanied by nasal voice.

3) Weakness in chewing, choking on drinking water, and difficulty swallowing.

4) Weak neck, difficulty in raising the head, weakness in turning the neck and shrugging the shoulders.

5) Difficulty in raising arms, combing hair, going up stairs, squatting, and getting on the bus.

Traditional Chinese medicine can ** myasthenia gravis, and the clinical effect is significant and can improve the symptoms of fatigue and fatigue. Traditional Chinese medicine believes that myasthenia gravis is mostly caused by a deficiency of the spleen qi. Because of the main muscles and limbs of the spleen, if the spleen is deficient, the source of qi and blood biochemistry is lacking, the skin is not nourished, and it will lead to impotence and waste over time.

Traditional Chinese medicine** mostly takes tonifying the middle and invigorating qi, strengthening the spleen and improving the clearing as the main treatment methods.

Don't panic if you have myasthenia gravis, be positive, as long as you choose the right method, the disease has the possibility of being active, and you don't want to find the question of how long you live. Of course, the scientific and effective method is the key, and at present, the best method for this disease is stem cell transplantation.

Myasthenia gravis** There are two groups of people who are prone to myasthenia gravis, such as those aged 20-40 and those around 60 years old after the age of 40. Specifically, it is divided into the following articles:

1. In the stage of young women, the immune system is relatively active, so they are prone to myasthenia gravis. Myotis gravis is divided into many types, such as eye muscle type that is simple eyelid drooping, limb type that is, limb weakness, severe cases of respiratory involvement that lead to respiratory muscle weakness, at this time the patient needs to be put on a ventilator. When such patients arrive at the hospital, they are seen for thymic lesions.

If there is thymic lesions, such as thymic hyperplasia or thymoma in young women, surgery is performed first, and after the thymus immune organ is removed, the drug is adjusted according to the eye muscle type or systemic type;

2. Middle-aged and elderly people with muscle weakness should be seen whether it is paraneoplastic syndrome or tumor causing myasthenia gravis. First of all, tumor-related screening is required to rule out the cause of the tumor, and then see if it is a thymic lesion such as thymoma. In the case of thymoma, the thymoma should be operated on first**, and then according to the type of thymus pathology and the patient's muscle weakness type, the appropriate immunosuppressant will be selected for symptoms**.

Common** myasthenia gravis drugs such as pyridostigmine bromide, commonly used immune preparations such as tacrolimus, and some monoclonal antibodies such as rituximab, cyclosporine, cyclophosphamide and other immunosuppressants. However, these drugs need to be selected by doctors according to the patient's condition and individualized**.

After myasthenia gravis is diagnosed, cholinesterase inhibitors are first given, and autoimmune responses can be suppressed with hormones, and patients who meet the indications can be surgically removed from the thymus or thymus radiation**.

Drugs**. 1.Cholinesterase inhibitors: pyridostigmine bromide, mainly to improve symptoms.

2.Adrenocorticotropic hormones: methylprednisolone, prednisone, dexamethasone, etc.

It can suppress the autoimmune response and is suitable for various types of myasthenia gravis. It mainly inhibits the production of ACHR antibodies to achieve the best effect. Of particular note, some patients may experience exacerbations and even myasthenic crises in the short term after high-dose corticosteroid shocks**.

Therefore, those who take high doses of hormones** must be hospitalized and prepared for rescue. Oral prednisone should be taken in the morning, and high-dose and long-term use of corticosteroids can induce diabetes, necrosis of the femoral head, bleeding gastric ulcer, severe secondary infection, Cushing's syndrome, etc. Patients and their families should be informed of these conditions for understanding and consent before taking hormones**.

3.Immunosuppressants: azathioprine, cyclophosphamide, suitable for adrenocorticosteroids can not be used, intolerant or have poor efficacy.

Although immunosuppressants have a certain amount of ***, the dosage is small, and in most cases*** is rare. If there is a decrease in blood leukocytes or thrombocytopenia, hair loss, gastrointestinal reactions, hemorrhagic cystitis, etc., the drug should be discontinued, and changes in liver and kidney function should be noted.

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Surgery**. Surgical removal of the thymus removes the initiating antigen from the autoimmune response in patients with myasthenia gravis. Indications are patients with thymic hypertrophy and high ACHR antibody titer, patients with various types of myasthenia gravis with thymoma, young female systemic patients, and those who are not satisfied with the response to anticholinesterase inhibitors**. Contraindications are in patients with myasthenic crisis.