【摘要】 目的:通过专家共识法,初步讨论形成重症肌无力(痿证)中医证候分型,治则及方药,为重症肌无力中医临床实践指南的制修订提供了专家共识级别的推荐依据。方法:通过文献检索,纳入涉及中医证候、症状、治则、用药、针刺为主的文献,进行重症肌无力(痿证)证候分型分析,利用提及率筛选临床常用证候,最后经过长春中医药大学附属医院、北京中医药大学东方医院、广东省中医院、安徽中医学院附属医院等10家三甲医院,共12位专家,共同讨论初步确定了重症肌无力(痿证)中医证候分型、治则及方药。结果:确定了脾胃气虚证、脾肾两虚证、气阴两虚证、大气下陷证等5个证候分型,益气升阳、调补脾胃、温补脾肾、益气养阴、益气回阳升陷5个治则,以及补中益气汤加减、补中益气汤合右归丸加减、生脉散合补中益气汤、升陷汤加减等5个方剂。结论:专家共识法对重症肌无力中医证候筛选,体现了文献研究同临床实践及科学方法相结合的理念,更符合目前中医证候的研究思路。更多还原

【Abstract】 This study preliminarily discussed the TCM syndrome types of myasthenia gravis(or flaccidity) and its treatments and prescriptions through consensus method, providing evidence and level revision of the recommended expert consensus of myasthenia gravis in TCM clinical practice guideline. Literatures over TCM syndrome types, symptoms, therapeutic regime, medication and acupuncture were involved in the syndrome analysis of myasthenia gravis through literature retrieval. The common clinical syndromes were outputted by mentioned rate. Ten first-rate hospitals were finally included, such as The Affiliated Hospital of Changchun University of Traditional Chinese Medicine, Dongfang Hospital of Beijing University of Chinese Medicine, Guangdong Province Traditional Chinese Medical Hospital and Affiliated Hospital of Anhui University of Traditional Chinese Medicine. Twelve experts in aggregate were confirmed to participate in the discussion for the identification of the TCM syndrome types, treatments and prescriptions of myasthenia gravis. As a result, five TCM syndrome types, such as syndrome of spleen and stomach qi deficiency, syndrome of spleen-kidney deficiency, deficiency syndrome of both qi and yin, syndrome of deficiency and sinking of qi, were confirmed; while five therapeutic regimes were approved, including reinforcement of qi, tonification of spleen and stomach, tonification of spleen and kidney qi, tonification of qi and yin, the supplement of qi and restoration of yang for ascending qi collapse. In addition, five prescriptions were supported by the experts, such as Bu Zhong Yi Qi(BZYQ) decoction, BZYQ decoction combined with You Gui pills, BZYQ decoction combined with Sheng Mai powders and Sheng Xian decoction. In conclusion, the expert consensus method for the screen of TCM syndrome types of myasthenia gravis embodied the conception of literature research based on the clinical practice combined wKiethy wthoer dscsi:e ntific methods in conformity with the current research approaches to TCM syndrome types.Expert consensus, myasthenia gravis, traditional Chinese medicine, syndrome classification更多还原