中医药研究论丛

281.8针药并用治疗施打新冠疫苗後新发重症肌无力之病例报告

TJ TCM.28(1) : 103-114, 2025

DOI : 10.6516/TJTCM.202503_28(1).0008

针药并用治疗施打新冠疫苗後新发重症肌无力之病例报告

Acupuncture and Chinese Medicine Combined Treatment of New-Onset Myasthenia Gravis after Covid-19 Vaccination: A Case Report

林湘宛1,2张清贸1,3,4吴大鹏1,*

1台北荣民总医院传统医学部,台北,台湾

2中国医药大学学士後中医学系,台中,台湾

3国立阳明交通大学传统医药研究所,台北,台湾

4国立阳明交通大学医学系,台北,台湾

【摘要】

自新型冠状病毒疫情(Coronavirus disease-2019,COVID-19)爆发以来,新冠疫苗接种成为预防大流行之重要保护措施,然而施打疫苗仍有一定的风险及副作用,本病例为一位48岁男性患者,无过去相关病史,於2022年2月15日施打新冠疫苗两周後出现右眼复视、右上眼睑午後下垂无力、右眼转侧至左侧不利以及头晕等症状,经振兴医院诊断为重症肌无力(Myasthenia Gravis),但未服用任何相关治疗药物,於2022年8月23日前来台北荣民总医院传统医学部就诊。

经中医辨证诊断患者为肝郁脾虚、肝肾阴亏,给予针灸与中药合并治疗,治则以疏肝健脾、滋补肝肾为主,治疗一个月後,患者已未见复视症状,眼睑下垂、眼睛转动不利症状均有显着改善。疫苗後发生重症肌无力之病例相当罕见且机转至今尚未完全明了,因此提出本治疗有效之病例报告以供未来中医同道治疗经验之叁考。

【关键词】重症肌无力 ; 新冠疫苗 ; 针灸 ; 中药
【Summary】
Since the outbreak of coronavirus disease 2019 pandemic, vaccination has become a indispensable administration of protecting people. However, adverse events from vaccination might still be reported. Here we present a case of a 48-year-old male patient without history of autoimmune diseases, who suffered from right eye diplopia, ptosis (more severe in the evening), divergence insufficiency and dizziness 2 weeks after received his third shot of covid-19 vaccine on February 15, 2022. Later, he was diagnosis with myasthenia gravis at Cheng Hsin General Hospital but refused pharmacological therapy. Therefore, he came to Center for Traditional Medicine of Taipei Veterans General Hospital for treatment on August 23, 2022. After the evaluation of four diagnostic methods from Traditional Chinese Medicine, the patient was diagnosed with "stagnation of liver qi with spleen deficiency" and "liver yin and kidney yin deficiency"; therefore, treated with acupuncture and Chinese medicine combined treatment under the principle of "dispersing stagnated liver qi and strengthening spleen" and "nourishing liver and kidney". Myasthenia gravis related symptoms like diplopia disappeared, and other symptoms like ptosis and divergence insufficiency gradually improved after regular treatment and follow up by clinic for 1 month. New-onset myasthenia gravis after covid-19 happens rarely and its mechanism remains unknown. Hence, we share the experience of this effective clinical case study for the reference.
【Keywords】Myasthenia Gravis; Covid-19 vaccination; Acupuncture; Chinese Medicine