Abstract: OBJECTIVE: To investigate the effect of Jianpiyiqi granule, prepared according to a Traditional Chinese Medicine(TCM) formula, on the ocular type of myasthenia gravis(MG) caused by a defect in synaptic transmission at the neuromuscular junction.METHODS: A total of 155 children with ocular MG were recruited from January 2008 to January 2015.All individuals received ineffective glucocorticoid treatment prior to admission, and were given Jianpiyiqi granules(two doses per day) for 12 months.Plasma levels of acetylcholine receptor autoantibodies(ACh R-Ab), cytokines, immune parameters and clinical score were analyzed.RESULTS: After intervention with Jianpiyiqi granule for 12 months, the levels of cytokines [including interleukin(IL)-6, IL-12, IL-17], immune parameters[including immunoglobulin G(Ig G), Ig M, free triiodothyronine, free thyroxine] and ACh R-Ab were sig-nificantly decreased(P = 0.042, P = 0.049, P = 0.011,P = 0.02, P = 0.04, P = 0.03, P = 0.01; F = 21.60, P =0.000). In contrast, IL-4 levels were significantly increased(P = 0.049). The absolute clinical score after treatment declined significantly compared with before treatment(F = 33.24, P = 0.000). The effective cure rate and the total effective rate gradually increased to a maximum of 149(96.2%) and 151(97.4%) in MG patients after 12 months of treatment, respectively.CONCLUSION: The Jianpiyiqi granule treatment lowered ACh R-Ab levels and improved cytokine and other immune parameter levels, which suggests that the granule could be an ancillary treatment for ocular MG in children caused by a defect in synaptic transmission at the neuromuscular junction.

Key words: Myasthenia gravis, Receptors,cholinergic, Autoantibodies, Cytokines, Neuromuscular junction, Jianpiyiqi granule