Summary of medical history,　Patient Zhang,female, 47 years old, was admitted to our department on June 16, 2023, with the chief complaint of "progressive weakness in all four limbs for over 4 years, aggravated with shortness of breath for the past two weeks." Present illness history: Over 4 years ago, the patient experienced progressive weakness in all four limbs without an apparent trigger. She was unable to stand or walk, and her symptoms were worse in the morning and exacerbated by activity and exertion. There were no accompanying symptoms such as drooping of the eyelids or muscle atrophy. She was diagnosed with "myasthenia gravis" at Zhongshan People's Hospital and had been receiving long-term outpatient follow-up and treatment, with a stable condition. In March 2022, her symptoms worsened, accompanied by drooping of the eyelids and double vision, but she showed improvement after treatment in our department and was discharged. Two weeks ago, her symptoms worsened again, accompanied by shortness of breath, and she required endotracheal intubation and mechanical ventilation assistance at Zhongshan People's Hospital. She received intravenous immunoglobulin and steroid pulse therapy, but there was no significant improvement in her symptoms, leading to her transfer to our hospital. Past medical history: Rheumatoid arthritis for over 20 years, long-term use of methylprednisolone and methotrexate. In March 2022, she was admitted to our department due to worsening myasthenia gravis, and after discharge, her oral dose of methylprednisolone was gradually reduced to 16 mg once daily and pyridostigmine bromide tablets 60 mg four times daily.,TCM diagnosis,　1.Impotence syndrome, deficiency of qi in the spleen and stomach, internal accumulation of phlegm-dampness; 2.syndrome of collapse, syndrome pattern of Qi deficiency with Yin and Yang about to collapse.,Western medicine diagnosis,　1.Myasthenic crisis; 2.Pneumonia; 3.Rheumatoid arthritis.,Therapeutic methods,　Western medicine treatment includes plasma therapy, hormonal shock therapy after treatment, anti-infection, and symptomatic treatment. Traditional Chinese medicine treatment focuses on reinforcing the spleen and invigorating qi, later adjusting to tonify qi and support yang, strengthen yin and stop sweating, and in the later stage, replenishing deficiencies, dispelling pathogenic factors, and preventing relapse.,Clinical outcomes,　Clinical symptoms and imaging examination have improved.