中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
34期
29-31
,共3页
面部单侧痉挛%肉毒毒素类%巴氯芬
麵部單側痙攣%肉毒毒素類%巴氯芬
면부단측경련%육독독소류%파록분
Hemifacial spasm%Botulinum toxins%Baclofen
目的 比较局部注射A型肉毒毒素(BTXA)与口服巴氯芬治疗偏侧面肌痉挛(HFS)的效果.方法 将2010年7月至2012年6月确诊HFS患者66例按随机数字表法分为BTXA治疗组和巴氯芬治疗组,对BTXA治疗组33例患者进行局部多点靶肌注射BTXA治疗,对巴氯芬治疗组33例患者给予口服巴氯芬治疗,采用Cohen痉挛分级评分法,分别在治疗前、治疗2周、治疗4周对两组患者进行痉挛程度评分.结果 两组治疗前痉挛程度评分比较差异无统计学意义(P＞0.05)；两组治疗2、4周时痉挛程度评分均较治疗前明显缓解[BTXA治疗组:(1.80±0.70)、(1.57±0.17)分比(3.15±0.43)分；巴氯芬治疗组:(2.14±0.60)、(1.14±0.70)分比(3.00±0.48)分],差异有统计学意义(P＜0.01)；巴氯芬治疗组治疗2、4周时痉挛程度评分均较BTXA治疗组改善明显,差异有统计学意义(P＜ 0.05或＜0.01)；治疗4周时两组痉挛缓解程度等级比较差异有统计学意义(P＜0.05).BTXA治疗组不良反应发生率为15.15％(5/33),巴氯芬治疗组不良反应发生率为51.52％(17/33),两组比较差异有统计学意义(P＜0.01).结论 局部注射BTXA与口服小剂量巴氯芬治疗HFS均可达到明显缓解,但BTXA治疗症状改善达峰时间较巴氯芬治疗短,且痉挛改善更完全,不良反应较少,患者依从性高,可作为HFS治疗首选方法.
目的 比較跼部註射A型肉毒毒素(BTXA)與口服巴氯芬治療偏側麵肌痙攣(HFS)的效果.方法 將2010年7月至2012年6月確診HFS患者66例按隨機數字錶法分為BTXA治療組和巴氯芬治療組,對BTXA治療組33例患者進行跼部多點靶肌註射BTXA治療,對巴氯芬治療組33例患者給予口服巴氯芬治療,採用Cohen痙攣分級評分法,分彆在治療前、治療2週、治療4週對兩組患者進行痙攣程度評分.結果 兩組治療前痙攣程度評分比較差異無統計學意義(P＞0.05)；兩組治療2、4週時痙攣程度評分均較治療前明顯緩解[BTXA治療組:(1.80±0.70)、(1.57±0.17)分比(3.15±0.43)分；巴氯芬治療組:(2.14±0.60)、(1.14±0.70)分比(3.00±0.48)分],差異有統計學意義(P＜0.01)；巴氯芬治療組治療2、4週時痙攣程度評分均較BTXA治療組改善明顯,差異有統計學意義(P＜ 0.05或＜0.01)；治療4週時兩組痙攣緩解程度等級比較差異有統計學意義(P＜0.05).BTXA治療組不良反應髮生率為15.15％(5/33),巴氯芬治療組不良反應髮生率為51.52％(17/33),兩組比較差異有統計學意義(P＜0.01).結論 跼部註射BTXA與口服小劑量巴氯芬治療HFS均可達到明顯緩解,但BTXA治療癥狀改善達峰時間較巴氯芬治療短,且痙攣改善更完全,不良反應較少,患者依從性高,可作為HFS治療首選方法.
목적 비교국부주사A형육독독소(BTXA)여구복파록분치료편측면기경련(HFS)적효과.방법 장2010년7월지2012년6월학진HFS환자66례안수궤수자표법분위BTXA치료조화파록분치료조,대BTXA치료조33례환자진행국부다점파기주사BTXA치료,대파록분치료조33례환자급여구복파록분치료,채용Cohen경련분급평분법,분별재치료전、치료2주、치료4주대량조환자진행경련정도평분.결과 량조치료전경련정도평분비교차이무통계학의의(P＞0.05)；량조치료2、4주시경련정도평분균교치료전명현완해[BTXA치료조:(1.80±0.70)、(1.57±0.17)분비(3.15±0.43)분；파록분치료조:(2.14±0.60)、(1.14±0.70)분비(3.00±0.48)분],차이유통계학의의(P＜0.01)；파록분치료조치료2、4주시경련정도평분균교BTXA치료조개선명현,차이유통계학의의(P＜ 0.05혹＜0.01)；치료4주시량조경련완해정도등급비교차이유통계학의의(P＜0.05).BTXA치료조불량반응발생솔위15.15％(5/33),파록분치료조불량반응발생솔위51.52％(17/33),량조비교차이유통계학의의(P＜0.01).결론 국부주사BTXA여구복소제량파록분치료HFS균가체도명현완해,단BTXA치료증상개선체봉시간교파록분치료단,차경련개선경완전,불량반응교소,환자의종성고,가작위HFS치료수선방법.
Objective To compare the therapeutic effect of local injection of botulinum toxin A (BTXA) and oral baclofen in hemifacial spasm (HFS).Methods Sixty-six patients with HFS were divided into BTXA treatment group (33 patients) and baclofen treatment group (33 patients) by random digits table.The patients in BTXA treatment group was given local multipoint target muscle injection of BTXA,and the patients in baclofen treatment group was given oral baclofen.The therapeutic effect was assessed after treatment of 2 weeks and 4 weeks.Results The scores of spasticity before treatment had no significant difference between two groups (P ＞ 0.05).After treatment of 2 weeks and 4 weeks,the scores of spasticity in BTXA treatment group and baclofen treatment group were significantly decreased [BTXA treatment group:(1.80 ±0.70),(1.57 ± 0.17) scores vs.(3.15 ±0.43) scores;baclofen treatment group:(2.14 ±0.60),(1.14 ± 0.70) scores vs.(3.00 ± 0.48) scores] (P ＜ 0.01).The scores of spasticity in BTXA treatment group after treatment of 2 weeks and 4 weeks were significantly lower than those in baclofen treatment group (P ＜0.05 or ＜0.01).After treatment of 4 weeks,the grades of spasticity between two groups had significant difference (P ＜0.05).The rate of adverse reaction in BTXA treatment group [15.15％ (5/33)] was significantly lower than that in baclofen treatment group [51.52％ (17/33)] (P ＜ 0.01).Conclusions Local injection of BTXA and low dose oral baclofen in treatment of HFS can reach the obvious relief.But BTXA treatment has rapid onset,Iess adverse reaction and high compliance of the patients,and also symptoms improve more completely after BTXA treatment.BTXA can be used as preferred method of treating HFS.
