A型肉毒毒素重复治疗与首次治疗偏侧面肌痉挛的疗效比较  

Comparsion on Efficacy of Repeated Treatment and First Treatment of Botulinum Toxin Type A for Hemifacial Spasm

作　　者：张璇[1] 尤素伟[1] 吕洲[1] 闫媛媛 高丽娜 ZHANG Xuan;YOU Suwei;LYU Zhou;YAN Yuanyuan;GAO Li’na(Dept.of Neurology,Handan Central Hospital,Hebei Handan 056002,China;Quality Control Office,Handan Central Hospital,Hebei Handan 056002,China)

机构地区：[1]邯郸市中心医院神经内科,河北邯郸056002 [2]邯郸市中心医院质管办,河北邯郸056002

出　　处：《中国医院用药评价与分析》2019年第7期797-800,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：河北省卫计委青年科技项目课题(No.20171118)

摘　　要：目的:比较A型肉毒毒素重复治疗与首次治疗偏侧面肌痉挛的疗效.方法:选取2016—2018年邯郸市中心医院收治的偏侧面肌痉挛患者164例,根据A型肉毒毒素治疗的次数分组,其中76例首次接受A型肉毒毒素治疗的为首次治疗组,88例重复接受A型肉毒毒素治疗的为重复治疗组.观察两组患者的临床疗效、面神经电图、瞬目反射与不良反应发生情况.结果:重复治疗组患者的总有效率为100.00%(88/88),略高于首次治疗组的97.37%(74/76),但差异无统计学意义(P>0.05);重复治疗组患者的完全缓解率为70.45%(62/88),明显高于首次治疗组的60.53%(46/76),差异有统计学意义(P<0.05).重复治疗组患者患侧运动神经传导复合肌肉动作电位(CMAP)振幅显著低于健侧,差异有统计学意义(P<0.05).两组患者治疗前后CMAP差值(ΔCMAP),瞬目反射R1差值(ΔR1)、R2差值(ΔR2)和R3差值(ΔR3)的差异均无统计学意义(P>0.05).重复治疗组患者的不良反应发生率为9.09%(8/88),明显低于首次治疗组的21.05%(16/76),差异有统计学意义(P<0.05).结论:A型肉毒毒素重复治疗与首次治疗偏侧面肌痉挛的疗效相近,临床获益情况均较好,其中重复治疗方案的综合疗效更优.OBJECTIVE:To compare the efficacy of repeated treatment and first treatment of botulinum toxin type A for hemifacial spasm.METHODS:Totally 164 patients with hemifacial spasm admitted into Handan Central Hospital from 2016 to 2018 were according to the number of treatment times for botulinum toxin type A,76 patients who received botulinum toxin type A for the first time were set as the first treatment group,and 88 patients who received botulinum toxin type A repeatedly were set as the repeated treatment group.The clinical efficacy,facial nerve electrogram,blink reflex and adverse drug reactions of two groups were observed.RESULTS:The total effective rate was 100.00%(88/88)in the repeated treatment group,higher than 97.37%(74/76)in the first treatment group,yet the difference was not statistically significant(P>0.05).The complete response rate was 70.45%(62/88)in the repeated treatment group,significantly higher than that in the first treatment group 60.53%(46/76),and the difference was statistically significant(P<0.05).In the repeated treatment group,the amplitude of compound muscle action potential(CMAP)was significantly lower than that of the healthy side,and the difference was statistically significant(P<0.05).The differences inΔCMAP,blink reflexΔR1,ΔR2 andΔR3 between two groups before and after treatment were not statistically significant(P>0.05).The incidence of adverse drug reactions in the repeated treatment group was 9.09%(8/88),significantly lower than that in the first treatment group[21.05%(16/76)],the difference was statistically significant(P<0.05).CONCLUSIONS:The repeated treatment of BTX-A for hemifacial spasm is similar to the first treatment,with better clinical benefits,among which the comprehensive efficacy evaluation of the repeated treatment scheme is better.

关 键 词：偏侧面肌痉挛 A型肉毒毒素 重复治疗 首次治疗 

分 类 号：R97[医药卫生—药品]