A型肉毒素治疗肌源性颞下颌关节紊乱病的研究进展  

Research progress on the application of botulinum toxin type A in the treatment of myogenous temporoman⁃dibular disorders

作　　者：陈奕帆 汤良晨 陈敏儿 张萧 唐贶昀 李志勇 CHEN Yifan;TANG Liangchen;CHEN Min’er;ZHANG Xiao;TANG Kuangyun;LI Zhiyong(Maxillofacial Surgery,Stomatology Hospital,School of Stomatology,Zhejiang University School of Medicine&Clinical Research Center for Oral Diseases of Zhejiang Province&Key Laboratory of Oral Biomedical Research of Zhejiang Province&Cancer Center of Zhejiang University&Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province,Hangzhou 310006,China)

机构地区：[1]浙江大学医学院附属口腔医院口腔颌面外科浙江大学口腔医学院浙江省口腔疾病临床医学研究中心浙江省口腔生物医学研究重点实验室浙江大学癌症研究院口腔生物材料与器械浙江省工程研究中心,浙江杭州310006

出　　处：《口腔疾病防治》2024年第6期470-477,共8页Journal of Prevention and Treatment for Stomatological Diseases

基　　金：国家自然科学基金项目(82201016);口腔疾病研究国家重点实验室开放课题(SKLOD2023OF05)。

摘　　要：肌源性颞下颌关节紊乱病(myogenous temporomandibular disorders,M⁃TMD)是颞下颌关节紊乱病(temporomandibular disorders,TMD)的主要亚型之一,肌痛为最典型表现,发病率呈逐年上升的趋势。A型肉毒素(botulinum toxin type A,BTX⁃A)是一种由肉毒杆菌产生的强效神经毒素,可抑制乙酰胆碱从突触前膜释放,从而阻断神经肌肉接头信号传导,使得注射区肌肉麻痹,BTX⁃A在口腔颌面部非美容性的应用是未来的研究热点。近年来越来越多研究聚焦于BTX⁃A用于M⁃TMD的治疗,文献回顾结果显示,在疼痛部位单次注射适宜剂量(单侧10~50 U)的BTX⁃A可在3~6个月内持续改善肌痛症状,必要时需重复注射。注射后常见不良反应如咀嚼无力、面瘫等均为暂时性,并可通过规范操作规避其发生,但目前临床仍缺少标准化的注射技术指南。Myogenous temporomandibular disorder(M⁃TMD)is one of the main subtypes of temporomandibular dis⁃order(TMD)and typically manifests as masticatory myofascial pain;the incidence of TMD has been increasing annually in recent years.Botulinum toxin type A(BTX⁃A)is a potent neurotoxin produced by Clostridium botulinum.BTX⁃A in⁃hibits the release of acetylcholine from the presynaptic membrane,thereby blocking neuromuscular junction signaling.The noncosmetic application of BTX⁃A in the oral and maxillofacial regions is a prominent research topic.In recent years,an increasing number of studies have focused on the application of BTX⁃A in the treatment of M⁃TMD.The re⁃sults of a literature review revealed that an appropriate dose(10⁃50 U unilaterally)of BTX⁃A administered in a single in⁃jection into the masticatory muscles can effectively treat myalgia over a period of 3⁃6 months.Common adverse effects,such as masticatory weakness and facial paralysis,are transient and can be avoided by standardized injection tech⁃niques.However,there is a lack of standardized guidelines for injection techniques in clinical practice.

关 键 词：A型肉毒素 肌源性颞下颌关节病 颞下颌关节紊乱病 咀嚼肌 肌痛 乙酰胆碱 副作用 临床应用 

分 类 号：R78[医药卫生—口腔医学]