A型肉毒素治疗特发性眼睑痉挛眼睑肌张力障碍的效果  

Effect of botulinum toxin type A in the treatment of eyelid dystonia due to idiopathic blepharospasm

作　　者：曹晶晶 郭素梅 魏星[2] CAO Jingjing;GUO Sumei;WEI Xing(Department of Ophtholmology,Zhoukou Ophtholmology Hospital(Zhoukou No.7 People’s Hospital),Zhoukou 466000,China;Department of Ophthalmology,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]周口市眼科医院(周口市第七人民医院)眼科,周口466000 [2]郑州大学第二附属医院眼科,郑州450000

出　　处：《西北药学杂志》2024年第5期113-118,共6页Northwest Pharmaceutical Journal

基　　金：2020年河南省医学科技攻关计划联合共建项目(编号:LHGJ20190323)。

摘　　要：目的 观察A型肉毒素注射液治疗特发性眼睑痉挛(blepharospasm,BSP)的效果。方法 选取收治的94例特发性BSP患者,使用随机抽签法分为对照组与研究组,每组47例。对照组予以针灸、抗精神病药物等治疗,研究组在对照组治疗的基础上予以A型肉毒素治疗。比较2组的疗效、不良反应、治疗前后疾病严重程度[Jankovic评定量表(Jankovic rating scale,JRS)]、眼睑肌张力障碍[肌张力障碍症状量表(Burke-Fahn-Marsden dystonia rating scale,BFMDRS)]、干眼症状[眼表疾病指数量表(ocular surface disease index,OSDI)、眼部症状视觉模拟量表(visual analogue scale,VAS)评分]和中枢感觉传导通路兴奋性(P19’/N30’、N13’/P19’、P19/N30和N13/P19峰峰幅度)。结果 研究组的总有效率(95.74%)明显高于对照组(80.85%),P<0.05;治疗后,研究组的JRS、BFMDRS、OSDI和VAS评分以及P19’/N30’、N13’/P19’、P19/N30和N13/P19峰峰幅度均较对照组低(P<0.05);对照组未出现不良反应,研究组出现2例轻度眼睑肿胀、2例眼睑发僵及1例上睑下垂,但均在注射4周内自动消失。结论 A型肉毒素注射液治疗特发性BSP效果显著,可缓解疾病症状,减轻眼睑肌张力障碍,降低中枢感觉传导通路兴奋性。治疗过程中出现一些不良反应,但未影响患者病情,且会自动消失。Objective To observe the effect of Botulinum Toxin Type A Injections on idiopathic blepharospasm(BSP).Methods A total of 94 patients with idiopathic BSP were selected and divided into reference group and research group by random drawing method,47 cases in each group.The reference group received acupuncture and antipsychotic drugs,while the research group was treated with botulinum toxin type A based on the reference group.The efficacy,adverse reactions,disease severity[Jankovic rating scale(JRS)],eyelid dystonia[dystonia symptom scale(BFMDRS)],dry eye symptoms[ocular surface disease index scale(OSDI),ocular symptoms visual analog scale(VAS)],central sensory pathway excitability(peak-to-peak amplitude of P19’/N30’,N13’/P19’,P19/N30,N13/P19)before and after treatment in the 2 groups were compared.Results The total effective rate was 95.74%in the research group and 80.85%in the reference group,the research group was significantly higher than the reference group(P<0.05).After treatment,the JRS,BFMDRS,OSDI,VAS scores and the peak-to-peak amplitudes of P19’/N30’,N13’/P19’,P19/N30,and N13/P19 in the research group were lower than those in the reference group(P<0.05).There was no adverse reaction in the reference group,and 2 cases of mild eyelid swelling,2 cases of eyelid stiffness,and 1 case of ptosis occurred in the research group,but all of them disappeared automatically within 4 weeks of injection.Conclusion Botulinum Toxin Type A Injections have a significant effect in the treatment of idiopathic BSP,which can relieve disease symptoms,relieve eyelid dystonia,and reduce the excitability of central sensory conduction pathways.Although there are certain adverse reactions during the treatment,it does not affect the patient’s condition,and the adverse reactions will disappear automatically.The application is worth of promotion.

关 键 词：A型肉毒素 特发性眼睑痉挛 眼睑肌张力障碍 干眼症状 中枢感觉传导通路兴奋性 不良反应 

分 类 号：R988.1[医药卫生—药品]