A型肉毒毒素注射治疗丘脑痛11例体会  

Efficacy and safety of botulinum toxin type A in treating 11 cases of thalamic pain

作　　者：孙桂芳[1] 袁志浩[2] 胡文涛[1] 马兴荣[1] 张博爱[1] 卢宏[1] SUN Guifang;YUAN Zhihao;HU Wentao;MA Xingrong;ZHANG Boai;LU Hong(Department of Neurology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Urology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院神经内科,郑州450052 [2]郑州大学第一附属医院泌尿外科,郑州450052

出　　处：《郑州大学学报(医学版)》2025年第1期132-135,共4页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(81501111);河南省教育厅高校重点科研项目(18A320065)。

摘　　要：目的:观察A型肉毒毒素注射对丘脑痛的疗效和安全性。方法:11例丘脑痛患者入组。在标记的受累部位一次性注射A型肉毒毒素50~400 U,注射后随访12个月。分别在注射前、注射后1周以及注射后12个月内每月采用VAS评分评估疼痛程度,治疗后4个月进行患者总体感觉改善情况评分(PGIC评分),记录治疗和随访期间的副作用。结果:11例患者中9例完成随访,1例在治疗后4个月失访,1例在治疗后8个月效果下降,自行使用其他药物治疗。9例中男7例,女2例,年龄52~82(68.3±10.8)岁。疼痛持续时间(13.3±3.7)个月,治疗前VAS评分(5.7±0.5)分,治疗后1周VAS评分均值降至2分,说明患者疼痛大为缓解,治疗8个月以后部分患者疗效下降,但治疗后12个月中,总体镇痛效果维持在较低水平(均值1.9~2.8),且较为稳定。根据PGIC评分,7例明显好转,2例轻微好转。注射后1周内1例出现面部不对称和眼睑下垂,1例出现面部不对称,均在5周内自行消失。结论:A型肉毒毒素注射治疗丘脑痛有效且安全。Aim:To explore the efficacy and safety of botulinum toxin type A(BTX-A)in treating thalamic pain.Methods:Eleven patients with thalamic pain received one-time intradermal injection of BTX-A(50~400 U)into the marked affected site,and then were followed up for 12 months.Before injection,1 week after injection and every month during follow-up,the degree of pain was evaluated using the Visual Analogue Scale(VAS)score.Four months after treatment,the Patient Global Impression of Change(PGIC)score was conducted to assess patients′overall perception of improvement.Side effects during treatment and follow-up were recorded.Results:Among the 11 cases,9 completed the follow-up.One case was lost to follow-up 4 months after treatment,and another case had a decline in the treatment effect 8 months after treatment and then chose other drugs for treatment on his own.Among the 9 cases,there were 7 males and 2 females,with age of 52-82(68.3±10.8)years.The duration of pain was(13.3±3.7)months.Before treatment,the VAS score was(5.7±0.5)points.One week after treatment,the average VAS score dropped to 2 points,indicating that the patients′pain was greatly relieved.After 8 months treatment,the treatment effect declined in some patients,but during the 12 months follow-up,the overall analgesic effect was maintained at a relatively low level,with an average value ranging from 1.9 to 2.8 points and was relatively stable.According to the PGIC score,7 cases showed significant improvement and 2 cases had slight improvement.Within 1 week after injection,1 developed facial asymmetry and eyelid ptosis,another had facial asymmetry,and all these symptoms disappeared spontaneously within 5 weeks.Conclusion:BTX-A injection is effective and safe in treating thalamic pain.

关 键 词：A型肉毒毒素 丘脑痛 VAS评分 

分 类 号：R741.05[医药卫生—神经病学与精神病学]