A型肉毒毒素治疗痉挛性斜颈的临床研究

Clinical study of botulinum toxin type A in the treatment of spasmodic torticollis

目的观察A型肉毒毒素（BTx—A）治疗痉挛性斜颈的效果。方法对64例痉挛性斜颈患者在颈部肌肉多点注射BTX—A，分析评价其疗效。结果痉挛性斜颈患者经BTX．A治疗后症状明显改善，BTX。A用量（120．37±25．26）U；注射点数（30．00±4．85）个；Tsui评分治疗前为（13．08±4．16）分，治疗后2周为（4．21±2．63）分，差异有统计学意义（P〈0．01）。完全缓解16例（25．O％），明显改善39例（60．9％），部分改善8例（12．5％），无效1例（1．6％），有效率85．9％（55／64）；疗效维持时间为（16．86±4．57）周；重复治疗者复发症状减轻，治疗剂量下降，疗效仍良好。所有患者均未见严重不良反应。结论BTX．A治疗痉挛性斜颈是一种安全有效、简便易行的治疗手段，可作为治疗痉挛性斜颈的首选药物。

Objective To evaluate the therapeutic effect of botulinum toxin type A （BTX-A） injection in the treatment of spasmodic torticollis. Methods Sixty-four patients with spasmodic torticollis underwent the treatment of intramuscular injection of BTX-A in neck muscles. As a result, the efficiency of BTX-A therapy could be evaluated successfully. Results Considerable improvement of symptoms for the spasmodic torticollis patients was observed with BTX-A treatment. The average dose of BTX-A was（ 120.37 _± 25.26） U. Injection points were 30.00 ~ 4.85. The Tsui scores before treatment were （ 13.08 ± 4.16） scores, and 2 weeks after treatment were （4.21 ± 2.63 ） scores. The Tsui scores showed a significant reduction after BTX-A injections （P 〈 0.01 ）. After treatment complete remission rate was 25.0% （16/64）, significant improvement rate was 60.9% （39/64）, partial improvement rate was 12.5% （8/64）, invalid rate was 1.6% （1/64） and efficient rate was 85.9% （55/64）. Duration of effect was （ 16.86 ± 4.57） weeks. Patients who received repeated injections also had good response,with symptoms improved and dosage of BTX-A reduced.No serious adverse events happened in treatments. Conclusion BTX-A therapy is simple and effective in the treatment of spasmodic torticollis and should be considered as the first-choice treatment for the condition.