A型肉毒毒素注射治疗偏侧面肌痉挛的临床应用价值

Clinical Contrast Study of Botulinum Toxin Type A Injection Treating Hemifacial Spasm

目的:探讨A型肉毒毒素注射治疗偏侧面肌痉挛的临床应用价值及其安全性。方法:应用A型肉毒毒素注射治疗105例偏侧面肌痉挛患者,单纯口服药物治疗44例偏侧面肌痉挛患者。对比观察2组平均起效时间、疗效持续时间、不良反应发生率、不良反应持续时间、年平均治疗次数、年平均治疗费用、显效率及总有效率。结果:2组平均起效时间分别为(3.4±1.4)d和(12.6±3.9)d,疗效持续时间分别为(169.5±46.3)d和(6.8±2.8)d,不良反应发生率分别为28.6%和68.2%,不良反应持续时间分别为(16.5±5.7)d和(6.3±1.1)d,年平均治疗天数分别为(2.6±0.7)d和(292.6±80.4)d,年平均治疗费用分别为(972.4±67.4)元和(1 873.3±547.6)元,显效率分别为94.3%和34.1%,总有效率分别为100.0%和59.1%,2组上述结果之间比较均有显著差异(P<0.01)。结论:与口服药物治疗相比,应用A型肉毒毒素局部注射治疗偏侧面肌痉挛不仅临床起效快,疗效显著,不良反应较少,临床安全性好,而且治疗成本较低,具有较高的临床应用价值,可作为无禁忌证偏侧面肌痉挛患者的首选治疗。

Objective：To contrastlly investigate the efficacy and safety of BTX A injections（B1） and purely orally drug treatment（PDT） for hemifacial spasm. Methods： Clinical efficacy was evaluated by observing average on-effect time（AET）, average efficacy duration （AED）, side-effects incidence rate（SIR）, average side-effects duration（ASD）, average treatment frequency （ATF） per year, average treatment cost（ATC） per year, excellence rate（ER） and total effective rate（TER） ,after 100 patients with hemifacial spasm treated with BI and 40 patients with PDT. Results： There were obviously differences between BI group and PDT group in AET（respectively 3.4 ± 1.4 days and 12.6 ± 3.9 days ）, AED （respectively 169.5 ± 46.3 days and 6.8 ± 2.8 days ）, SIR（respectively 28.6% and 68.2%）, ASD （respectively 16.5 ± 5.7 days and 6.3 ± 1.1 days）, ATF（respectively 2.6 ± 0.7 days and 292.6 ± 80.4 days ）, ATC（respectively 972.4 ± 67.4 yuan and 1873.3 ± 547.6 yuan）, ER（respectively 94.3% and 34.1 % ）, and TER（respectively 100.0 % and 59. 1 % ） ） （all P〈0.01 ）. Conclusions： Because of high ER, fine safety and low ATC, BTX-A injection has obvious advantage on purely orally drug treatment and is the first choice for hemifacial spasm.