胃镜下胃壁注射A型肉毒毒素治疗单纯性肥胖的临床研究

Endoscopic gastric intramural injection of botulinum toxin A for treatment of obesity:A randomized controlled clinical trial

目的研究胃镜下胃壁注射A型肉毒毒素(BTX-A)治疗单纯性肥胖的减重疗效和安全性。方法 19例单纯性肥胖患者随机分为试验组Ⅰ(BTX-A200U)和试验组Ⅱ(BTX-A300U),胃镜下将药物注射于胃壁肌层共20个点,治疗前和治疗后1周、4周、12周分别对进食量、体重、BMI、腰围、臀围、胃固体排空时间、胃电图等进行随访。结果两组患者治疗后进食量较治疗前明显减少(P<0.05);体重、BMI、腰围、臀围均明显减少(P<0.05);胃固体半排空时间明显延长(P<0.05),胃延迟相时间延长,但无统计学差异;胃电图各指标治疗前后无明显变化。无明显不良反应发生。结论胃镜下注射BTX-A能减慢胃排空、减少进食量,安全有效地减轻体重。

Objective To investigate the safety and efficacy of botulinum toxin A injected into the gastric wall for the treatment of obesity. Methods 19 patients with simple obesity were randomized into 2 groups （group Ⅰ, 200 U BTX-A and group Ⅱ,300 U BTX-A）. 20 puncture sites were seleeted into the gastric wall. Food intake,body weight, BMI ,waistline, hip circumference ,gastric emptying time and electrogastrogram were recorded before injection and 1 week,4 weeks and 12 weeks after the treatment. Results All patients reported redueed food intake after the injeetion（P 〈0. 05）. Body weight,BMI,waistline and hip circumference decreased after the treatment （P 〈0. 05）. The semi-gastric solid emptying time were significant longer than before the treatment （ P 〈 0. 05 ）. There were no differences between the two groups. No clinically significant side effects were observed. Conclusions Endoscopic injection of BTX-A can be a safe choice for weight loss of obese patients by reducing food intake and delaying gastric emptying.