两种稀释度A型肉毒毒素治疗腋臭的疗效比较研究

Effect of Botulinum Toxin Type-A in the Treatment of Bromhidrosis Using Two Dilutions

背景肉毒毒素治疗腋臭,已有一定时日。临床证实,其疗效相对比较可靠,不良反应小。但是,肉毒毒素的配制方案,尚无统一标准,甚至肉毒毒素生产厂家也未能给出确切方案。目的探讨两种不同稀释度A型肉毒毒素治疗腋臭疗效的差异。方法选取2014年1月—2017年6月南方医科大学深圳医院门诊收治的腋臭患者120例为研究对象,每级患者采用随机数字法分为A组59例,B组61例。A组以0.9%氯化钠溶液稀释A型肉毒毒素为50 U/1 ml,B组以0.9%氯化钠溶液稀释A型肉毒毒素为50 U/2 ml,皮丘式注射。注射后随访14 d,记录患者起效时间及治疗效果。结果随访显示,注射A型肉毒毒素后第3天开始有患者认为有效,到第14天,全部起效。A组平均起效时间为(7.3±2.0)d,B组平均起效时间为(6.5±2.0)d,差异有统计学意义(t=2.029,P=0.045)。A组患者无效8例,有效26例,显效25例;B组患者无效5例,有效29例,显效27例,两组患者治疗效果比较,差异无统计学意义(u=-0.492,P=0.622)。结论两种不同稀释度A型肉毒毒素治疗腋臭疗效相近,但低浓度起效更快。

Background Botulinum toxin has been used to treat axillary osmidrosis for a long time with relatively good efficacy and less toxic side effects.However,no one can give a unified standard for botulinum toxin preparation,including manufacturers.Objective To investigate the difference in efficacy of botulinum toxin type-A(BTX-A) at two different dilutions for the treatment of bromhidrosis.Methods This study included 120 outpatients with bromhidrosis treated at Shenzhen Hospital of Southern Medical University from January 2014 to June 2017,who were randomly divided via a random number table into group A(n=59) and group B(n=61).In group A,BTX-A was diluted with 0.9% sodium chloride solution to 50 U/1 ml,and in group B,BTX-A was diluted with 0.9% sodium chloride solution to 50 U/2 ml,to form an intravenous injection-induced skin rash.The patients were followed-up for 2 weeks after injection,and the onset time and treatment effects were recorded.Results During the follow-up period,some patients experienced symptom relief(onset) as early as the 3 rd day after BTX-A injection,and on the 14 th day,all patients experienced onset.The average onset time was(7.3±2.0) days in group A,and(6.5±2.0) days in group B.The difference was statistically significant(t=2.029,P=0.045).In group A,therapy was ineffective in 8 patients,effective in 26 patients,and markedly effective in 25 patients.In group B,therapy was ineffective in 5 patients,effective in 29 patients,and markedly effective in 27 patients.There was no significant difference in the treatment effect between the two groups(u=-0.492,P=0.622).Conclusion Two different dilutions of BTX-A had similar effects on bromhidrosis,however,patients in the lower concentration group experienced faster symptom relief.