肉毒毒素A注射唾液腺联合甲磺酸双氢麦角碱治疗帕金森病流涎症临床观察

Clinical observation of BTX-A injection into salivary glands combined with dihydroergozine mesylate in the treatment of salivation in Parkinson’s disease

目的探讨肉毒毒素A注射唾液腺联合甲磺酸双氢麦角碱治疗帕金森病流涎症的临床疗效和安全性。方法选取2021-01—2022-12徐州市中心医院帕金森病伴流涎患者40例,随机分为治疗组及对照组各20例。治疗组在超声引导下予以80 U肉毒毒素A双侧腮腺和颌下腺分别注射30 U及10 U及联合甲磺酸双氢麦角碱2.5 mg,2次/d,口服,对照组予以超声引导下80 U肉毒毒素A双侧腮腺和颌下腺分别注射30 U及10 U。采用流涎频率评分、教师流涎分级法(TDS)中关于流涎的分级标准于肉毒毒素A治疗前、治疗12周后评估各组患者的流涎程度。结果肉毒毒素A联合治疗12周后,2组患者流涎频率评分疗效比较,治疗组总有效率为95%高于对照组的70%(P=0.0013);2组患者教师流涎分级疗效比较,治疗组总有效率为95%高于对照组的50%(P=0.004)。结论肉毒毒素A注射唾液腺联合甲磺酸双氢麦角碱可明显改善帕金森病患者的流涎症状。

Objective To probe the clinical etfect and safety of BTX-A injection into salivary glands com⁃bined with dihydroergozine mesylate in the treatment of salivation in Parkinson’s disease.Methods Forty patients with Parkinson’s disease accompanied by salivation were selected from Xuzhou Central Hospital from January 2021 to December 2022,and were randomly divided into treatment group and control group with 20 patients in each group.In the treatment group,80 U BTX-A bilateral parotid gland and submandibular gland were injected with 30 U and 10 U,respectively under ultrasound guidance and combined with dihydroergot mesylate 2.5 mg,bid,po;in the con⁃trol group,80 U BTX-A bilateral parotid gland and submandibular gland were injected with 30 U and 10 U,respec⁃tively under ultrasound guidance.Salivation frequency score and teacher salivation grading(TDS)were used to evalu⁃ate the salivation degree of each group before and after 12 weeks of BTX-A treatment.Results After 12 weeks of BTX-A combination therapy,the efficacy of salivation frequency scores in the two groups was compared:the total ef⁃fective rate of the treatment group was 95%higher than that of the control group of 70%(P=0.0013).The total ef⁃fective rate of the treatment group was 95%higher than that of the control group(P=0.004).Conclusion Injection of dihydroergot mesylate combined with BTX-A into salivary glands can significantly improve salivation symptoms in patients with Parkinson’s disease.