不同浓度A型肉毒毒素治疗面肌痉挛的效果比较

Comparison of therapeutic effects of different concentrations of botulinum toxin type A in the treatment of facial spasm

目的比较不同浓度A型肉毒毒素治疗面肌痉挛的临床效果。方法随机对照研究。抽取2018年9月至2022年5月濮阳市安阳地区医院收治的面肌痉挛患者82例,按照随机数字表法分为高浓度组与低浓度组,每组41例。高浓度组注射50 U/mL的A型肉毒毒素;低浓度组注射25 U/mL的A型肉毒毒素。比较两组临床有效率、治疗后各个时间点的Cohen下降值、药物起效时间、药物持续时间和不良反应发生情况。结果高浓度组总有效率(95.12%,39/41)高于低浓度组(80.49%,33/41),P<0.05。治疗后第1周至3个月内,两组Cohen下降值比较差异未见统计学意义(P>0.05);治疗后第4、5个月,低浓度组Cohen下降值均小于高浓度组(P均<0.05);治疗后第6~12个月,两组Cohen下降值趋于一致(P>0.05)。高浓度组药物起效时间短于低浓度组,持续时间长于低浓度组(P<0.05)。低浓度组不良反应发生率(4.88%,2/41)低于高浓度组(17.07%,8/41),且低浓度组不良反应持续时间短于高浓度组(P<0.05)。结论不同浓度A型肉毒毒素治疗面肌痉挛各有优缺点,50 U/mL高浓度A型肉毒毒素虽能提高治疗效果,但不良反应的发生风险较高;25 U/mL低浓度A型肉毒毒素的效果虽不及高浓度,但安全性较高。

Objective To compare the clinical efficacy of different concentrations of botulinum toxin type A in the treatment of facial spasm.Methods This study was a randomized controlled trail.A total of 82 patients with facial spasm admitted to Anyang District Hospital in Puyang from September 2018 to May 2022 were selected,and they were divided into high concentration group and low concentration group by random number table method,with 41 cases in each group.The high concentration group was injected with botulinum toxin type A of 50 U/mL,the low concentration group was injected with botulinum toxin type A of 25 U/mL.The clinical effective rate,Cohen decrease at various time points after treatment,drug onset time,drug duration,and incidence of adverse reactions were compared between the two groups.Results The total effective rate of the high concentration group(95.12%,39/41)was higher than that of the low concentration group(80.49%,33/41),P<0.05.Within the first week to three months after treatment,there was no significant difference in the decrease in Cohen values between the two groups(P>0.05).The decrease in Cohen values in the low concentration group was lower than that in the high concentration group at the fourth and fifth months after treatment(all P<0.05).The decrease in Cohen values in the two groups tended to be consistent from 6 to 12 months after treatment(P>0.05).The onset time of drugs in the high concentration group was shorter than that in the low concentration group,and the drug duration was longer than that in the low concentration group(P<0.05).The incidence of adverse reactions in the low concentration group(4.88%,2/41)was significantly lower than that in the high concentration group(17.07%,8/41),while the duration of adverse reactions in the low concentration group was shorter than that in the high concentration group(P<0.05).Conclusions Different concentrations of botulinum toxin A have their own advantages and disadvantages in the treatment of facial spasm.Choosing a high concentration of botulinum toxin A of 50 U/mL can improve the treatment effect,but the risk of adverse reactions is higher.Although the effect of low concentration of botulinum toxin type A(25 U/mL)is not as good as the high concentration,its safety is relatively high.