A型肉毒毒素治疗特发性眼睑痉挛的临床研究

To investigate the clinical treatment effects of botulinum toxin A on idiopathic blepharospasm

目的 探讨A型肉毒毒素对特发性眼睑痉挛患者的临床诊疗。方法 :对 2 2例 (41只眼 )特发性眼睑痉挛患者进行眼睑多点注射A型肉毒毒素治疗 ,以氟哌啶醇治疗 2 0例 (38只眼 )特发性眼睑痉挛患者作为对照。对两组治疗前后的病情分级、临床疗效和复发率进行比较。结果 :A型肉毒毒素治疗组和氟派啶醇对照组的总有效率分别为 10 0 %和 6 5 % ,显效率分别为 90 9%与 2 5 0 % (χ2 =6 2 4 ,P <0 0 5 ) ,A型肉毒毒素明显优于对照组 ,且无全身不良反应 ,局部反应轻。在 6～ 36个月的随访期间 ,A型肉毒毒素治疗组和氟哌啶醇对照组的复发率分别为 6 3 6 %(14 / 2 2 )与 95 0 % (19/ 2 0 ) (χ2 =4 76 ,P <0 0 5 )。结论 :A型肉毒毒素为治疗特发性眼睑痉挛的首选药物 ,且方法简便易行 ,可在门诊开展。但复发率较高 。

Objective: To investigate the clinical treatment effects of botulinum toxin A on idiopathic blepharospasm. Methods: 22 cases (41 eyes) of idiopathic blepharospasm were treated with injection botulinum toxin A in eyelids, and 20 cases (38 eyes) of idiopathic blepharospasm take haloperidol as comparison, Blepharospasm intensity grade, clinical treatment effects and recurrence rate were undertaken comparison in two groups. Results: The total effectiveness of botulinum toxin A group and haloperidol group was 100% and 65%, and the basic cure rate of botulinum toxin A group and haloperidol group was 90.9% and 25.0% (χ 2=6.24,P<0.05). There was statistically significant difference in two groups, and no negative reaction in botulinum toxin A group. After follow up for 6～36 months, the recurrence rate of botulinum toxin A group and haloperidol group was 63.6%(14/22) and 95.0% (19/20) (χ 2=4.76, P<0.05). Conclusion: Injection botulinum toxin A in eyelids is first hand medicine for idiopathic blepharospasm, and it is a kind of safe, simple, convenient and effective treatment method which can be treated in clinic service, but the recurrence rate is still higher, how to reduce the recurrence rate will be a question for study.