[1]马蕴青,贺彩红,连亚军#,等.用3种剂量A型肉毒毒素治疗原发性三叉神经痛的疗效比较*[J].郑州大学学报(医学版),2014,(04):536.
 MA Yunqing,HE Caihong,LIAN Yajun,et al.Three doses of botulinum toxin type A for treatment of classic trigeminal neuralgia[J].JOURNAL OF ZHENGZHOU UNIVERSITY(MEDICAL SCIENCES),2014,(04):536.
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用3种剂量A型肉毒毒素治疗原发性三叉神经痛的疗效比较*
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《郑州大学学报(医学版)》[ISSN:1671-6825/CN:41-1340/R]

卷:
期数:
2014年04期
页码:
536
栏目:
应用研究
出版日期:
2014-07-20

文章信息/Info

Title:
Three doses of botulinum toxin type A for treatment of classic trigeminal neuralgia
作者:
马蕴青贺彩红连亚军#陈媛张海峰谢南昌吴川杰郑亚珂 张璐张毅
郑州大学第一附属医院神经内科 郑州 450052
Author(s):
MA Yunqing HE Caihong LIAN Yajun CHEN Yuan ZHANG Haifeng XIE Nanchang WU Chuanjie ZHENG Yake ZHANG Lu ZHANG Yi
Department of Neurology,the First Affiliated Hospital,Zhengzhou University, Zhengzhou 450052
关键词:
三叉神经痛A型肉毒毒素焦虑抑郁睡眠障碍
Keywords:
Key wordstrigeminal neuralgiabotulinum toxin type Aanxietydepressionsleep interference
分类号:
R745.1+1
摘要:
目的:观察3种剂量A型肉毒毒素治疗三叉神经痛的疗效,焦虑、抑郁、睡眠变化及其不良反应。方法:选取原发性三叉神经痛患者87例,随机分为25 U/mL组(28例)、50 U/mL组(31例)和75 U/mL组(28例)3种剂量组,分别于疼痛部位多点皮内注射不同剂量的A型肉毒毒素,对每位患者治疗前及治疗后8周内每周进行视觉模拟(VAS)评分、焦虑评分、抑郁评分、睡眠干扰评分,并于第8周进行患者总体印象改变评分,观察疗效及其安全性。结果:3组治疗后疼痛治疗有效率差异无统计学意义(χ2=3.482,P=0.175)。治疗后3组焦虑、抑郁和睡眠评分均较各自治疗前显著降低,但3组有效率比较差异无统计学意义。治疗后3组患者总体印象改变改善率差异无统计学意义(χ2=1.345,P=0.510)。7例出现注射部位短暂性的肌肉松弛,2例出现注射部位肿胀,均自行消失,未进行处理,未见全身性不良反应。结论:不同剂量A型肉毒毒素治疗三叉神经痛均有效。
Abstract:
AbstractAim: To observe the efficacy, anxiety, depression, sleep interference and adverse reaction of botulinum toxin type A (BTXA) with three doses for the treatment of trigeminal neuralgia. Methods: Eighty seven patients with trigeminal neuralgia were randomized into three dose groups: BTXA 25 U/mL(n=28), BTXA 50 U/mL (n=31), BTXA 75 U/mL(n=28) and local multipoint injection of different doses of BTXA was administrated. Followup visits were conducted every week after the injection,and the overall duration of the study for each patient was 8 weeks to observe the visual analogue scale (VAS), anxiety, depression and sleep interference score and the patient global impression of change (PGIC) scale at endpoint, assessing the efficacy and safety. Results: There was no significant difference in VAS efficacy among three groups(χ2=3.482,P=0.175). The scores of anxiety, depression and sleep interference of three groups reduced significantly compared to baseline screening period, but there were no significant differences among three groups. There were no significant differences in PGIC among three groups(χ2=1.345,P=0.510). Seven patients experienced transient muscle relaxation and two patients experienced edema in the injection area. All adverse reaction disappeared automatically without treatment, and there was no systemic adverse reaction. Conclusion: Three different doses of BTXA for treatment of trigeminal neuralgia were all efficient, and there were no significant differences in multiple observation indexes among three groups.

参考文献/References:

[1]Olesen J,Steiner TJ.The international classification of headache disorders, 2nd edn (ICDHII)[J].J Neurol Neurosurg Psychiatry,2004,75(6):808 [2]Macianskyte D,Januzis G,Kubilius R,et al.Associations between chronic pain and depressive symptoms in patients with trigeminal neuralgia[J].Medicina (Kaunas),2011,47(7):386 [3]Wu CJ,Lian YJ,Zheng YK,et al.Botulinum toxin type A for the treatment of trigeminal neuralgia: results from a randomized, doubleblind, placebocontrolled trial[J].Cephalalgia,2012,32(6):443 [4]Micheli F,Scorticati MC,Raina G.Beneficial effects of botulinum toxin type a for patients with painful tic convulsif[J].Clin Neuropharmacol,2002,25(5):260 [5]Piovesan EJ,Teive HG,Kowacs PA,et al.An open study of botulinumA toxin treatment of trigeminal neuralgia[J].Neurology,2005,65(8):1306 [6]Türk U,Ilhan S,Alp R,et al.Botulinum toxin and intractable trigeminal neuralgia[J].Clin Neuropharmacol,2005,28(4):161 [7]Zúiga C,Díaz S,Piedimonte F,et al.Beneficial effects of botulinum toxin type A in trigeminal neuralgia[J].Arq Neuropsiquiatr,2008,66(3A):500 [8]Bohluli B,Motamedi MH,Bagheri SC,et al.Use of botulinum toxin A for drugrefractory trigeminal neuralgia: preliminary report[J].Oral Surg Oral Med Oral Pathol Oral Radiol Endod,2011,111(1):47 [9]Revill SI,Robinson JO,Rosen M,et al.The reliability of a linear analogue for evaluating pain[J].Anaesthesia,1976,31(9):1191 [10]连亚军,魏红玲,张博爱,等.A型肉毒毒素治疗面肌痉挛和局限性肌张力障碍795例[J].郑州大学学报:医学版,2009,44(2):440 [11]Wu CJ,Shen JH,Chen Y,et al.Comparison of two different formulations of botulinum toxin A for the treatment of blepharospasm and hemifacial spasm[J].Turk Neurosurg,2011,21(4):625 [12]Wu CJ,Lian YJ.Botulium toxin type A for trigeminal neuralgia:we have the prima facie evidence[J].Cephalagia,2012,32(15):1156 [13]申继红,连亚军,郑亚珂,等.A型肉毒毒素治疗原发性三叉神经痛的疗效观察[J].中国康复医学杂志,2011,26(5):483 [14]Aoki KR.Review of a proposed mechanism for the antinociceptive action of botulinum toxin type A[J].Neurotoxicology,2005,26(5):785 [15]Meng J,Ovsepian SV,Wang J,et al.Activation of TRPV1 mediates calcitonin generelated peptide release, which excites trigeminal sensory neurons and is attenuated by a retargeted botulinum toxin with antinociceptive potential[J].J Neurosci,2009,29(15):4981 [16]Woolf CJ,Costigan M.Transcriptional and posttranslational plasticity and the generation of inflammatory pain[J].Proc Natl Acad Sci USA,1999,96(14):7723 [17]Radat F,Creac' h C,Swendsen JD,et al.Psychiatric comorbidity in the evolution from migraine to medication overuse headache[J].Cephalalgia,2005,25(7):519 [18]Cupini LM,De Murtas M,Costa C,et al.Obsessivecompulsive disorder and migraine with medicationoveruse headache[J].Headache,2009,49(7):1005 [19]Zakrzewska JM,Jassim S,Bulman JS.A prospective, longitudinal study on patients with trigeminal neuralgia who underwent radiofrequency thermocoagulation of the Gasserian ganglion[J].Pain,1999,79(1):51

相似文献/References:

[1]连亚军,魏红玲,张博爱,等.A型肉毒毒素治疗面肌痉挛和局限性肌张力障碍795例[J].郑州大学学报(医学版),2009,(02):440.

备注/Memo

备注/Memo:
*河南省教育厅自然科学研究资助计划项目2011A320038;河南省卫生厅课题201203006;#通讯作者,女 1964年4月生,博士,教授,主任医师,研究方向:癫痫、头面痛疾病、脑血管病,Email:lianyajun369@sina.com
更新日期/Last Update: 1900-01-01