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目的观察A型肉毒毒素(BTXA)治疗偏侧面肌痉孪、睑痉孪、Meige’s综合征、痉孪性斜颈的疗效。方法治疗组(A组)用BTXA对86例患者进行头颈部肌肉多点注射,对照组(B组)50例根据诊断选用不同的药物或/和针灸、理疗、中医药治疗。观察两组疗效及副作用。结果A组治疗后当日至3d内开始见效,7～15d达高峰,疗效维持2～6月。总有效率为100%,疗效明显高于B组(P<0.001)。BTXA重复注射疗效无下降,1例HFS患者第三次注射产生耐药性,少数患者有轻微的局部副反应,未见全身副作用。B组62%(31例)的患者疗效维持5～15月后减退,需逐渐增加剂量,少数患者出现白细胞减少、肝功能损害、皮疹、共济失调等不良反应。结论A型肉毒毒素局部注射是治疗头颈部肌张力障碍的一种安全、有效、简便的方法。
Objective To observe the efficacy of botulinum toxin type A (BTXA) in the treatment of hemifacial spasm, blepharospasm, Meige’s syndrome and spasmodic torticollis. Methods The treatment group (group A) received BTXA for 86 cases of head and neck muscle injection, while the control group (group B) 50 cases were selected according to the diagnosis of different drugs and / or acupuncture, physiotherapy and Chinese medicine treatment. The curative effect and side effect of two groups were observed. Results A group began to take effect from the first day to the third day after treatment and peaked at 7 to 15 days. The therapeutic effect was maintained for 2 to 6 months. The total effective rate was 100%, the effect was significantly higher than the B group (P <0.001). BTXA repeated injection of no effect, a case of HFS patients with third injection of drug resistance, a small number of patients with minor local side effects, no systemic side effects. In group B, 62% (31 cases) of the patients maintained their efficacy after 5 to 15 months, and gradually increased the dose. A few patients showed leukopenia, liver dysfunction, rash, ataxia and other adverse reactions. Conclusion Botulinum toxin type A injection is a safe, effective and simple method for the treatment of head and neck dystonia.