A型肉毒毒素治疗初次咀嚼综合征的疗效分析

Analysis of curative effect of botulinum toxin type A in the treatment of First Bite Syndrome

摘要:

目的：探索局部注射肉毒毒素治疗初次咀嚼综合征（FBS）的临床疗效。方法：选择在我科行咽旁间隙肿瘤切除术后发生了FBS症状并且经普通药物治疗无效的13例患者，使用A型肉毒毒素（BTA），在其患侧腮腺区进行多点注射，根据症状缓解的程度，部分患者进行了多次注射，随访1年以上，以视觉模拟量表（VAS）评估A型肉毒毒素对于FBS的治疗效果。结果：总体而言，患者在治疗后1个月（4.9±1.7）、3个月（2.8±1.2）以及12个月（2.1±1.7），VAS评分分别与治疗前（8.1±1.1）相比，均明显降低，差异均具体统计学意义（P<0.05），注射后3个月（2.8±1.2）与注射后1个月（4.9±1.7）相比，VAS评价进一步下降，差异同样具体统计学意义（P<0.05），但注射后12个月（2.1±1.7）与注射后3个月（2.8±1.2）相比，VAS评分虽有下降，但下降趋势不明显，差异无统计学意义（P>0.05）。总体而言，注射后有11例患者效果明显（VAS≤3），另外2例患者疼痛症状有所缓解，但仍未达到理想的效果。所有在注射BTA后，未发生相关并发症。结论：FBS患者经过腮腺区局部注射BTA后，其疼痛症状明显缓解，BTA注射是治疗FBS的一种有效方法。

Abstract:

Objective: To explore the clinical efficacy of local injection of botulinum toxin in the treatment of First Bite Syndrome (FBS). Method: Select 13 patients with FBS pain symptoms in our department who have not been treated with conventional analgesic drugs, use botulinum toxin type A, and perform multi-point injections in the parotid area of the affected side. According to the degree of symptom relief, some patients receive after multiple injections, followed up for more than 1 year, the visual analog scale (VAS) was used to evaluate the therapeutic effect of botulinum toxin type A on FBS. Results: Overall, patients'' VAS scores were compared with those before treatment (8.1±1.1) at 1 month (4.9±1.7), 3 months (2.8±1.2), and 12 months (2.1±1.7) after treatment, were significantly reduced, and the differences were statistically significant (P<0.05). Compared with 3 months after injection (2.8±1.2) and 1 month after injection (4.9±1.7), the VAS evaluation further decreased, and the difference was statistically specific Significance (P<0.05), but 12 months after injection (2.1±1.7) compared with 3 months after injection (2.8±1.2), although the VAS score decreased, the downward trend was not obvious, and the difference was not statistically significant ( P>0.05). Overall, 11 patients had obvious effects after injection (VAS≤3), and the pain symptoms of the other 2 patients were relieved, but did not achieve satisfactory results. No related complications occurred after BTA injection. Conclusion: After local injection of BTA in the parotid area, patients with FBS have obvious pain relief. BTA injection is an effective method for the treatment of FBS.