【摘要】 目的观察A型肉毒素治疗面肌痉挛的疗效。方法选取面肌痉挛患者32例,依据痉挛肌肉选取面部注射点局部注射A型肉毒素,配合心理治疗,定期随访观察疗效。应用SPSS22.0统计软件对治疗前后肌肉痉挛强度分级比较及不同民族疗效的持续时间(周)比较采用单因素方差分析;肌肉痉挛注射前后变化采用有序多分类秩和检验。结果全部患者按肌肉痉挛强度Cohen标准分级,Ⅰ级~Ⅱ级8例,Ⅲ级~Ⅳ级24例。病情越轻,疗效越好,不同等级之间疗效比较的差异显著。首次注射后完全缓解28例,占87.5%,部分缓解4例,占12.5%,总有效率100%,1周后复诊没有追加注射患者。9例(占28.13%)3个月~6个月后复发,其中3例(占9.4%),重复注射,均部分缓解。不同民族患者间疗效比较未见差别。结论 A型肉毒素治疗面肌痉挛简易、安全、有效。病情越轻,疗效越好。注意病情观察越仔细,部位选择越精确,疗效越好。其次,注射更多的肌肉及每条肌肉多点注射,疗效越好。配合心理治疗亦可以提高疗效,减少复发,故临床需要综合性个体化治疗。更多还原

【Abstract】 Objective To observe the curative effect of type A botulinum toxin treatment of facial spasm.Methods On the basis of cramping muscle select facial point of local injection of type A botulinum toxin injection,with psychological treatment, regular follow-up observation curative effect. Single factor analysis of variance(ANOVA) was utilized to compare the muscle spasm intensity before and after treatment, and the treatment duration(weeks) of different ethnic groups. Orderly multiple rank sum test was utilized to analyze the change of muscle spasti city before and after injection. SPSS 22.0 software was used for statistical analyses. Results A total of 32 patients,according to the strength of muscle spasm Cohen standard classification,Ⅰ~Ⅱ level 8 cases,24 cases Ⅲ~Ⅳ level.The lighter disease, curative effect is better,curative effect comparison of differences between different levels significantly(table 1). Complete response after the first injection of 28 cases, accounting for 87%, partial in 4 cases, accounting for 12.5%, total effective rate was 100%(table 2), 1 week after the follow-up patients with no additional injection. 9 cases(28.13%) recurrence after 3 ~ 6 months,3 cases(9.4%), repeated injections,partially alleviated. Curative effect comparison between different nationality patients did not see the difference.Conclusion Type A botulinum toxin in the treatment of facial spasm of simple and easy, safe and effective. The disease is the lighter, the better curative effect. Pay attention to more carefully observation, site selection, the more precise the curative effect is better. Second, more muscle injection and each muscle multi-point injection, the better curative effect. Cooperate with psychological treatment can also improve curative effect, reduce recurrence,clinical need individualized comprehensive treatment. Curative effect between different ethnic groups patients did not have the difference.更多还原