Jankovic J
Department of Neurology, Baylor College of Medicine, Houston, Texas 77030,USA.
J Neurol Neurosurg Psychiatry. 2004 Jul;75(7):951-7. doi: 10.1136/jnnp.2003.034702.
Botulinum toxin, the most potent biological toxin, has become a powerful therapeutic tool for a growing number of clinical applications. This review draws attention to new findings about the mechanism of action of botulinum toxin and briefly reviews some of its most frequent uses, focusing on evidence based data. Double blind, placebo controlled studies, as well as open label clinical trials, provide evidence that, when appropriate targets and doses are selected, botulinum toxin temporarily ameliorates disorders associated with excessive muscle contraction or autonomic dysfunction. When injected not more often than every three months, the risk of blocking antibodies is slight. Long term experience with this agent suggests that it is an effective and safe treatment not only for approved indications but also for an increasing number of off-label indications.
肉毒杆菌毒素是最具毒性的生物毒素，已成为越来越多临床应用中的强大治疗工具。本综述关注肉毒杆菌毒素作用机制的新发现，并简要回顾其一些最常见的用途，重点是基于证据的数据。双盲、安慰剂对照研究以及开放标签临床试验均提供了证据表明，当选择合适的靶点和剂量时，肉毒杆菌毒素可暂时改善与肌肉过度收缩或自主神经功能障碍相关的病症。每三个月注射不超过一次时，产生阻断抗体的风险很小。长期使用该药物的经验表明，它不仅对已批准的适应症有效且安全，对越来越多的未获批准适应症也是如此。
