Su Cheng-San, Lan Min-Yu, Liu Jia-Shou, Chang Chiung-Chih, Lai Shung-Lon, Wu Hsiu-Shan, Chen Shun-Sheng, Chang Yung-Yee
Department of Neurology, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan.
Acta Neurol Taiwan. 2006 Sep;15(3):170-6.
To investigate the effect of botulinum toxin type A (BTX-A; Botox) in reducing saliva in patients with Parkinsonism.
Fifteen patients with clinical diagnosis of idiopathic Parkinson's disease, dementia with Lewy bodies, or multiple system atrophy were enrolled in this open clinical trial. A total of 40-unit dose of Botox was injected into the bilateral parotid and submandibular glands. Objective measuring of saliva production with dental rods, subjective Drooling Score, personal impression of clinical improvement, and the duration of response were used for the global assessment of sialorrhea after BTX-A treatment.
All patients showed objective reduction in saliva production following BTX-A treatment and the mean production was reduced at a significant level. The severity of sialorrhea assessed by Drooling Score was 5.87 +/- 0.92 (range: 5-8) and 3.60 +/- 1.18 (range: 2-6) respectively (p<0.001) before and after BTX-A injection. The mean duration of BTX-A response extended for 16.3 +/- 5.7 weeks (range: 5-24). No severe adverse effect nor worsening of existing dysphagia was observed in all Parkinsonian patients.
Parkinsonian drooling may undermine patient's health and daily activity. BTX-A local injection is a safe and effective measure in counteracting sialorrhea, even in patients associated with moderate dysphagia.
研究A型肉毒毒素（BTX-A；保妥适）对帕金森病患者减少唾液分泌的效果。
15例临床诊断为特发性帕金森病、路易体痴呆或多系统萎缩的患者参与了这项开放性临床试验。将总计40单位剂量的保妥适注射到双侧腮腺和颌下腺。使用牙棒客观测量唾液分泌量、主观流涎评分、临床改善的个人印象以及反应持续时间，对BTX-A治疗后的流涎情况进行整体评估。
所有患者在BTX-A治疗后唾液分泌量均出现客观减少，平均分泌量显著降低。BTX-A注射前后，通过流涎评分评估的流涎严重程度分别为5.87±0.92（范围：5 - 8）和3.60±1.18（范围：2 - 6）（p<0.001）。BTX-A反应的平均持续时间延长至16.3±5.7周（范围：5 - 24）。所有帕金森病患者均未观察到严重不良反应，现有吞咽困难也未加重。
帕金森病流涎可能损害患者健康和日常活动。BTX-A局部注射是对抗流涎的一种安全有效的措施，即使是伴有中度吞咽困难的患者。
