肉毒杆菌毒素在口面部疼痛疾病中的应用批判性综述。

A critical review of the use of botulinum toxin in orofacial pain disorders.

作者信息

Clark Glenn T, Stiles Alan, Lockerman Larry Z, Gross Sheldon G

机构信息

Department of Diagnostic Sciences, Orofacial Pain and Oral Medicine Center, University of Southern California, 925 West 34th Street, Los Angeles, CA 90089, USA.

出版信息

Dent Clin North Am. 2007 Jan;51(1):245-61, ix. doi: 10.1016/j.cden.2006.09.003.

DOI:10.1016/j.cden.2006.09.003

PMID:17185069

Abstract

This article reviews the appropriate use, cautions, and contraindication for botulinum neurotoxin (BoNT) and reviews the peer-reviewed literature that describes its efficacy for treatment of various chronic orofacial pain disorders. The literature has long suggested that BoNT is of value for orofacial hyperactivity and more recently for some orofacial pain disorders; however, the results are not as promising for orofacial pain. The available data from randomized, double-blind, placebo-controlled trials (RBCTs) do not support the use of BoNT as a substantially better therapy than what is being used already. The one exception is that BoNT has reasonable RBCT data to support its use as a migraine prophylaxis therapy. The major caveat is that the use of BoNT in chronic orofacial pain is "off-label".

摘要

本文回顾了肉毒杆菌神经毒素（BoNT）的合理使用、注意事项及禁忌证，并综述了描述其治疗各种慢性口面部疼痛疾病疗效的同行评审文献。长期以来，文献表明BoNT对口面部活动亢进有价值，最近也显示对某些口面部疼痛疾病有价值；然而，其对口面部疼痛的治疗效果并不那么令人满意。来自随机、双盲、安慰剂对照试验（RBCT）的现有数据并不支持将BoNT作为比现有治疗方法明显更好的疗法。唯一的例外是，BoNT有合理的RBCT数据支持其作为偏头痛预防性治疗的用途。主要的警告是，BoNT在慢性口面部疼痛中的使用属于“超说明书用药”。