Benson Jennifer, Daugherty Kimberly K
Kroger Pharmacy, Frankenmuth, MI, USA.
Ann Pharmacother. 2007 Jan;41(1):79-85. doi: 10.1345/aph.1H381. Epub 2006 Dec 26.
To review the efficacy and safety of botulinum toxin A (BTX) in the treatment of sialorrhea.
A PubMed search and reference list review was performed to find clinical trials on BTX in the treatment of sialorrhea. The search was limited to English-language trials involving human subjects. Articles from 1965 to October 2006 were searched, using key words botulinum, botulinum toxin, Botox, sialorrhea, saliva, salivary gland, and drooling.
Reports of 15 studies were found on BTX in the treatment of sialorrhea in human subjects. Four controlled trials are presented in detail, and 11 uncontrolled studies are summarized.
One controlled trial found that BTX caused significant reductions in patients' severity and frequency of drooling compared with placebo. Another found significant saliva reductions in the treatment group receiving the highest dose of BTX but found no subjective improvement compared with the placebo group. A third study comparing BTX with placebo found significant improvements in subjective and objective measures of drooling in the treatment group. A fourth controlled trial found significant reductions from baseline levels of drooling after patients received BTX injections. Similar efficacy was found between the BTX and scopolamine treatment groups.
Evidence indicates that BTX is a safe and effective treatment for sialorrhea. More research is needed to determine the ideal dose, injection location, and technique of BTX injections.
回顾A型肉毒杆菌毒素（BTX）治疗流涎症的疗效和安全性。
进行了PubMed检索及参考文献列表回顾，以查找关于BTX治疗流涎症的临床试验。检索限于涉及人类受试者的英文试验。检索了1965年至2006年10月的文章，使用了关键词肉毒杆菌、肉毒杆菌毒素、保妥适、流涎症、唾液、唾液腺和流口水。
找到15项关于BTX治疗人类流涎症的研究报告。详细介绍了4项对照试验，并总结了11项非对照研究。
一项对照试验发现，与安慰剂相比，BTX可显著降低患者流口水严重程度和频率。另一项试验发现，接受最高剂量BTX的治疗组唾液显著减少，但与安慰剂组相比主观症状无改善。第三项比较BTX与安慰剂的研究发现，治疗组在流口水主观和客观指标方面有显著改善。第四项对照试验发现，患者接受BTX注射后，流口水水平较基线有显著降低。BTX与东莨菪碱治疗组疗效相似。
有证据表明BTX是治疗流涎症的一种安全有效的方法。需要更多研究来确定BTX注射的理想剂量、注射部位和技术。
