Mittermair Reinhard, Keller Christian, Geibel John
Department of General and Transplant Surgery, University Hospital, Medical University Innsbruck, Austria.
Obes Surg. 2007 Jun;17(6):732-6. doi: 10.1007/s11695-007-9135-x.
Botulinum toxin A (BTX-A) is a powerful and long-acting inhibitor of muscular contractions in both striated and smooth muscles. Hypothetically, BTX-A should inhibit the acetylcholine-mediated peristalsis, which is mainly responsible for gastric motility, and thereby induce slowed gastric emptying, earlier satiety and weight loss. The aim of this study was to observe the effects of endoscopic intragastric injections of BTX-A in obese patients.
After approval by the University Ethics Committee, 10 female patients with class I obesity (body mass index 30-35) were double-blind randomized into 2 groups (BTX-A and 0.9% Saline). In Group 1, 200 U BTX-A were injected endoscopically into the antrum and the distal gastric body. In Group 2, 0.9% saline was injected endoscopically into the antrum and the distal gastric body. Body weight and feeling of satiety were recorded monthly over a period of 6 months.
Both groups (BTX-A and 0.9% Saline) showed no significant weight reduction (P>0.05). One patient in Group 1 and two patients in Group 2 reported a feeling of early satiety. No adverse effects related to BTX-A or complications resulting from the endoscopic procedure were observed.
Intragastric injection of BTX-A for the treatment of obesity does not seem to reduce body weight.
A型肉毒杆菌毒素（BTX-A）是一种强效且长效的横纹肌和平滑肌收缩抑制剂。据推测，BTX-A应能抑制乙酰胆碱介导的蠕动，而蠕动是胃动力的主要成因，从而导致胃排空减慢、早饱感增强及体重减轻。本研究旨在观察内镜下胃内注射BTX-A对肥胖患者的影响。
经大学伦理委员会批准，10名I级肥胖女性患者（体重指数30 - 35）被双盲随机分为两组（BTX-A组和0.9%生理盐水组）。第1组通过内镜将200 U BTX-A注射至胃窦和胃体远端。第2组通过内镜将0.9%生理盐水注射至胃窦和胃体远端。在6个月的时间里，每月记录体重和饱腹感。
两组（BTX-A组和0.9%生理盐水组）均未出现显著体重减轻（P>0.05）。第1组有1名患者，第2组有2名患者报告有早饱感。未观察到与BTX-A相关的不良反应或内镜操作引起的并发症。
胃内注射BTX-A治疗肥胖似乎并不能减轻体重。
