Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany,
J Neural Transm (Vienna). 2013 Nov;120(11):1565-7. doi: 10.1007/s00702-013-1021-1. Epub 2013 Jun 14.
Botulinum toxin is considered the treatment of choice for axillary hyperhidrosis. Its dosing, however, varies widely. We wanted to study differences in efficacy and adverse effects when Botox(®) 100 MU (B100) or Botox(®) 50 MU (B50) per axilla is applied. In a prospective double blind intraindividual side to side comparison design, we studied 51 patients (38 females, 13 males, age 32.8 ± 13.0 years) with symmetric axillary hyperhidrosis receiving B100 bilaterally the baseline period (BP), B100 unilaterally and B50 contralaterally at direct comparison (DC) and B50 bilaterally during the extension period (EP). 90 % of the patients reported the overall therapeutic effect as 'excellent', 10 % as 'good' during throughout the study. The duration of the therapeutic effect until it began to decline was 3.2 ± 1.3 months at BP, 3.2 ± 1.1 months at DC and 3.3 ± 1.4 months at EP. At DC none of the patients reported side to side differences of the therapeutic effect with respect to onset latency, intensity and duration. Injection site pain was identical on both sides. The clinical examination at the time of the re-injections did not reveal any side differences of the therapeutic effect. Throughout the study none of the patients reported adverse effects. Data suggest that the therapeutic effect of Botox(®) saturates at B50. Higher Botox(®) doses seem not to be necessary thus reducing costs for the treatment substantially.
肉毒毒素被认为是治疗腋窝多汗症的首选方法。然而，其剂量差异很大。我们想研究在每侧腋窝注射肉毒毒素 100MU（B100）或 50MU（B50）时疗效和不良反应的差异。在一项前瞻性、双盲、双侧自身对照设计中，我们研究了 51 例（38 名女性，13 名男性，年龄 32.8±13.0 岁）双侧腋窝多汗症患者，在基线期（BP）双侧注射 B100，直接比较时（DC）单侧注射 B100 对侧注射 B50，在扩展期（EP）双侧注射 B50。90%的患者在整个研究过程中报告总体治疗效果为“极好”，10%报告为“良好”。BP 时治疗效果开始下降的持续时间为 3.2±1.3 个月，DC 时为 3.2±1.1 个月，EP 时为 3.3±1.4 个月。在 DC 时，没有患者报告治疗效果的起始潜伏期、强度和持续时间存在双侧差异。双侧注射部位疼痛相同。再次注射时的临床检查未发现治疗效果的任何双侧差异。整个研究过程中，没有患者报告不良反应。数据表明，肉毒毒素的治疗效果在 B50 时达到饱和。更高的肉毒毒素剂量似乎没有必要，从而大大降低了治疗成本。
