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Botulinum toxin A injection for chronic anal fissures and anal sphincter spasm improves quality of life in recessive dystrophic epidermolysis bullosa.注射A型肉毒杆菌毒素治疗慢性肛裂和肛门括约肌痉挛可改善隐性营养不良性大疱性表皮松解症患者的生活质量。
Int J Womens Dermatol. 2015 Oct 23;1(4):167-169. doi: 10.1016/j.ijwd.2015.08.002. eCollection 2015 Dec.
2
A comparison of injections of botulinum toxin and topical nitroglycerin ointment for the treatment of chronic anal fissure.肉毒杆菌毒素注射与外用硝酸甘油软膏治疗慢性肛裂的比较。
N Engl J Med. 1999 Jul 8;341(2):65-9. doi: 10.1056/NEJM199907083410201.
3
Fissurectomy-botulinum toxin: a novel sphincter-sparing procedure for medically resistant chronic anal fissure.肛裂切除术-肉毒杆菌毒素：一种用于治疗药物抵抗性慢性肛裂的新型保留括约肌手术。
Dis Colon Rectum. 2004 Nov;47(11):1947-52. doi: 10.1007/s10350-004-0693-x.
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Increased anal basal pressure in chronic anal fissures may be caused by overreaction of the anal-external sphincter continence reflex.慢性肛裂患者肛门基础压力增加可能是由肛门外括约肌节制反射过度反应引起的。
Med Hypotheses. 2016 Sep;94:25-9. doi: 10.1016/j.mehy.2016.06.005. Epub 2016 Jun 5.
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A contraction response of the internal anal sphincter to Botulinum toxin: does low-pressure chronic anal fissure have a different pathophysiology?肛门内括约肌对肉毒毒素的收缩反应：低压力慢性肛裂是否具有不同的病理生理学？
Colorectal Dis. 2011 Sep;13(9):1014-8. doi: 10.1111/j.1463-1318.2010.02318.x. Epub 2010 May 17.
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A comparison of botulinum toxin and saline for the treatment of chronic anal fissure.肉毒杆菌毒素与生理盐水治疗慢性肛裂的比较
N Engl J Med. 1998 Jan 22;338(4):217-20. doi: 10.1056/NEJM199801223380402.
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Long-term outcome of the use of botulinum toxin injection for functional anal pain.肉毒杆菌毒素注射治疗功能性肛门疼痛的长期疗效。
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Histology and function of the internal anal sphincter after injection of botulinum toxin.注射肉毒杆菌毒素后肛门内括约肌的组织学与功能
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Partial lateral internal sphincterotomy versus combined botulinum toxin A injection and topical diltiazem in the treatment of chronic anal fissure: a randomized clinical trial.部分外侧内括约肌切开术与肉毒杆菌毒素A注射联合局部应用地尔硫䓬治疗慢性肛裂的随机临床试验
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[Favourable results with local injections of botulinum-A toxin in patients with chronic isosorbide dinitrate ointment-resistant anal fissures].[肉毒杆菌A毒素局部注射治疗慢性硝酸异山梨酯软膏耐药性肛裂患者的良好效果]
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Consensus-based guidelines for the provision of palliative and end-of-life care for people living with epidermolysis bullosa.针对大疱性表皮松解症患者的姑息治疗和临终关怀提供的基于共识的指南。
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Small molecule drug development for rare genodermatoses - evaluation of the current status in epidermolysis bullosa.罕见遗传性皮肤病小分子药物研发——大疱性表皮松解症现状评估。
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本文引用的文献

1
Recessive dystrophic epidermolysis bullosa (RDEB) complicated by secondary hepatic amyloidosis.隐性营养不良性大疱性表皮松解症（RDEB）并发继发性肝淀粉样变性。
JAAD Case Rep. 2015 Sep 24;1(6):337-9. doi: 10.1016/j.jdcr.2015.07.006. eCollection 2015 Nov.
2
A phase II randomized vehicle-controlled trial of intradermal allogeneic fibroblasts for recessive dystrophic epidermolysis bullosa.一项用于隐性营养不良型大疱性表皮松解症的皮内同种异体成纤维细胞的 II 期随机对照试验。
J Am Acad Dermatol. 2013 Dec;69(6):898-908.e7. doi: 10.1016/j.jaad.2013.08.014. Epub 2013 Sep 24.
3
Botulinum toxin in the treatment of sweat-worsened foot problems in patients with epidermolysis bullosa simplex and pachyonychia congenita.肉毒毒素治疗单纯型大疱性表皮松解症和先天性厚甲症患者的汗症性足部问题。
Br J Dermatol. 2010 Nov;163(5):1072-6. doi: 10.1111/j.1365-2133.2010.09927.x.
4
Quality of life evaluation in epidermolysis bullosa (EB) through the development of the QOLEB questionnaire: an EB-specific quality of life instrument.通过开发 QOLEB 问卷评估大疱性表皮松解症（EB）患者的生活质量：一种专门针对 EB 的生活质量评估工具。
Br J Dermatol. 2009 Dec;161(6):1323-30. doi: 10.1111/j.1365-2133.2009.09347.x. Epub 2009 Jun 11.
5
Treatment of epidermolysis bullosa simplex, Weber-Cockayne type, with botulinum toxin type A.A型肉毒杆菌毒素治疗单纯性大疱性表皮松解症，Weber-Cockayne型。
Arch Dermatol. 2009 Jan;145(1):13-5. doi: 10.1001/archdermatol.2008.546.
6
Randomized clinical trial comparing botulinum toxin injections with 0.2 per cent nitroglycerin ointment for chronic anal fissure.比较肉毒杆菌毒素注射与0.2%硝酸甘油软膏治疗慢性肛裂的随机临床试验。
Br J Surg. 2007 Feb;94(2):162-7. doi: 10.1002/bjs.5514.
7
Treatment of plantar hyperhidrosis with botulinum toxin type A.A型肉毒杆菌毒素治疗足底多汗症。
Int J Dermatol. 2004 Dec;43(12):969-71. doi: 10.1111/j.1365-4632.2004.02304.x.
8
Botulinum neurotoxin to treat chronic anal fissure: results of a randomized "Botox vs. Dysport" controlled trial.肉毒杆菌神经毒素治疗慢性肛裂：一项“肉毒杆菌毒素A对比Dysport”随机对照试验的结果
Aliment Pharmacol Ther. 2004 Mar 15;19(6):695-701. doi: 10.1111/j.1365-2036.2004.01895.x.
9
Long-term follow-up (42 months) of chronic anal fissure after healing with botulinum toxin.肉毒杆菌毒素治疗慢性肛裂愈合后的长期随访（42个月）
Gastroenterology. 2002 Jul;123(1):112-7. doi: 10.1053/gast.2002.34219.
10
Repeat botulin toxin injections in anal fissure: in patients with relapse and after insufficient effect of first treatment.肛裂患者重复注射肉毒杆菌毒素：用于复发患者及首次治疗效果不佳者。
Dig Dis Sci. 1999 Aug;44(8):1588-9. doi: 10.1023/a:1026610910080.

注射A型肉毒杆菌毒素治疗慢性肛裂和肛门括约肌痉挛可改善隐性营养不良性大疱性表皮松解症患者的生活质量。

Botulinum toxin A injection for chronic anal fissures and anal sphincter spasm improves quality of life in recessive dystrophic epidermolysis bullosa.

作者信息

Chaptini Cassandra, Casey Genevieve, Harris Adam G, Wattchow David, Gordon Lynne, Murrell Dedee F

机构信息

Flinders Medical Centre, Adelaide, Australia.

Women's and Children's Hospital, Adelaide, Australia.

出版信息

Int J Womens Dermatol. 2015 Oct 23;1(4):167-169. doi: 10.1016/j.ijwd.2015.08.002. eCollection 2015 Dec.

DOI:10.1016/j.ijwd.2015.08.002
PMID:28491983
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5419760/
Abstract

We report a 20-year-old female with generalized, severe, recessive dystrophic epidermolysis bullosa who developed secondary chronic anal fissures. This resulted in anal sphincter spasm and severe, disabling pain. She was treated with five botulinum toxin A injections into the internal anal sphincter over a period of 2 years and gained marked improvement in her symptoms. This case demonstrates the successful use of botulinum toxin A injections to relieve anal sphincter spasm and fissuring, with long-term improvement.

摘要

我们报告一名20岁患有全身性、重度隐性营养不良性大疱性表皮松解症的女性，她出现了继发性慢性肛裂。这导致肛门括约肌痉挛和严重的、致残性疼痛。在2年的时间里，她接受了5次肉毒杆菌毒素A注射到肛门内括约肌，症状得到了显著改善。该病例证明了肉毒杆菌毒素A注射在缓解肛门括约肌痉挛和肛裂方面的成功应用，并带来了长期改善。