Department of Rehabilitation Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea.
Toxins (Basel). 2018 Sep 3;10(9):355. doi: 10.3390/toxins10090355.
Myofascial pain syndrome is a common painful condition encountered in the general population. Previous studies evaluating the efficacy of botulinum toxin for the treatment of myofascial pain syndrome are limited, with variable results. This prospective study investigated the efficacy and safety of direct injection of Prabotulinumtoxin A (Nabota) into painful muscle groups for cervical and shoulder girdle myofascial pain. Twelve patients with chronic myofascial pain syndrome of the neck and shoulder underwent an injection of Prabotulinumtoxin A. Painful muscles containing trigger points were injected in the mid-belly. Pain scores and quality of life measurements were assessed at baseline, as well as 6 weeks and 12 weeks post-injection. Safety and tolerability were also assessed. This trial is registered under clinical research information service (CRIS) number KCT0001634. Patients injected with Prabotulinumtoxin A showed a significant improvement in pain at 12 weeks ( < 0.001). At 6 weeks, the pain had not significantly improved compared with baseline ( = 0.063). However, at that time, 41.7% of patients were characterized as Prabotulinumtoxin A responders, with a 30% reduction in pain rating score compared to baseline. In the Neck Disability Index scores, the patients demonstrated significant improvement at both 6 weeks and 12 weeks. No serious adverse effects occurred during the study. Prabotulinumtoxin A injection into chronically painful muscles associated with cervical and shoulder girdle myofascial pain syndrome resulted in an improvement in pain scores and quality of life lasting at least 12 weeks. Additionally, the injections were well tolerated. As these are preliminary findings in a pilot study, future studies should carefully consider using randomized, controlled, prospective trials.
肌筋膜疼痛综合征是一种常见的疼痛病症，在普通人群中较为常见。先前评估肉毒毒素治疗肌筋膜疼痛综合征疗效的研究有限，结果存在差异。本前瞻性研究调查了直接向颈肩部肌筋膜疼痛的疼痛肌肉群注射帕洛诺司琼毒素 A（Nabota）的疗效和安全性。12 例慢性颈肩部肌筋膜疼痛综合征患者接受了帕洛诺司琼毒素 A 注射。在中腹部注射含有触发点的疼痛肌肉。在基线、注射后 6 周和 12 周评估疼痛评分和生活质量测量值。还评估了安全性和耐受性。该试验在临床研究信息服务（CRIS）编号 KCT0001634 下注册。注射帕洛诺司琼毒素 A 的患者在 12 周时疼痛明显改善（<0.001）。在 6 周时，与基线相比，疼痛没有显著改善（=0.063）。然而，此时，41.7%的患者被认为是帕洛诺司琼毒素 A 反应者，与基线相比疼痛评分降低了 30%。在颈部残疾指数评分中，患者在 6 周和 12 周时均表现出显著改善。研究过程中未发生严重不良事件。将帕洛诺司琼毒素 A 注射到与颈肩部肌筋膜疼痛综合征相关的慢性疼痛肌肉中，可使疼痛评分和生活质量至少在 12 周内得到改善。此外，注射耐受性良好。由于这些是初步研究结果，因此未来的研究应仔细考虑使用随机、对照、前瞻性试验。
