Ruiz-Roca Juan Antonio, Pons-Fuster Eduardo, Lopez-Jornet Pia
Department of Stomatology, Faculty of Dentistry, University of Murcia, 30008 Murcia, Spain.
Research Investigations, Instituto Murciano de Investigación Biosanitaria (IMIB), 30120 Murcia, Spain.
J Clin Med. 2019 Mar 6;8(3):317. doi: 10.3390/jcm8030317.
The main objective was to assess the efficacy of botulinum toxin-based treatment for sialorrhea in adult patients with Parkinson's disease. The search was performed by using the Medline-PubMed, EMBASE and Cochrane Library databases from January 2000⁻December 2017, in English/Spanish in patients with Parkinson's disease and sialorrhea. The methodological quality of trials was carried out by following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria and the Newcastle⁻Ottawa Scale (NOS). Finally, a total of 21 articles were identified as fulfilling the inclusion criteria. There is no consensus regarding the site of injection of the toxin (single or multiple points), toxin dose or follow-up period. In all cases there was a reduction of sialorrhea. Treatment safety increases with the use of ultrasonography. Effects approximately occur at one week post-injection and for 3⁻5 months. Botulinum toxin is an effective therapeutic strategy or option in treating sialorrhea in adult patients with Parkinson's disease. More studies with a better design, larger samples and a longer follow-up period are required to confirm these data.
主要目的是评估基于肉毒杆菌毒素的治疗方法对成年帕金森病患者流涎症的疗效。检索使用了2000年1月至2017年12月的Medline-PubMed、EMBASE和Cochrane图书馆数据库，检索语言为英语/西班牙语，检索对象为患有帕金森病和流涎症的患者。按照PRISMA（系统评价和Meta分析的首选报告项目）标准和纽卡斯尔-渥太华量表（NOS）对试验的方法学质量进行评估。最终，共确定21篇文章符合纳入标准。关于毒素注射部位（单点或多点）、毒素剂量或随访期尚无共识。在所有病例中，流涎症均有所减轻。使用超声检查可提高治疗安全性。效果大约在注射后一周出现，持续3至5个月。肉毒杆菌毒素是治疗成年帕金森病患者流涎症的一种有效治疗策略或选择。需要更多设计更好、样本量更大且随访期更长的研究来证实这些数据。
