Mohajir Wasay A, Khurana Shruti, Singh Khushboo, Chong Reubyn William, Bhutani Manoop S
Department of Gastroenterology, Texas A&M College of Medicine and Baylor Scott & White Medical Center, Round Rock, Texas.
Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, Texas.
Gastroenterol Hepatol (N Y). 2023 Apr;19(4):198-212.
The discovery of botulinum toxin A (BTX)'s therapeutic properties has led to studies evaluating its usefulness in multiple medical disorders. Its use in the gastrointestinal (GI) tract has been studied for 30 years. Multiple databases, including PubMed, AccessMedicine, ClinicalKey, Cochrane Library, Embase, and Medline, were used to review research from case series to randomized controlled trials on BTX use in the GI tract. This article reviews the current literature on the efficacy of BTX and the strength of recommendations for or against its use in various disorders, including cricopharyngeal dysphagia, achalasia, nonachalasia motility disorders, gastroparesis, obesity, sphincter of Oddi disorders, chronic anal fissure, chronic idiopathic anal pain, and anismus. The appeal of BTX comes from its simplicity of administration, good safety profile, and reliability in decreasing muscular tone. However, there are several drawbacks that limit its use, including the lack of long-term efficacy and/or limited data in many GI disorders.
肉毒杆菌毒素A（BTX）治疗特性的发现促使人们开展研究，评估其在多种医学病症中的效用。其在胃肠道（GI）的应用已研究了30年。包括PubMed、AccessMedicine、ClinicalKey、Cochrane图书馆、Embase和Medline在内的多个数据库被用于回顾从病例系列到随机对照试验等关于BTX在胃肠道应用的研究。本文回顾了当前关于BTX疗效的文献，以及支持或反对其用于各种病症（包括环咽肌失弛缓症、贲门失弛缓症、非贲门失弛缓症性动力障碍、胃轻瘫、肥胖症、Oddi括约肌紊乱、慢性肛裂、慢性特发性肛门疼痛和排便障碍）的推荐强度。BTX的吸引力在于其给药简便、安全性良好以及降低肌张力的可靠性。然而，也存在一些限制其使用的缺点，包括在许多胃肠道疾病中缺乏长期疗效和/或数据有限。
