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肉毒杆菌毒素治疗神经性疼痛的疗效:一项系统评价。

The efficacy of botulinum toxin in neuropathic pain: a systematic review.

作者信息

Oliveira Kaísa Menezes, Barreto Eduardo Silva Reis, Alencar Vinicius Borges, Lins-Kusterer Liliane Elze Falcão, Azi Liana Maria Torres de Araujo, Kraychete Durval Campos

机构信息

School of Medicine, Federal University of Bahia, Salvador, Brazil.

出版信息

Br J Pain. 2024 Oct;18(5):388-402. doi: 10.1177/20494637241254191. Epub 2024 May 9.

Abstract

INTRODUCTION

Neuropathic pain (NP) is characterised as a lesion or disease directly affecting the somatosensory system. This study aims to analyse the efficacy of botulinum toxin type A (BT-A) in the treatment of neuropathic pain.

METHODS

This systematic literature review, guided by PRISMA, applied the PICO strategy with the following criteria: (P = patients with neuropathic pain, I = botulinum toxin, C = placebo or active drug, and O = pain relief).

RESULTS

Fourteen articles, all randomised controlled trials with a placebo control, were included in the review. A total of 645 patients were randomised, with 353 patients receiving treatment with botulinum toxin type A in doses ranging from 25U to 400U. The evaluated studies addressed trigeminal neuralgia, diabetic polyneuropathy, post-herpetic neuralgia, spinal cord injury, phantom limb pain, and peripheral neuropathic pain after trauma or surgery.

CONCLUSION

BT-A has emerged as a promising treatment for various origins of neuropathic pain. Therefore, future studies should adopt stricter criteria regarding dosage and routes of administration to ensure effective and consistent BT-A application.

摘要

引言

神经性疼痛(NP)的特征是直接影响躯体感觉系统的损伤或疾病。本研究旨在分析A型肉毒毒素(BT-A)治疗神经性疼痛的疗效。

方法

本系统文献综述以PRISMA为指导,采用PICO策略,标准如下:(P = 神经性疼痛患者,I = 肉毒毒素,C = 安慰剂或活性药物,O = 疼痛缓解)。

结果

该综述纳入了14篇文章,均为有安慰剂对照的随机对照试验。共有645例患者被随机分组,353例患者接受了剂量为25U至400U的A型肉毒毒素治疗。评估的研究涉及三叉神经痛、糖尿病性多发性神经病变、带状疱疹后神经痛、脊髓损伤、幻肢痛以及创伤或手术后的周围神经性疼痛。

结论

BT-A已成为一种有前景的治疗多种病因神经性疼痛的方法。因此,未来的研究应在剂量和给药途径方面采用更严格的标准,以确保BT-A的有效和一致应用。

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本文引用的文献

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Mechanisms of Botulinum Toxin Type A Action on Pain.A型肉毒毒素作用于疼痛的机制。
Toxins (Basel). 2019 Aug 5;11(8):459. doi: 10.3390/toxins11080459.
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Neuropathic cancer pain: prevalence, pathophysiology, and management.神经性癌症疼痛:患病率、病理生理学和管理。
Korean J Intern Med. 2018 Nov;33(6):1058-1069. doi: 10.3904/kjim.2018.162. Epub 2018 Jun 25.
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Botulinum Toxin for Central Neuropathic Pain.肉毒毒素治疗中枢性神经病理性疼痛
Toxins (Basel). 2018 Jun 1;10(6):224. doi: 10.3390/toxins10060224.

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