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病灶内注射A型肉毒杆菌毒素与曲安奈德治疗烧伤后瘙痒的对比评估

Comparative Evaluation of Intralesional Injection of Botulinum Toxin Type A Triamcinolone Acetonide in Treating Post-Burn Pruritus.

作者信息

Hoseininejad Seyed Saheb, Rahbar Roozbeh, Farhadi Mahtab, Godarzi Shahram

机构信息

Department of Plastic & Reconstructive Surgery, School of Medicine, Ahvaz Joundishapur University of Medical Sciences, Ahvaz, Iran.

出版信息

Maedica (Bucur). 2024 Dec;19(4):763-768. doi: 10.26574/maedica.2024.19.4.763.

Abstract

BACKGROUND AND OBJECTIVES

Pathological scars resulting from burns can impair both aesthetic and physical functions, often causing chronic pruritus. Thus, this study aimed to compare the effectiveness of intralesional botulinum toxin type A (BTX-A) and triamcinolone acetonide (TAC) in reducing pruritus and scar thickness caused by burns.

METHODS

This single-blind clinical trial was conducted on 60 patients experiencing post-burn pruritus. Patients selected a scar area with the highest degree of pruritus, which was divided into two equal parts. BTX-A was injected into one half and TAC into the other. Pruritus severity was assessed using the visual analog scale (VAS), the pain was assessed using the numeric rating scale (NRS), and scar thickness and the Vancouver scar scale (VSS) scores were at four time points.

RESULTS

The study involved 60 patients with a mean age of 35.72 years (range: 21-64 years). The results indicated that BTX-A was more effective than TAC in reducing scar thickness and pruritus. Changes in scar thickness from V1 to V4 demonstrated that BTX-A achieved more significant scar reduction than TAC (P=0.0287), and pruritus severity decreased significantly in the BTX-A group (P=0.0482).

CONCLUSION

Based on the results, BTX-A treatment is more effective than TAC in reducing pruritus and scar thickness in patients with chronic post-burn pruritus. Further studies with larger sample sizes and extended follow-up periods are required to confirm these findings.

摘要

背景与目的

烧伤导致的病理性瘢痕会损害美观和身体功能,常引起慢性瘙痒。因此,本研究旨在比较病灶内注射A型肉毒杆菌毒素(BTX-A)和曲安奈德(TAC)在减轻烧伤所致瘙痒和瘢痕厚度方面的效果。

方法

本单盲临床试验针对60例烧伤后瘙痒患者开展。患者选择瘙痒程度最高的瘢痕区域,将其分为两个相等的部分。一半注射BTX-A,另一半注射TAC。在四个时间点使用视觉模拟量表(VAS)评估瘙痒严重程度,使用数字评分量表(NRS)评估疼痛,测量瘢痕厚度并计算温哥华瘢痕量表(VSS)得分。

结果

该研究纳入60例患者,平均年龄35.72岁(范围:21 - 64岁)。结果表明,在减轻瘢痕厚度和瘙痒方面,BTX-A比TAC更有效。从V1到V4瘢痕厚度的变化显示,BTX-A比TAC实现了更显著的瘢痕减轻(P = 0.0287),且BTX-A组的瘙痒严重程度显著降低(P = 0.0482)。

结论

基于研究结果,对于慢性烧伤后瘙痒患者,BTX-A治疗在减轻瘙痒和瘢痕厚度方面比TAC更有效。需要更大样本量和更长随访期的进一步研究来证实这些发现。

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本文引用的文献

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Post-Burn Pruritus.烧伤后瘙痒。
Int J Mol Sci. 2020 May 29;21(11):3880. doi: 10.3390/ijms21113880.
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Post burn pruritus--a review of current treatment options.烧伤后瘙痒——现有治疗选择的综述。
Burns. 2012 Aug;38(5):621-9. doi: 10.1016/j.burns.2011.12.003. Epub 2012 Jan 12.

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