富含脂肪基质细胞的高密度脂肪移植联合A型肉毒毒素治疗雷诺现象的疗效：一项前瞻性队列研究。

Efficacy of adipose stromal cells-enriched high-density fat graft combined with BTX-A for Raynaud's phenomenon: a prospective cohort study.

作者信息

Deng Chengliang, Liu Xin, Wei Miaomiao, Wu Bihua, Zhang Tianhua, Xiao Shune, Min Peiru, Zhang Yixin

机构信息

Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.

Department of Burns and Plastic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, China.

出版信息

Arthritis Res Ther. 2025 Mar 19;27(1):56. doi: 10.1186/s13075-025-03533-8.

DOI:10.1186/s13075-025-03533-8

PMID:40108705

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11921646/

Abstract

BACKGROUND

Conventional treatments for Raynaud's phenomenon (RP) often show limited effectiveness due to their inability to address both vascular and inflammatory aspects. This study evaluates the combination of high-density fat grafting (HDFG) with botulinum toxin A (BTX-A) for treating RP.

METHODS

Eleven patients with 20 affected hands diagnosed with RP were recruited and randomly assigned to receive either HDFG combined with BTX-A (intervention group, n = 11) or HDFG alone (control group, n = 9). Efficacy was assessed using Visual Analog Scale (VAS) pain scores and McCabe Cold Sensitivity Scores, along with finger ulcer healing time and infrared thermal imaging to evaluate blood perfusion improvements.

RESULTS

The HDFG-BTX group showed significant improvements in hand symptoms. VAS pain scores decreased from a pre-treatment mean of 5.33 to 0.84 post-treatment (mean reduction of 4.49, p = 0.018), indicating effective pain relief. McCabe scores improved from 272.73 to 75.00 (mean reduction of 197.73, p = 0.001), demonstrating reduced cold sensitivity. Ulcer healing time was shorter in the HDFG-BTX group (14.25 days) compared to HDFG alone (25.6 days, p < 0.001), highlighting faster recovery. Infrared imaging indicated significant enhancements in blood perfusion.

CONCLUSION

HDFG combined with BTX-A is a reliable and beneficial intervention for RP, leading to high patient satisfaction.

摘要

背景

雷诺现象（RP）的传统治疗方法往往效果有限，因为它们无法同时解决血管和炎症方面的问题。本研究评估了高密度脂肪移植（HDFG）联合肉毒杆菌毒素A（BTX-A）治疗RP的效果。

方法

招募了11例患有20只患手的RP患者，并随机分配接受HDFG联合BTX-A治疗（干预组，n = 11）或仅接受HDFG治疗（对照组，n = 9）。使用视觉模拟量表（VAS）疼痛评分、麦凯布冷敏评分评估疗效，同时结合手指溃疡愈合时间和红外热成像来评估血液灌注改善情况。

结果

HDFG-BTX组手部症状有显著改善。VAS疼痛评分从治疗前的平均5.33降至治疗后的0.84（平均降低4.49，p = 0.018），表明疼痛得到有效缓解。麦凯布评分从272.73提高到75.00（平均降低197.73，p = 0.001），表明冷敏性降低。HDFG-BTX组的溃疡愈合时间（14.25天）比仅接受HDFG治疗的组（25.6天，p < 0.001）短，并突出显示恢复更快。红外成像表明血液灌注有显著增强。