國立臺灣大學醫學院復健科謝正宜2006-07-262018-07-132006-07-262018-07-132005-07-31http://ntur.lib.ntu.edu.tw//handle/246246/28992腦性麻痺合併有流涎問題的比例約 10-37%，肉毒桿菌毒素抑制神經末稍乙醯 膽鹼分泌的機轉應可減少唾液之分泌。本 研究的目的是評估利用A 型肉毒桿菌毒 素局部注射於唾液腺的方法來治療腦性 麻痺患者流涎的可行性，並確認此注射劑 量是否適當及了解藥效維持的時間和可 能的副作用。病患隨機分成治療組與對照 組，其中治療組接受肉毒桿菌毒素注射入 單側之頷下腺及耳下腺腺體中，每公斤體 重使用2 U (Botox)；對照組接受生理食 鹽水注射入單側之頷下腺及耳下腺腺體 中。病患在注射前一週與注射後特定時間 點分別測量流涎嚴重度與頻率、流涎量、 流涎商數三種指標，並比較治療組與對照 組、治療組注射肉毒桿菌毒素前後三種指 標的差異。結果顯示，術後三個月內治療 組比對照組病患的流涎獲得顯著的改 善，且治療組的病患顯著的比未注射肉毒 桿菌毒素前有明顯的改善，治療及追蹤期 間並未發現嚴重的副作用。由本研究的結 果，我們認為肉毒桿菌毒素注射治療腦性 麻痺患者流涎是個有效且副作用少的方 式。About 10-37% patients with cerebral palsy have the problem of drooling. Botulinum toxin might be able to lower the amount of saliva through its mechanism in inhibiting the acetylcholine release from neuroglandular junction. The aim of this study is to evaluate the effect, side-effects and safety of botulinum toxin injection in treating drooling in cerebral palsy. We conducted a randomized double-blinded placebo-controlled trial with botulinum toxin and normal saline injected to major salivary glands in experimental and control group respectively. Outcome measures including drooling severity and frequency scale, the amount of saliva production, and the drooling quotient were used for evaluation before injection and at regular intervals after injection. The results showed that drooling improved significantly in experimental group within 12 weeks after injection. In patients receiving botulinum toxin injection, all outcome measures differed significantly before and during the 14 weeks after injection. There is no side effect during the 22 weeks follow-up periods. In the study of application of botulinum toxin type A to treat drooling in cerebral palsy, we found botulinum toxin injection is effective and safe.application/pdf278926 bytesapplication/pdfzh-TW國立臺灣大學醫學院復健科腦性麻痺流涎肉毒桿菌毒 素cerebral palsydroolingbotulinum toxinjournal articlehttp://ntur.lib.ntu.edu.tw/bitstream/246246/28992/1/932614B002005.pdf