背景:面肌痉挛(HFS)是一种使人衰弱的疾病,其特征是由面神经支配的肌肉的不自主的强直和阵挛性收缩。肉毒杆菌毒素A(BTX-A)是HFS的一线选择和最有效的药物治疗。本研究的目的是评估BTX-A治疗对HFS患者身心健康的影响。
方法:研究对象包括65名HFS患者和65名匹配的健康对照。采用康奈尔医学指数(CMI)自评问卷对所有参与者的心理健康状况进行检测。局部注射BTX-A,并采用科恩等级标准对痉挛程度进行分层,进一步评估BTX-A在HFS患者治疗前和治疗后两个月的疗效。采用CMI自评问卷对治疗后2个月的HFS患者进行再评价,并将这些患者的评估因素与治疗前的患者进行比较。
结果:躯体化评分,抑郁症,焦虑,不适应,灵敏度,愤怒,紧张,M-R,HFS组总分明显高于对照组(均P<0.05)。治疗后两个月,在接受BTX-A治疗的65例HFS患者中,42人(64.6%)完全缓解,16人(24.6%)明显缓解,7人(10.8%)部分缓解,0(0%)例无效,总有效率为89.2%。BTX-A治疗后两个月,躯体化的分数,紧张,焦虑,抑郁症,灵敏度,HFS患者的M-R和总分均低于治疗前(均P<0.05)。
结论:HFS患者常伴有躯体化,愤怒,不适应,灵敏度,焦虑,抑郁症,和紧张。BTX-A不仅可以缓解HFS的症状,而且还改善了躯体化,紧张,焦虑,抑郁症,和敏感性。
BACKGROUND: Hemifacial spasm (HFS) is a debilitating disease characterized by involuntary tonic and clonic contractions of muscles innervated by the facial nerve. Botulinum toxin A (BTX-A) is the first-line option and the most effective medical treatment for HFS. The objective of this study was to evaluate the effect of BTX-A therapy on the physical and mental health of HFS patients.
METHODS: Participants included 65 HFS patients and 65 matched healthy controls in the study. Cornell Medical Index (CMI) self-assessment questionnaire was used to detect the psychological health of all participants. Local injection of BTX-A was applied, and the Cohen hierarchical criteria were employed to stratify the degree of spasticity, further evaluating the efficacy of BTX-A before and two months after treatment in HFS patients. The HFS patients at two months post-treatment were re-evaluated by CMI self-assessment questionnaire, and the evaluated factors of these patients were compared with those of patients before treatment.
RESULTS: The scores of somatization, depression, anxiety, inadaptation, sensitivity, anger, tension, M-R, and total scores in the HFS group were significantly higher than those in the control group (all P<0.05). Two months post-treatment, among 65 HFS patients who received with BTX-A treatment, 42 (64.6%) were completely relieved, 16 (24.6%) were significantly relieved, 7 (10.8%) were partially relieved, and 0 (0%) cases were invalid, and the total effective rate was 89.2%. Two months after BTX-A treatment, the scores of somatization, tension, anxiety, depression, sensitivity, M-R and total scores of patients with HFS were lower than those before treatment (all P<0.05).
CONCLUSIONS: Patients with HFS are often accompanied by somatization, anger, inadaptation, sensitivity, anxiety, depression, and tension. BTX-A can not only alleviate the symptoms of HFS, but also improve the somatization, tension, anxiety, depression, and sensitivity.