■评估A型肉毒杆菌毒素(BTX-A)治疗与颞下颌关节紊乱病(TMD)相关的肌筋膜疼痛的疗效。
■这项研究是根据PRISMA2020声明指南进行的。PubMed,Embase,搜索了Cochrane图书馆数据库。仅纳入随机对照试验。主要结果是视觉模拟量表上的疼痛评分,次要结局是最大张口和不良反应.使用Cochrane偏倚工具评估风险偏倚。使用相同干预措施的研究的荟萃分析,controls,评估方法,并进行了随访持续时间。
■共检索到519项研究,其中20项随机对照试验纳入定性分析,6项纳入荟萃分析.结果表明,与安慰剂相比,BTX-A注射更有效地缓解肌筋膜疼痛,其效果与常规方法相似。然而,两组最大张口无差异。在使用RoB2.0工具进行研究评估后,六项研究显示偏见的风险较低,13项研究对报告的结果表示了一些担忧,只有一项研究显示偏倚风险很高。在四项研究中观察到BTX-A注射的不良反应。
■总而言之,BTX-A可有效缓解TMD患者的疼痛,但不能改善张口。尽量减少不利影响,对于保守治疗不能完全缓解疼痛的TMD患者,我们建议使用低剂量的BTX-A.
UNASSIGNED: To assess the therapeutic efficacy of botulinum toxin type A (BTX-A) for managing myofascial pain related to temporomandibular disorders (TMDs).
UNASSIGNED: This study was conducted according to the PRISMA 2020 statement guidelines. The PubMed, Embase, and Cochrane Library databases were searched. Only randomized controlled trials were included. The primary outcome was a pain score on the visual analog scale, and the secondary outcomes were maximum mouth opening and adverse effects. The Cochrane risk of bias tool was used to assess risk bias. A meta-analysis of studies with the same interventions, controls, assessment methods, and follow-up durations was performed.
UNASSIGNED: A total of 519 studies were retrieved, of which 20 randomized controlled trials were included in the qualitative analysis and six were included in the meta-analysis. The results showed that, compared with placebo, BTX-A injection was more effective at relieving myofascial pain, and its effect was similar to that of conventional methods. However, there was no difference in maximum mouth opening between the two groups. After the study assessment with the RoB 2.0 tool, six studies showed a low risk of bias, 13 studies showed some concerns regarding the reported results, and only one study showed a high risk of bias. Adverse effects of BTX-A injection were observed in four studies.
UNASSIGNED: In conclusion, BTX-A is effective at relieving pain in TMD patients but does not improve mouth opening. To minimize adverse effects, we recommend a low dose of BTX-A for TMD patients who do not experience complete pain relief from conservative treatments.