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Arthritis Rheumatol：肉毒杆菌毒素治疗硬皮病相关的雷诺现象的治疗效果如何？

2017-05-29 xing.T MedSci原创

BTX-A硬皮病PR
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该研究基于实验室的LDI血量数据并不支持使用BTX-A来治疗所有硬皮病患者的RP。次要的临床结局显示出了一些积极的，但仍存可疑的临床意义效应。BTX-A治疗RP的作用应该在更多的同质性患者人群和独特的临床情况来进一步研究。

近日，风湿疾病领域权威杂志Arthritis & Rheumatology上发表了一篇研究文章，研究人员旨在评估局部注射A型肉毒毒素（BTX-A）对改善继发于硬皮病的Raynaud现象（RP）患者手部血液量方面的疗效。

在这项随机、双盲、安慰剂对照的临床试验中，硬皮病相关的RP患者随机选择一只手注射BTX-A（2.5毫升50单位）治疗，另一只手注射无菌生理盐水（2.5毫升）。注射后随访1个月和4个月后，进行了患者手部激光多普勒成像（LDI）检查，评估了患者报告的临床结局和体格检查。研究人员采用配对t检验和带有广义估计方程的人口平均广义模型来比较了患者结局。

该研究共纳入了40例患者，有25例为局限性硬皮病患者，另有15例弥漫性硬皮病患者。从基线到随访后1个月，与安慰剂比较，注射BTX-A的手平均血流量显著减少。该模型估计的差异具有统计学意义（平均差异为-30.08流量单位，95%可信区间为-56.19至-3.98，p=0.024）。这种差异主要受长期RP和弥漫性硬皮病患者的影响。在随访4个月后，组间血流量的改变并没有显著不同。临床指标包括QuickDASH、McCabe评分、疼痛VAS评分和Raynaud疾病评分，在注射BTX-A的手中略有改善。

该研究基于实验室的LDI血量数据并不支持使用BTX-A来治疗所有硬皮病患者的RP。次要的临床结局显示出了一些积极的，但仍存可疑的临床意义效应。BTX-A治疗RP的作用应该在更多的同质性患者人群和独特的临床情况来进一步研究。

原始出处：

Ricardo J. Bello, et al. The Therapeutic Efficacy of Botulinum Toxin in Treating Scleroderma-Associated Raynaud's Phenomenon: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial Assessing. Arthritis & Rheumatology.2017. http://onlinelibrary.wiley.com/doi/10.1002/art.40123/full

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    2017-09-11 ms6390871039024434

    #Arthritis#

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    2017-10-08 jxrzshh

    #治疗效果#

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    2017-05-31 zhaojie88

    #ART#

    0

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    2017-05-31 rgjl

    #硬皮病#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1972375, encodeId=749e19e237595, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Mon Sep 11 11:23:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893955, encodeId=30a0189395532, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sun Oct 08 03:23:00 CST 2017, time=2017-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356293, encodeId=296a13562938d, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377121, encodeId=c36313e712177, content=<a href='/topic/show?id=dccfe3605ff' target=_blank style='color:#2F92EE;'>#硬皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73605, encryptionId=dccfe3605ff, topicName=硬皮病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423577, encodeId=b3ac14235e793, content=<a href='/topic/show?id=383598855a8' target=_blank style='color:#2F92EE;'>#雷诺现象#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98855, encryptionId=383598855a8, topicName=雷诺现象)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69373802647, createdName=宋威, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521344, encodeId=96e0152134401, content=<a href='/topic/show?id=34f38085491' target=_blank style='color:#2F92EE;'>#肉毒杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80854, encryptionId=34f38085491, topicName=肉毒杆菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60f411331131, createdName=liubm559, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540545, encodeId=4c27154054579, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204071, encodeId=bf932040e188, content=好好努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon May 29 17:25:54 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-31 宋威

    #雷诺现象#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1972375, encodeId=749e19e237595, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Mon Sep 11 11:23:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893955, encodeId=30a0189395532, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sun Oct 08 03:23:00 CST 2017, time=2017-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356293, encodeId=296a13562938d, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377121, encodeId=c36313e712177, content=<a href='/topic/show?id=dccfe3605ff' target=_blank style='color:#2F92EE;'>#硬皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73605, encryptionId=dccfe3605ff, topicName=硬皮病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423577, encodeId=b3ac14235e793, content=<a href='/topic/show?id=383598855a8' target=_blank style='color:#2F92EE;'>#雷诺现象#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98855, encryptionId=383598855a8, topicName=雷诺现象)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69373802647, createdName=宋威, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521344, encodeId=96e0152134401, content=<a href='/topic/show?id=34f38085491' target=_blank style='color:#2F92EE;'>#肉毒杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80854, encryptionId=34f38085491, topicName=肉毒杆菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60f411331131, createdName=liubm559, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540545, encodeId=4c27154054579, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204071, encodeId=bf932040e188, content=好好努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon May 29 17:25:54 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-31 liubm559

    #肉毒杆菌#

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1972375, encodeId=749e19e237595, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Mon Sep 11 11:23:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893955, encodeId=30a0189395532, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sun Oct 08 03:23:00 CST 2017, time=2017-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356293, encodeId=296a13562938d, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377121, encodeId=c36313e712177, content=<a href='/topic/show?id=dccfe3605ff' target=_blank style='color:#2F92EE;'>#硬皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73605, encryptionId=dccfe3605ff, topicName=硬皮病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423577, encodeId=b3ac14235e793, content=<a href='/topic/show?id=383598855a8' target=_blank style='color:#2F92EE;'>#雷诺现象#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98855, encryptionId=383598855a8, topicName=雷诺现象)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69373802647, createdName=宋威, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521344, encodeId=96e0152134401, content=<a href='/topic/show?id=34f38085491' target=_blank style='color:#2F92EE;'>#肉毒杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80854, encryptionId=34f38085491, topicName=肉毒杆菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60f411331131, createdName=liubm559, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540545, encodeId=4c27154054579, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204071, encodeId=bf932040e188, content=好好努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon May 29 17:25:54 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-31 wsusan1970

    #肉毒杆菌毒素#

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1972375, encodeId=749e19e237595, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Mon Sep 11 11:23:00 CST 2017, time=2017-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893955, encodeId=30a0189395532, content=<a href='/topic/show?id=5e456463eee' target=_blank style='color:#2F92EE;'>#治疗效果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=64637, encryptionId=5e456463eee, topicName=治疗效果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=373a131, createdName=jxrzshh, createdTime=Sun Oct 08 03:23:00 CST 2017, time=2017-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1356293, encodeId=296a13562938d, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377121, encodeId=c36313e712177, content=<a href='/topic/show?id=dccfe3605ff' target=_blank style='color:#2F92EE;'>#硬皮病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73605, encryptionId=dccfe3605ff, topicName=硬皮病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8b48400, createdName=rgjl, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1423577, encodeId=b3ac14235e793, content=<a href='/topic/show?id=383598855a8' target=_blank style='color:#2F92EE;'>#雷诺现象#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98855, encryptionId=383598855a8, topicName=雷诺现象)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=69373802647, createdName=宋威, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1521344, encodeId=96e0152134401, content=<a href='/topic/show?id=34f38085491' target=_blank style='color:#2F92EE;'>#肉毒杆菌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80854, encryptionId=34f38085491, topicName=肉毒杆菌)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=60f411331131, createdName=liubm559, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1540545, encodeId=4c27154054579, content=<a href='/topic/show?id=943e8085574' target=_blank style='color:#2F92EE;'>#肉毒杆菌毒素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80855, encryptionId=943e8085574, topicName=肉毒杆菌毒素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5efb13261288, createdName=wsusan1970, createdTime=Wed May 31 05:23:00 CST 2017, time=2017-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=204071, encodeId=bf932040e188, content=好好努力学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45101626056, createdName=忠诚向上, createdTime=Mon May 29 17:25:54 CST 2017, time=2017-05-29, status=1, ipAttribution=)]
    2017-05-29 忠诚向上

    好好努力学习

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