A型肉毒毒素治疗咀嚼肌疼痛研究现状

Current Status of Research on Botulinum Toxin Type A for the Treatment of Masticatory Muscle Pain

摘要: 颞下颌关节紊乱综合征(TMD)是一种影响颞下颌关节及其周围肌肉和相关结构的临床问题，表现为关节疼痛、咀嚼肌功能障碍等症状。颞下颌关节疼痛常包含咀嚼肌疼痛、颞下颌关节疼痛和头痛等，其中最常见的疼痛为咀嚼肌疼痛，约占颞下颌关节紊乱综合征总人数的45%，咀嚼及疼痛的主要特征为局部疼痛或者牵涉痛、肌肉僵硬以及不明病因的肌肉感觉改变，A型肉毒毒素(BTX-A)作为一种非手术治疗手段，因其能够缓解咀嚼肌过度紧张与疼痛，逐渐受到临床研究的关注。本文综述了BTX-A在治疗TMD中的应用，包括其作用机制、对肌肉疼痛和最大张口度(MMO)的影响，以及其安全性和副作用。

Abstract: Temporomandibular joint disorder syndrome (TMD) is a clinical problem affecting the temporomandibular joint and its surrounding muscles and related structures, which manifests itself as joint pain, masticatory muscle dysfunction, etc. Temporomandibular joint pain often includes masticatory muscle pain, temporomandibular joint pain and headache, among which masticatory muscle pain is the most common pain, accounting for about 45% of the total number of temporomandibular joint disorder syndrome. The main characteristics of mastication and pain are local pain or referred pain, muscle stiffness and muscle sensory changes of unknown etiology. Botulinum toxin type A (BTX-A), as a non-surgical treatment, is gradually gaining attention in clinical studies because of its ability to alleviate the excessive tension and pain of masticatory muscles. This article reviews the application of BTX-A in the treatment of TMD, including its mechanism of action, effects on muscle pain and maximum mouth opening (MMO), as well as its safety and side effects.