研究疾病:
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痉挛性斜颈
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研究疾病代码:
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8A02(ICD11)
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Target disease:
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Spasmodic torticollis
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Target disease code:
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研究类型:
Study type:
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干预性研究
Interventional study
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研究设计:
Study design:
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随机平行对照
randomized controlled trial(parallel group design)
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研究所处阶段:
Study phase:
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探索性研究/预试验
Pilot clinical trial
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研究目的:
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本项研究立足颈部肌张力障碍(CD)发病的中枢脑神经网络功能异常,基于本团队的前期研究基础,提出颈部推拿联合肉毒毒素可能是通过改善CD患者脑神经网络功能异常发挥治疗作用。设计开展颈部推拿联合BTX-A治疗CD的高质量临床试验,以期提高临床疗效,降低CD复发率,改善CD患者的生存质量,为颈部推拿联合BTX-A治疗CD提供强有力的证据支持。
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Objectives of Study:
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This study based on cervical dystonia (CD) central nerve network dysfunction of the disease, based on the team's previous research foundation, proposed the neck massage combined botulinum toxin may be through improving neural network dysfunction play a role of treatment for patients with CD. To design and carry out high-quality clinical trials of neck massage combined with BTX-A in the treatment of CD, in order to improve the clinical efficacy, reduce the recurrence rate of CD, improve the quality of life of CD patients, and provide strong evidence for neck massage combined with BTX-A in the treatment of CD.
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药物成份或治疗方案详述:
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肉毒杆菌毒素A型(BTX-A)(商品名:衡力,兰州生物制品研究所,规格:100U/支)注射。治疗前先观察和触摸痉挛及肥厚肌肉,痉挛肌肉的局部酸痛作为参考;患者取坐位,应用中空、外层绝缘的特殊肌电电极,侧极连接肌电图记录仪,后接注射器;经皮肤注入痉挛肥厚靶肌肉。初次注射一般使用1~3支,主要肌肉注射参考点和剂量见表1。
表1 BTX-A注射主要肌肉注射参考点和剂量
靶肌肉 参考点 剂量
胸锁乳突肌 上2/3部3点 0.5mL/点
胸骨和锁骨头各1点 0.3mL/点
斜方肌 8点 0.3mL/点
头颈夹肌 5点 0.5mL/点
后颈部深肌 5点 0.5mL/点
斜角肌 4点 0.3mL/点
肩胛提肌 3点 0.3mL/点
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Description for medicine or protocol of treatment in detail:
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Botulinum toxin type A (BTX-A) (trade name: Hengli, Lanzhou Institute of Biological Products, specification: 100U/vial) injection.Before treatment, the spastic and hypertrophic muscles were observed and touched, and the local soreness of the spastic muscles was used as a reference. The patient was in a sitting position, and a hollow, outer insulated special electromyography electrode was used. The side electrode was connected to the electromyography recorder, and the syringe was connected to the back. Percutaneous injection target muscle spasm hypertrophy. One to three branches are generally used for the primary injection, and the main intramuscular injection reference points and doses are shown in Table 1.
Table 1 Reference points and doses for major intramuscular injections of BTX-A
Target muscle reference point dose
3 points 0.5mL/ point in the upper 2/3 of sternocleidomastoid muscle
Sternum and clavicle head 1 point 0.3 mL/point
Trapezius 8 points 0.3mL/ point
Head and neck splenius 5 0.5 mL/point
5 points 0.5mL/ point for deep muscles of the posterior neck
Scalenus muscle 4 points 0.3mL/ point
Levator scapularis 3 points 0.3mL/ point
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纳入标准:
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① 符合原发性颈部肌张力障碍的诊断;
② 年龄≥18岁且≤65岁,性别不限;
③ 头颅MRI检查无结构性损伤或异常;
④ 入组前3个月内未接受肉毒素治疗以及未服用或者精神疾病的药物;
⑤ 无其他严重的神经或精神疾病;
⑥ 签定知情同意书。
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Inclusion criteria
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① Consistent with the diagnosis of primary cervical dystonia;
② The age of 18 and 65 years old or less, or gender not limited;
③ There was no structural injury or abnormality in brain MRI;
④ No botulinum toxin treatment and no medication for mental disorders within 3 months before enrollment;
⑤ No other serious neurological or mental illness;
⑥ The signing of the informed consent.
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排除标准:
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① 使用过脑深部电刺激术(DBS)、改良Foerster-Dandy术、痉挛肌肉选择性切除术等治疗;
② 怀孕或哺乳妇女。
③ 由其他疾病如炎症、外伤、肿瘤等原因引起的身体疼痛;近期服用止痛药物,酒精或药物依赖。
④ 精神情绪类疾病引起的睡眠异常。
⑤ 既往有焦虑症、抑郁症等精神情绪类疾病。
⑥ 帕金森病、痴呆等原因引起的认知功能障碍。
⑦ 其他疾病如鼻炎、急性上呼吸道感染、肿瘤等原因引起的嗅觉障碍。
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Exclusion criteria:
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① Deep brain stimulation (DBS), modified Foerster-Dandy's surgery, and selective resection of spastic muscles were used;
② Pregnant or breastfeeding women.
③ By other diseases such as inflammation, trauma, tumor, etc. The cause physical pain; Recent analgesic drugs, alcohol or drug dependence.
④ Emotional diseases caused by abnormal sleep.
⑤ Previous mental and emotional diseases such as anxiety and depression.
⑥ Parkinson's disease, dementia and other causes of cognitive dysfunction.
⑦ Olfactory dysfunction caused by other diseases such as rhinitis, acute upper respiratory tract infection, and tumor.
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研究实施时间:
Study execute time:
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从From
2024-06-30
至To
2025-12-31
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征募观察对象时间:
Recruiting time:
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从From
2024-06-30
至To
2025-12-31
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