肉毒桿菌毒素在下泌尿道疾病的臨床應用

Clinical Applications of Botulinum A Toxin for Lower Urinary Tract Diseases

廖永明(Yuan-Ming Liaw) ； 郭漢崇(Hann-Chorng kuo)

《慈濟醫學雜誌》 16卷6期 (2004/12) Pp. 349-357

https://doi.org/10.6440/TZUCMJ.200412.0349

摘要

肉毒桿菌毒素近年來已被廣泛應用於人類各系統因肌肉張力過高造成的疾病。基於它在藥理學上可以抑制神經肌肉接合前之乙醯膽鹼之釋放，肉毒桿菌毒素也被應用於神經性因或非神經性因之尿道外括約肌痙攣及逼尿肌活性過強。研究也證實，肉毒桿菌毒素施打於前列腺內可治前列腺阻塞造成之慢性尿滯留，尤其針封具有手術危險性之病患。最近在治療不明原因逼尿肌活性過強、膀胱敏感症，以及間質性膀胱炎方面也有很大的進展。已知的注射肉毒桿菌毒素副作用極少。未來全面的應用此一毒素治療各頹型下尿路疾病將可預期。

關鍵字

神經性排尿障礙 ； 下尿路症狀 ； 膀胱內治療 ； 肉毒桿菌毒素

並列摘要

Botulinum A toxin has been widely applied to the treatment of muscular hypertonicity for many different functional systems of the human body. Due to the toxin’s pharmacological effect of inhibiting acetylcholine release from presynaptic neuromuscular junctions, botulinum A toxin has been used for the treatment of spastic urethral sphincter as well as detrusor overactivity associated with both neurogenic and non-neurogenic etiologies. It has also been demonstrated that botulinum A toxin is effective at reducing prostatic gland volume as part of the treatment of benign prostatic hyperplasia with associated chronic urinary retention especially for a subset of such patients who are at surgical risk. The promising therapeutic effects of the toxin as regards idiopathic detrusor overactivity, bladder hypersensitivity, and interstitial cystitis have already gained great attention internationally. The known adverse effects related to botulinum A toxin injection have achieved little attention. World-wide clinical studies of the use of botulinum A toxin have been undertaken and the optimal therapeutic regimen for treating individual lower urinary-tract disease will likely be developed in the near future.

並列關鍵字

neurogenic voiding dysfunction ； lower urinary-tract symptoms ； intravesical therapy ； botulinum toxin