【 文献重点摘要 】
 

Botulinum toxins (BoNTs) are produced by several anaerobic species of the genus Clostridium and, although they were originally considered lethal toxins, today they find their usefulness in the treatment of a wide range of pathologies in various medical specialties. Botulinum neurotoxin has been identified in seven different isoforms (BoNT-A, BoNT-B, BoNT-C, BoNT-D, BoNT-E, BoNT-F, and BoNT-G). Neurotoxigenic Clostridia can produce more than 40 different BoNT subtypes and, recently, a new BoNT serotype (BoNT-X) has been reported in some studies. BoNT-X has not been shown to actually be an active neurotoxin despite its catalytically active LC, so it should be described as a putative eighth serotype. The mechanism of action of the serotypes is similar: they inhibit the release of acetylcholine from the nerve endings but their therapeutically potency varies. Botulinum toxin type A (BoNT-A) is the most studied serotype for therapeutic purposes. Regarding the gynecological pathology, a series of studies based on the efficiency of its use in the treatment of refractory myofascial pelvic pain, vaginism, dyspareunia, vulvodynia and overactive bladder or urinary incontinence have been reported. The current study is a review of the literature regarding the efficiency of BoNT-A in the gynecological pathology and on the long and short-term effects of its administration.

Keywords

botulinum toxin; chronic pelvic pain; overactive detrusor; vaginism

肉毒杆菌毒素(BoNTs)是由梭状芽孢杆菌属的几个厌氧物种产生的，虽然它们最初被认为是致命的毒素，但今天发现它们在治疗各种医学专科的各种病理疾病中都很有用。肉毒杆菌神经毒素已被鉴定为七种不同的亚型(BONT-A、BONT-B、BONT-C、BONT-D、BONT-E、BONT-F和BONT-G)。神经毒素性梭状芽孢杆菌可以产生40多种不同的BONT亚型，最近一些研究报道了一种新的BONT血清型(BONT-X)。尽管BoNT-X具有催化活性的LC，但尚未证明它实际上是一种活性神经毒素，因此它应该被描述为推定的第八种血清型。血清型的作用机制相似：它们抑制神经末梢释放乙酰胆碱，但它们的治疗效力不同。A型肉毒毒素(BoNT-A)是目前研究最多的治疗血清型。在妇科病理学方面，根据其治疗顽固性肌筋膜盆腔疼痛、阴道病、性交困难、外阴疼痛和膀胱或尿失禁的疗效，已报道了一系列研究。目前的研究是关于BONT-A在妇科病理学中的有效性以及其应用的长期和短期效果的文献综述。

关键词

肉毒杆菌毒素；慢性盆腔疼痛；逼尿肌过度活动；阴道病