【 文献重点摘要 】
 

Background: The authors evaluated the efficacy of a combined regimen of botulinum toxin type A (Botox) and a steroid (triamcinolone acetonide) for treating hypertrophic scars in comparison with the treatment with each drug alone.

Methods: Twenty excised human hypertrophic scar fragments obtained from surgically treated burn patients were divided into four groups: negative control (group A), triamcinolone alone (group B), Botox alone (group C), and a combination of triamcinolone and Botox (group D). These specimens were implanted into the backs of nude mice after intralesional injection from each group and were observed for 4 weeks. In total, 12 mice and 48 scars were studied. After 4 weeks, the hypertrophic scars were removed from the backs. The authors compared the scar weights, decorin staining, and the Cell Counting Kit-8 assay to evaluate treatment efficacy.

Results: Significant differences in scar weight reduction were observed among the four groups (group A, 10 percent; group B, 17 percent; group C, 23 percent; and group D, 30 percent; p < 0.05). Treatment groups (groups B, C, and D) showed strong decorin staining. Significant differences in reduction of fibroblast proliferation were observed among the four groups (group A, 0.58; group B, 0.44; group C, 0.21; and group D, 0.08; p < 0.05). Botox or triamcinolone intralesional monotherapy showed significant therapeutic efficacy compared with the control group. The combined therapy further exhibited a significant therapeutic effect compared with monotherapy.

Conclusion: This study indicates the potential of Botox and triamcinolone when combined for intralesional therapy in treating hypertrophic scars.

背景：作者评价了A型肉毒毒素(肉毒杆菌毒素)和类固醇(曲安奈德)联合治疗增生性瘢痕的疗效，并与单独使用两种药物进行了比较。

方法：20例烧伤手术切除的增生性瘢痕分为4组：阴性对照组(A组)、单纯曲安奈德组(B组)、单纯肉毒杆菌素组(C组)和曲安奈德联合肉毒杆菌素组(D组)。各组瘤内注射后植入裸鼠背部，观察4周。总共对12只小鼠和48个瘢痕进行了研究。4周后，去除背部增生性瘢痕。作者比较了瘢痕重量、核心蛋白聚糖染色和细胞计数试剂盒-8试验，以评估治疗效果。

结果：A组瘢痕重量减少10%，B组减少17%，C组减少23%，D组减少30%，差异有统计学意义(P<0.05)。治疗组(B、C、D组)粘附素染色较深。4组间成纤维细胞增殖抑制有显著性差异(A组为0.58；B组为0.44；C组为0.21；D组为0.08；P<0.05)。肉毒杆菌或曲安奈德病灶内单一治疗与对照组相比有显著疗效。与单一治疗相比，联合治疗进一步显示出明显的疗效。

结论：本研究表明肉毒杆菌毒素和曲安奈德联合应用于增生性瘢痕的病灶内治疗是有潜力的。