{"title":"A型肉毒毒素治疗原发性腋下多汗症的疗效和安全性：荟萃分析和系统评价。","authors":"Jing Sun, Shuangyu Chen, Ting Yang, Liping Huang, Jing Tang, Yuebi Feng, Qiuyue Yu, Yu Wang, Yuanyuan Luo, Yao Tang, Lin Gao","doi":"10.1007/s00266-025-04909-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The clinical efficacy of botulinum toxin type A (BTX-A) injections for the treatment in primary axillary hyperhidrosis is a subject of ongoing debate. This study aims to consolidate and analyze the available evidence regarding the use of BTX-A as a therapeutic intervention for this conclusion.</p><p><strong>Method: </strong>This study was conducted in accordance with PRISMA guidelines and registered with PROSPERO. We included RCTs on BTX-A injections for PAH, comparing it to placebo or other treatments. A comprehensive literature search was conducted in multiple databases up to May 2024. Out of identified articles, some underwent full-text review and were included in the qualitative and quantitative synthesis. Statistical analyses were done using RevMan5.4, and study quality was assessed with the Cochrane risk of bias tool. Subgroup and sensitivity analyses were also conducted.</p><p><strong>Result: </strong>Twelve studies met our inclusion criteria (n = 904). BTX-A injection showed greater sweat reduction compared to placebo by gravimetric measurement (116.12 [92.68-139.57]; P < 0.05). BTX-A injection showed comparable sweat reduction to other treatments by gravimetric measurement (26.14 [- 26.8, 79.07]; P = 0.333) and HDSS (- 0.85 [- 1.20, 0.50], P = 0.413). The pain score of BTX-A injection is comparable to other treatments (- 0.41 [- 1.11, 0.29], P = 0.456). BTX-A injection exhibited fewer side effects compared to other treatments (0.18 [0.07, 0.43], P < 0.05).</p><p><strong>Conclusion: </strong>In primary axillary hyperhidrosis, BTX-A injection significantly reduces sweat production compared with placebo, and there is no statistically significant difference compared with other treatments. BTX-A injection had less fewer side effects compared with other treatments.</p><p><strong>Level of evidence i: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>","PeriodicalId":7609,"journal":{"name":"Aesthetic Plastic Surgery","volume":" ","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and Safety of Botulinum Toxin Type A in Primary Axillary Hyperhidrosis: A Meta-analysis and Systematic Review.\",\"authors\":\"Jing Sun, Shuangyu Chen, Ting Yang, Liping Huang, Jing Tang, Yuebi Feng, Qiuyue Yu, Yu Wang, Yuanyuan Luo, Yao Tang, Lin Gao\",\"doi\":\"10.1007/s00266-025-04909-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The clinical efficacy of botulinum toxin type A (BTX-A) injections for the treatment in primary axillary hyperhidrosis is a subject of ongoing debate. This study aims to consolidate and analyze the available evidence regarding the use of BTX-A as a therapeutic intervention for this conclusion.</p><p><strong>Method: </strong>This study was conducted in accordance with PRISMA guidelines and registered with PROSPERO. We included RCTs on BTX-A injections for PAH, comparing it to placebo or other treatments. A comprehensive literature search was conducted in multiple databases up to May 2024. Out of identified articles, some underwent full-text review and were included in the qualitative and quantitative synthesis. Statistical analyses were done using RevMan5.4, and study quality was assessed with the Cochrane risk of bias tool. Subgroup and sensitivity analyses were also conducted.</p><p><strong>Result: </strong>Twelve studies met our inclusion criteria (n = 904). BTX-A injection showed greater sweat reduction compared to placebo by gravimetric measurement (116.12 [92.68-139.57]; P < 0.05). BTX-A injection showed comparable sweat reduction to other treatments by gravimetric measurement (26.14 [- 26.8, 79.07]; P = 0.333) and HDSS (- 0.85 [- 1.20, 0.50], P = 0.413). The pain score of BTX-A injection is comparable to other treatments (- 0.41 [- 1.11, 0.29], P = 0.456). BTX-A injection exhibited fewer side effects compared to other treatments (0.18 [0.07, 0.43], P < 0.05).</p><p><strong>Conclusion: </strong>In primary axillary hyperhidrosis, BTX-A injection significantly reduces sweat production compared with placebo, and there is no statistically significant difference compared with other treatments. BTX-A injection had less fewer side effects compared with other treatments.</p><p><strong>Level of evidence i: </strong>This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .</p>\",\"PeriodicalId\":7609,\"journal\":{\"name\":\"Aesthetic Plastic Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2025-06-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Aesthetic Plastic Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00266-025-04909-6\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Aesthetic Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00266-025-04909-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
Efficacy and Safety of Botulinum Toxin Type A in Primary Axillary Hyperhidrosis: A Meta-analysis and Systematic Review.
Background: The clinical efficacy of botulinum toxin type A (BTX-A) injections for the treatment in primary axillary hyperhidrosis is a subject of ongoing debate. This study aims to consolidate and analyze the available evidence regarding the use of BTX-A as a therapeutic intervention for this conclusion.
Method: This study was conducted in accordance with PRISMA guidelines and registered with PROSPERO. We included RCTs on BTX-A injections for PAH, comparing it to placebo or other treatments. A comprehensive literature search was conducted in multiple databases up to May 2024. Out of identified articles, some underwent full-text review and were included in the qualitative and quantitative synthesis. Statistical analyses were done using RevMan5.4, and study quality was assessed with the Cochrane risk of bias tool. Subgroup and sensitivity analyses were also conducted.
Result: Twelve studies met our inclusion criteria (n = 904). BTX-A injection showed greater sweat reduction compared to placebo by gravimetric measurement (116.12 [92.68-139.57]; P < 0.05). BTX-A injection showed comparable sweat reduction to other treatments by gravimetric measurement (26.14 [- 26.8, 79.07]; P = 0.333) and HDSS (- 0.85 [- 1.20, 0.50], P = 0.413). The pain score of BTX-A injection is comparable to other treatments (- 0.41 [- 1.11, 0.29], P = 0.456). BTX-A injection exhibited fewer side effects compared to other treatments (0.18 [0.07, 0.43], P < 0.05).
Conclusion: In primary axillary hyperhidrosis, BTX-A injection significantly reduces sweat production compared with placebo, and there is no statistically significant difference compared with other treatments. BTX-A injection had less fewer side effects compared with other treatments.
Level of evidence i: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
期刊介绍：
Aesthetic Plastic Surgery is a publication of the International Society of Aesthetic Plastic Surgery and the official journal of the European Association of Societies of Aesthetic Plastic Surgery (EASAPS), Società Italiana di Chirurgia Plastica Ricostruttiva ed Estetica (SICPRE), Vereinigung der Deutschen Aesthetisch Plastischen Chirurgen (VDAPC), the Romanian Aesthetic Surgery Society (RASS), Asociación Española de Cirugía Estética Plástica (AECEP), La Sociedad Argentina de Cirugía Plástica, Estética y Reparadora (SACPER), the Rhinoplasty Society of Europe (RSE), the Iranian Society of Plastic and Aesthetic Surgeons (ISPAS), the Singapore Association of Plastic Surgeons (SAPS), the Australasian Society of Aesthetic Plastic Surgeons (ASAPS), the Egyptian Society of Plastic and Reconstructive Surgeons (ESPRS), and the Sociedad Chilena de Cirugía Plástica, Reconstructiva y Estética (SCCP).
Aesthetic Plastic Surgery provides a forum for original articles advancing the art of aesthetic plastic surgery. Many describe surgical craftsmanship; others deal with complications in surgical procedures and methods by which to treat or avoid them. Coverage includes "second thoughts" on established techniques, which might be abandoned, modified, or improved. Also included are case histories; improvements in surgical instruments, pharmaceuticals, and operating room equipment; and discussions of problems such as the role of psychosocial factors in the doctor-patient and the patient-public interrelationships.
Aesthetic Plastic Surgery is covered in Current Contents/Clinical Medicine, SciSearch, Research Alert, Index Medicus-Medline, and Excerpta Medica/Embase.
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