周亚光 于水 赵纪敏 赵梓纲

[摘要]目的：探究A型肉毒毒素治疗雄激素性脱发（Androgenic alopecia，AGA）的有效性及安全性。方法：将42例男性AGA患者随机分为A型肉毒毒素注射+非那雄胺口服组（注射+口服组）和A型肉毒毒素注射组（注射组），两组每3个月进行1次注射治疗，共2次。注射+口服组同时口服非那雄胺片，1毫克/次，1次/天。治疗期间定期记录头发变化及不良事件的发生。结果：两组患者经治疗后均有明显疗效。注射+口服组每次治疗后较上次治疗前头发数量均有明显增加;注射组患者治疗6个月后头发数量多于治疗前。两组每次治疗后头发数量进行比较，差异无明显统计学意义。两组均未出现明显副作用及并发症。结论：A型肉毒毒素治疗雄激素性脱发安全、有效，联合口服非那雄胺疗效更佳，可临床推广应用。

[关键词]A型肉毒毒素;非那雄胺;雄激素性脱发;双氢睾酮;毛囊微小化

[中图分类号]R758.71    [文献标志码]A    [文章编号]1008-6455（2021）05-0101-03

A Clinical Study on the Treatment of Androgenic Alopecia with Botulinum Toxin A

ZHOU Ya-guang， YU Shui， ZHAO Ji-min， ZHAO Zi-gang

（Department of Dermatology， Hainan Hospital of PLA General Hospital， Sanya 572013， Hainan， China）

Abstract：Objective  To investigate the efficacy and safety of botulinum toxin type A （BTA） in patients with androgenic alopecia （AGA）. Methods  42 male patients with AGA were randomly divided into two groups： botulinum toxin A injection+oral finasteride group （injection+oral group） and botulinum toxin A injection group （injection group）. All patients received the treatment for 6 months and were followed up every 3 months， 2 times in total during and The injection + oral group was given finasteride tablets， 1mg each time， once a day. After completion of the treatment. Hair changes and adverse events were recorded regularly during the treatment. Results  Hair counts in both groups were significantly higher as compared with those before treatment.Hair counts in the injection+oral group after each treatment was significantly increased compared with that before the last treatment and those in the injection group after 6 months of treatment was more than that before treatment. There was no significant difference between the two groups after treatment and no side effects and complications in both groups were observed. Conclusion  Botulinum toxin A is a safe and effective therapeutic strategy for the treatment of AGA.The combination of oral finasteride was more effective.

Key words： Botulinum toxin A; finasteride; androgenetic alopecia; dihydrotestosterone; miniaturization of hair follicle

雄激素性脫发（Androgenic alopecia， AGA）又称为脂溢性脱发或早秃，是一种发生于青春期和青春期后的毛发进行性减少疾病，也是最常见的脱发类型之一。AGA的特点是进行性的毛囊微小化，它的发生发展与多种遗传和环境因素有关。AGA的发病率在人种和性别上均有明显差异。在种族方面，白种人发病率最高，而非洲黑种人发病率最低[1];在性别方面，我国男性AGA患者的发病率远远高于女性，这也与本病为雄激素依赖的遗传性疾病有关[2-3]。近年来，随着社会不断发展，AGA的发病率逐年上升，发病年龄也呈年轻化趋势，大量患者饱受脱发的困扰。……