| Objective: To assess the efficacy and safety of botulinum toxin A (BTX-A) injection in the treatment of spastic cerebral palsy. Methods: A systematic search of all the studies published was conducted on the PubMed, EMbase, Cochrane Library, Chinese Biomedical Literature Database (CBM), China National Knowledge Internet (CNKI) and Wanfang Data medical information system (WF). Randomized controlled trials (RCT) of BTX-A treatment of spastic cerebral palsy were identified from database foundation to November 1, 2018. Two reviewers independently screened the literature according to inclusion and exclusion criteria, extracted the data, and assessed the methodological quality of included studies. Meta-analyses were performed by using the Rev-Man 5.3 and State 12 software. Results: Twenty-two studies involving 1218 patients were included. Among the patients, 620 cases were in the botulinum toxin group and 598 cases were in the control group. The results of the meta-analysis indicated that, compared with control group, BTX-A treatment group had advantages of modified Ashworth score (MD =-0.82, 95% CI -0.86 to -0.79, P<0.05), GMFM score (MD=9.22, 95% CI 7.80 to 10.65, P<0.05), ADL score (MD=11.38, 95% CI 7.51 to 15.24, P<0.05), CSS score (MD=-1.9, 95% CI -3.45 to -0.35, P<0.05), joint flexible degree (MD=0.7, 95% CI 0.39 to 1.02, P<0.05) and effective rate (RR=1.3, 95% CI 1.13 to 1.5, P<0.05). Conclusion: BTX-A was demonstrated to be effective for spastic cerebral palsy. BTX-A combined with rehabilitation therapy can significantly improve patient's motor function of limbs, muscle tension and quality of life. However, The therapeutic dose should be strictly controlled and the treatment approach should be chosen individually in?clinical work. |
