摘要
目的 探讨星状神经节阻滞(stellate ganglion block,SGB)对原发性痛经(primarydysmenorrheal,PD)的治疗效果及其作用机制。方法选择2007年10月~2011年6月,某医学院校护理学专业PD患者76例,采用SGB治疗。于行经前7d开始,月经来潮3d后停止,每日1次,左右交替进行,共治疗3个月经周期,即3个疗程。比较治疗开始前上次月经来潮24h内(T0)、第1疗程月经来潮24h内(T1)、第2疗程月经来潮24h内(T2)、第3疗程月经来潮24h内(T3)、第3疗程结束后3个月月经来潮24h内(T4)的视觉模拟评分法(visual analog scale,VAS)评分,睡眠影响指数(sleep interference scale,SIS)变化,同时于以上各时点静脉采血,酶联免疫吸附法(ELISA)测定血清前列腺素F2(prostaglandin F2α,PGF20t)浓度、前列腺素F2α前列腺素E2(prostaglandin F2α/prostaglandinE2,PGF2α/ PGE2)比值。结果TI、T2、T3、T4VAS分别为(1.83±0.52)、(1.48±0.21)、(1.25±0.14)、(1.30±0.25),与T0(6.35±1.42)比较,明显降低,差异有统计学意义(P〈0.01)。T1、T2、T]、T4SIS分别为(1.52±0.41)、(1.40±0.22)、(1.12±0.11)、(1.33±0.24),与T0(6.55±1.32)比较,明显降低,差异有统计学意义(P〈0.01)。T1、T2、T3、T4血清PGF2α分别为(5.1±1.1)、(4.9±1.2)、(4.8±1.6)、(4.9±1.7)μg/L,与T0(15.3±2.1)μg/L比较,差异有统计学意义(R0.05)。T1、T2、T3、T4血清PGF2a/PGE:比值分别为(2.1±1.3)、(1.9±1.4)、(1.8±1.1)、(2.1±1.3),与T0(5.2±1.6)比较,差异有统计学意义(P〈0.05)。结论SGB治疗PD,具有降低疼痛、改善睡眠的临床效果,疗效相对稳定,其作用机制可能与SGB降低经期血清PGF2α浓度、PGF2αPGE2比值有关。
Objective To investigate the efficacy of stellate ganglion block (SGB) as treatment in primary dysmenorrheal (PD) patients and the possible mechanism. Methods A total of 76 PD patients were referred to our clinic from October 2007 to June 2011. All of them received SGB switching from left to right ganglion once daily from 7 days before through 3 days after menstrual period in 3 consecutive menstruation cycles. The visual analog scale (VAS) and sleep interference scale (SIS) were recorded within 24 hours after the last untreated menstruation (To), the 1st treated menstruation (T1), the 2nd treated menstruation (T2), the 3rd treated menstruation (T3), and the 3rd menstruation after treatment (T4), respectively, in addition, the serum prostaglandin F2α (PGF2α) level and prostaglandin F2αprostaglandin E2 (FGE2αFGEE)ratio were measured at the above time points. Results The VAS scores at T1, T2, T3 and T4 were (1.83±0.52), (1.48±0.21), (1.25±0.14), (1.30±0.25), respectively, which were significantly less than that at To (6.35±1.42)(P〈0.01). The SIS scores at T1, T2, T3 and T4 were (1.52±0.41), (1.40±0.22), (1.12±0.11), (1.33±0.24),respectively,which were significantly less than that at To (6.55±1.32) (P〈0.01). The serum PGF2α and PGF2αPGE2 ratio at W1, W2, T3 and T4 were(5.1±1.1 )μg/L and (2.1±1.3), (4.9±1.2), ( 1.9±1.4), (4.8±1.6) μg/L, ( 1.8±1.1 ), (4.9±1.7) μg/L and (2.1±1.3), respectively, which were significantly less than that at To (15.3±2.1), (5.2±1.6) (P〈0.01). Conclusions SGB is effective in pain relief and sleep improvement for PD patient, which may be associated with the reduction of serum PGF2α level and PGF2α/PGE2 ratio.
出处
《国际麻醉学与复苏杂志》
CAS
2012年第5期291-293,302,共4页
International Journal of Anesthesiology and Resuscitation
关键词
星状神经节阻滞
原发性痛经
视觉模拟评分
睡眠影响指数
Stellate ganglion block
Primary dysmenorrhea
Visual analog scale
Sleep interference scale