星状神经节阻滞治疗经前期综合征的研究

Study of stellate ganglion block in the treatment of premenstrual syndrome

目的观察星状神经节阻滞治疗经前期综合征患者的疗效及对血清雌二醇(E2)、孕酮(P)的影响。方法选择112例星状神经节阻滞患者作为观察组,均在月经后7d行双侧星状神经节阻滞治疗,3d注射1次,4次为1个疗程,下个月经后7d行下个疗程,连续治疗3个月经周期。另选择健康自愿受试且年龄与观察组相仿女性作为对照组。分别采集对照组和观察组治疗前后月经周期中增殖期、分泌期、经前期、月经期4个不同时期的血样,用放射免疫法检测血清E2和P含量并进行比较;观察星状神经节阻滞治疗过程中经前乳房胀痛、失眠多梦、经行腹痛、经行头痛、烦躁易怒、经行水肿症状变化情况以及连续治疗3个月经周期后的总体疗效。结果观察组完成治疗100例。观察组增殖期、分泌期E2显著降低,P分泌期高峰阙如;治疗3个月经周期后,增殖期、分泌期E2均明显增高且接近正常水平,分泌期P恢复正常。治疗第3个月经周期,经前乳房胀痛、失眠多梦、经行头痛、烦躁易怒、经行水肿的总有效率均为100%,经行腹痛的总有效率为95%。治疗3个月经周期后总有效率为96%。结论经前期综合征患者月经不同时期激素水平尤其是血清E2、P的正常周期性变化紊乱是出现不同症状的重要机制;星状神经节阻滞通过对E2、P激素水平周期性变化失调的调节,促进机体内分泌的平衡,从而改善患者症状。

Objective It is to observe the curative effect of stellate ganglion block therapy on premenstrual syndrome and the effect on serum estradiol（E2） and progesterone（P）.Methods 112 patients under stellate ganglion block were selected as observation group,which was treated with the injection 7 days after menstruation once time per 3 days,4 times for 1 courses,7 days after the next menstruation the treatment continued,and they patients were treated for 3 menstruation cycles.Somehealthy women volunteers with the same age as observation group were selected as control group.Blood samples were collected before and after four different periods of menstrual cycle in both groups to detect serum E2 and P content by radioimmunoassay.The changes of major symptoms of premenstrual syndrome（premenstrual breast swelling pain,insomnia,dysmenorrhea,menstrualheadache,irritability,menstrual edema） were observed during the treatment course,and the total curative effect was evaluated after 3 cycles of treatment.Results 100 cases of patients completed their treatment in observation group.The level of E2 decreased much in secretion and proliferation stage,P secretion peak was lacking; E2 proliferative phase,secretory phase appeared two peak of stellate ganglion block therapy after 3 cycles,and close to the normal level（P〈 0.01）; P secretion peak return to normal.In the treatment of the third menstrual cycles,the total effective rates of the 6 major symptoms of premenstrual syndrome,premenstrual breast pain,insomnia,menstrualheadache,irritability,the edema were all 100%,that of abdominal pain reached 95%.The total efficiency was 96% after 3 cycles of treatment.Conclusion Hormone level changes periodically in different phases of menstrual cycle,especially serum E2,P changes is the important mechanism in patients with different symptoms of premenstrual syndrome; stellate ganglion block through a misaligned on E2,Phormone level changes periodically to improve endocrine balance thus to improve menstrual symptoms.