星状神经节阻滞治疗多囊卵巢综合征的临床观察

The effect of stellate ganglion block on patients with polycystic ovarian syndrome

目的观察星状神经节阻滞(SGB)治疗多囊卵巢综合征的疗效,并分析其机制。方法多囊卵巢综合征伴有闭经史1年以上的患者20例,交替行双侧SGB治疗。于治疗前、后用放射免疫分析检测血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)和睾酮(T)浓度,以及采用超声波检查子宫及双侧卵巢。结果SGB治疗6周后,12例患者月经来潮。经过治疗FSH浓度明显升高,LH浓度明显降低,LH/FSH明显降低(P<0.01);睾酮浓度较治疗前降低(P<0.05);雌二醇浓度治疗前、后无显著性差异(P>0.05)。治疗前所有患者B超检查显示双侧卵巢内只可见小的未成熟卵泡,治疗后17例患者显示双侧卵巢内出现成熟卵泡。结论SGB对多囊卵巢综合征有明显的治疗作用。这可能与SGB治疗改善了丘脑和垂体的血液供应从而调节垂体激素的分泌有关,它能抑制LH和睾酮的分泌,促进FSH分泌,引起性激素水平的改变。

Objective To investigate the effect of stellate ganglion block on patients with polycystic ovarian syndrome, and to explore its related mechanism.Methods 20 cases of polycystic ovarian syndrome with amenorrhea for 1 year were performed stellate ganglion block. The concentrations of FSH,LH, estradiol （E2） and testosterone （T） in plasm were measured by radioimmunoassay system before and after the treatment, and the uterus and bilateral ovaries of all the patients were checked by ultrasound. Results After 12 weeks treatment, 12 patients had menstruations. FSH was increased significantly, while LH and LH/FSH decreased markedly （ P 〈 0. 01）, and T level also decreased compared with that of pretreatment （ P 〈 0.05）. There was no significant change in E2 level. Graafian vesicle in ovary were found in 17 patients by ultrasound examination after treatment. Conclusion SGB has an effective treatment efficacy for patients with olycystic ovarian syndrome, probably through the improvement of blood supply of hypothalamus and pituitary, as well as their hormonal secreation.