星状神经节阻滞治疗围绝经期失眠症26例疗效分析

Effect of stellate ganglion block in the treatment of 26 perimenopausal patients with insomnia

目的观察星状神经节阻滞治疗围绝经期失眠症患者的临床疗效。方法选择我院门诊及住院确诊为围绝经期失眠症的患者26例,采用前入路径行星状神经节阻滞(SGB)治疗20次,观察睡眠改善情况,检测治疗前后血雌二醇(E2),促卵泡生成素(FSH)、黄体生成素(LH)的变化,用汉密尔顿焦虑量表(HamiltonanxietyscaleHAMA)评定患者焦虑症状的严重程度。结果血中E2由治疗前的(33.13±18.26)pmol/L升至(153.64±86.57)pmol/L(t=-8.00,P<0.01),FSH由治疗前的(52.74±20.16)U/L降至(37.96±12.48)U/L(t=2.08,P<0.05),LH由治疗前的(36.09±13.34)U/L降至(25.35±7.51)U/L(t=2.21,P<0.05)。睡眠改善的总有效率为84.6%。HAMA评分由治疗前的(19.9±6.87)分降至(11.4±4.1)分(t=3.35,P<0.01)。结论 GB治疗能有效改善患者失眠和焦虑症状,能调节围绝经期失眠症患者的神经平衡失调。

Objective To explore the clinical effect of stellate ganglion block （SGB） in the treatment of peri- menopausal patients with insomnia. Methods Twenty-six perimenopausal patients diagnosed as insomnia in the Cen- tral Hospital of Enshi were treated by SGB for 20 times via the anterior approach. The improvements of sleep was ob- served, the severity of anxiety symptoms was evaluated by Hamilton Anxiety Scale （HAMA）, and the changes of blood estradiol （E2）, Follicle-Stimulating Hormone （FSH） and luteinizing hormone （LH） were detected. Results The serum level of E2 increased from （33.13±18.26） pmol/L to （153.64±86.57） pmol/L （ t=-8.00, P〈0.01）, FSH decreased from （52.74±20.16） U/L to （37.96±12.48） U/L （t=2.08, P〈0.05）, and LH reduced from （36.09±13.34） U/L to （25.35±7.51） U/L （t=2.21, P〈0.05）. The total efficient rate of improvement of sleep was 84.6%, and the HAMA score decreased from （19.9±6.87） to （11.4±4.1） （t=3.35, P〈0.01）. Conclusion SGB can regulate perimenopausal patients with insomnia in nervous imbalance, and it may be effective in improving insomnia.