CAJ | 학술논문

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7 d行双侧星状神经节阻滞治疗，3 d注射1次，4次为1个疗程，下个月经后7 d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。
목적：관찰성상신경절조체치료경전기종합정환자적료효급대혈청자이순（ E2）、잉동（ P）적영향。방법선택112례성상신경절조체환자작위관찰조，균재월경후7 d행쌍측성상신경절조체치료，3 d주사1차，4차위1개료정，하개월경후7 d행하개료정，련속치료3개월경주기。령선택건강자원수시차년령여관찰조상방녀성작위대조조。분별채집대조조화관찰조치료전후월경주기중증식기、분비기、경전기、월경기4개불동시기적혈양，용방사면역법검측혈청E2화P함량병진행비교；관찰성상신경절조체치료과정중경전유방창통、실면다몽、경행복통、경행두통、번조역노、경행수종증상변화정황이급련속치료3개월경주기후적총체료효。결과관찰조완성치료100례。관찰조증식기、분비기E2현저강저，P분비기고봉궐여；치료3개월경주기후，증식기、분비기E2균명현증고차접근정상수평，분비기P회복정상。치료제3개월경주기，경전유방창통、실면다몽、경행두통、번조역노、경행수종적총유효솔균위100％，경행복통적총유효솔위95％。치료3개월경주기후총유효솔위96％。결론경전기종합정환자월경불동시기격소수평우기시혈청E2、P적정상주기성변화문란시출현불동증상적중요궤제；성상신경절조체통과대E2、P격소수평주기성변화실조적조절，촉진궤체내분비적평형，종이개선환자증상。
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.Some healthy 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, men-strual headache, irritability, menstrual edema) were observed during the treatment course, and the total curative effect was e-valuated 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 premenstru-al syndrome, premenstrual breast pain, insomnia, menstrual headache, irritability, the edema were all 100%, that of abdomi-nal pain reached 95%.The total efficiency was 96%after 3 cycles of treatment.Conclusion Hormone level changes periodi-cally in different phases of menstrual cycle, especially serum E2 , P changes is the important mechanism in patients with differ-ent symptoms of premenstrual syndrome;stellate ganglion block through a misaligned on E2 , P hormone level changes periodi-cally to improve endocrine balance thus to improve menstrual symptoms.