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摘要：
【摘要】目的:探讨星状神经节阻滞(stellate ganglion block ，SGB)对原发性痛经（primary dysmenorrhea，PD）的治疗效果及其作用机制.方法:选择2007年10月至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(100mm 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PGF2a浓度、PGF2a/PGE2比值。结果：T1、T2、T3、T4 VAS评分分别为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、T3、T4 SIS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PGF2a分别为5.14±1.12ng/ml、 4.95±1.21ng/ml、 4.87±1.65 ng/ml、 4.96±1.73ng/ml,与T0 15.35±2.13ng/ml比较，差异有统计学意义（P＜0.05）。T1、T2、T3、T4血清PGF2a/PGE2比值分别为2.10±1.35、1.94±1.42、1.87±1.12、2.01±1.33，与T0 5.22±1.67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PGF2a浓度、PGF2a/PGE2比值有关。
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Abstract: 【Abstract】Objective To evaluate the efficacy of Stellate ganglion block as treatment in primary dysmenorrheal patient and investigate the possible mechanism.Methods A total of 76 patients with primary dysmenorrhea were referred to our clinic from October 2007 to June 2011. All of them received stellate ganglion block once switching from left to right ganglion daily from 7 days before through 3 days after menstrual period in 3 consecutive menstruation cycles.Data of visual analog scale(VAS),sleep interference scale(SIS),serum PGF2a level,FGE2a/FGE2 ratio was recorded in the first day of the period at the one before treatment(T0) and the 1st(T1),2nd(T2),3rd(T3) period under treatment and the one 3 months after the end of the treatment(T4) respectively.Results VAS score of T1,T2,T3,T4 was 1.83±0.52,1.48±0.21,1.25±0.14,1.30±0.25 respectively（P＜0.01）;SIS score of T1,T2,T3,T4 was 1.52±0.41,1.40±0.22,1.12±0.11,1.33±0.24 respectively（P＜0.01）; serum PGF2a of T1,T2,T3,T4 was 5.14±1.12ng/ml, 4.95±1.21ng/ml, 4.87±1.65ng/ml, 4.96±1.73ng/ml（P＜0.05）and PGF2a/PGE2 ratio of T1,T2,T3,T4 was 2.10±1.35,1.94±1.42,1.87±1.12,2.01±1.33（P＜0.05）respectively.Conclusion Our study show that SGB is effective in pain relief and sleep improvement for primary dysmenorrheal patient, and its mechanism may be related to the reduction of serum PGF2a level,PGF2a/PGE2 ratio.
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