星状神经节阻滞术治疗创伤后应激障碍的临床效果研究

Clinical observation on stellate ganglion block in treatment of post-traumatic stress disorder

摘要:

目的探讨星状神经节阻滞（SGB）疗法对创伤后应激障碍（PTSD）的治疗效果。方法分析2012 年1 月-2015 年6 月于广西中医药大学附属瑞康医院就诊治疗的PTSD 患者53 例，依照治疗方法的不同将患者分为对照组21 例，观察组32 例。两组患者均接受口服帕罗西汀治疗，观察组配合应用SGB 治疗。采用PTSD筛查量表- 平民版（PCL-C）、抑郁症筛查量表（PHQ-9）、条目病人筛查问卷、贝克焦虑量表（BAI），以及视觉模拟评分法（VAS），比较两组患者治疗前、治疗后1 周以及治疗后1、3 和6 个月功能障碍改善情况。结果两组患者PHQ-9 评分、BAI 评分、VAS 评分以及PTSD 临床症状均较治疗前改善，其中治疗1 个月后，PHQ-9和BAI 评分下降幅度观察组> 对照组，差异有统计学意义（p <0.05）；治疗3 个月后，患者PCL-C 及VAS 评分下降幅度观察组> 对照组，差异有统计学意义（p <0.05）。结论与单纯帕罗西汀治疗相比，口服帕罗西汀联合SGB治疗有助于提高PTSD 的综合疗效，具有临床推广价值。

Abstract:

Objective To investigate the therapeutic effect of stellate ganglion block (SGB) in treatment of posttraumatic stress disorder (PTSD). Methods The patients with PTSD who were treated in our hospital from January 2012 to June 2015 were divided into control group (21 cases) and observation group (32 cases) according to the different treatment methods. All patients were treated with oral Paroxetine, the patients of the observation group were also treated with SGB. Each case was given marks using the PTSD Screening Scale (PCL -C), Patient Health Questionnaire Depression Scale (PHQ-9), Beck Anxiety Inventory (BAI) and Visual Analogue Scale (VAS) seperately before treatment, and at the end of the 1st week, and the 1st, 3rd and 6th month after treatment. Results Not only the scores of the PHQ-9, the BAI and the VAS, but also PTSD were significantly improved in both groups after treatment. Compared to the control group, the PHQ-9 and the BAI scores decreased more significantly in the observation group 1 month after treatment(p < 0.05), the decrease of the PCL-C and the VSA scores was more obvious in the observation group 3 months after treatment(p < 0.05). Conclusions Oral Paroxetine combined with SGB has better therapeutic effect than Paroxetine alone in treatment of PTSD.