星狀神經節阻滯 – 改善 PTSD、焦慮及更年期潮熱。
文章摘要：
星狀神經節阻滯不僅可用於慢性痛症，近年研究亦顯示它可能透過調節自律神經，改善 PTSD、焦慮及更年期潮熱。
星狀神經節：情緒與身體的雙向橋樑
星狀神經節是自律神經系統的一部分，位於頸胸交界附近的下頸部。
它主要是一個交感神經訊號的中繼站，負責把與頭頸部、面部、上肢及心臟相關的交感神經輸出傳遞出去。他也涉及把訊息向大腦回傳。星狀神經節可被視為周邊身體狀態與大腦情緒網絡之間的重要節點之一。
傳統應用：對付頑固的慢性痛症
在醫學上，星狀神經節阻滯（Stellate Ganglion Block, SGB）早已被廣泛應用於治療頭面及上肢相關的交感神經性痛症。
醫生會透過注射局部麻醉藥，暫時阻斷交感神經傳遞，藉此治療複雜性局部疼痛症候群（CRPS）、帶狀疱疹後神經痛、偏頭痛，以及部分與血管痙攣或交感神經過度活躍有關的病症。
醫學新突破：重啟情緒的「開關掣」？
近年來，醫學界開始重新審視星狀神經節與情緒調節之間的關係。
跟據兩個分別在2016 及 2020 年進行的雙盲隨機對照研究顯示，星狀神經節阻滯可在減輕創傷後壓力症候群（PTSD）症狀，並同時改善焦慮、抑鬱及疼痛相關表現。［1］［2］
其後的系統性回顧與統合分析亦傾向支持這種治療方向。［3］
另外，2023 年一項小的臨床研究亦顯示，星狀神經節阻滯可減輕焦慮症狀，效果可維持一個月或以上。［4］
除了情緒相關應用，星狀神經節阻滯亦可能改善更年期潮熱等症狀。［5］
背後的科學原理：為何能帶來較持久的改善？
一個只在局部停留數小時的麻醉藥，為何可能帶來維持數週甚至數月的改善，至今仍未完全確定。
Lipov 在 2009 年提出的假說認為，慢性壓力可能伴隨神經生長因子（NGF）與交感神經活性的異常升高，而星狀神經節阻滯可能暫時打斷這個惡性循環。［6］
Kim 等人在 2022 年則提出另一個解釋：星狀神經節阻滯的原理是暫時抑制過度活躍的交感輸出，令副交感神經系統較容易重新取得平衡，進而影響腦幹與情緒調節網絡。［7］
這個理論有助解釋，為何一個局部神經阻滯，有時會出現超出麻醉藥作用時間的中樞效應。
總結：開啟情緒治療的新方向
總括而言，星狀神經節阻滯原本是一項傳統的痛症介入治療，但近年研究顯示，它在情緒創傷、自律神經失衡與更年期症狀方面，亦可能具有臨床價值。
參考文獻：
Summary:
A stellate ganglion block is not only useful for treating chronic pain. Recent studies show that it may also help regulate the autonomic nervous system to improve post-traumatic stress disorder (PTSD), anxiety, and menopausal hot flushes.
The Stellate Ganglion: A Two-Way Bridge Between Emotions and the Body
The stellate ganglion is part of the autonomic nervous system, located in the lower neck near the junction of the chest. It acts primarily as a relay station for sympathetic nerve signals, transmitting outputs to the head, neck, face, upper limbs, and heart. It is also involved in sending sensory information back to the brain. Because of this, the stellate ganglion can be viewed as a crucial connection point between the body’s physical state and the brain’s emotional networks.
Traditional Uses: Tackling Stubborn Chronic Pain
A stellate ganglion block (SGB) has long been widely used to treat chroinc pain in the head, face, and upper limbs. Doctors temporarily block sympathetic nerve transmission by injecting a local anaesthetic. This procedure is used to treat conditions such as complex regional pain syndrome (CRPS), post-herpetic neuralgia (nerve pain following shingles), migraines, and certain disorders related to blood vessel spasms or an overactive sympathetic nervous system.
Medical Breakthroughs: Resetting the Emotional ‘Switch’?
In recent years, the medical community has begun to re-examine the relationship between the stellate ganglion and emotional regulation. According to two double-blind randomised controlled trials conducted in 2016 and 2020, a stellate ganglion block can effectively alleviate symptoms of post-traumatic stress disorder (PTSD) while simultaneously improving anxiety, depression, and pain-related issues [1][2].
Subsequent systematic reviews and meta-analyses have also supported this therapeutic approach [3].
Furthermore, a 2023 small clinical study showed that a stellate ganglion block can reduce anxiety symptoms, with the positive effects lasting for a month or longer [4].
Beyond its emotional applications, the procedure may also improve menopausal symptoms such as hot flushes [5].
The Science Behind It: Why Are the Effects So Long-Lasting?
How a local anaesthetic that remains in the body for only a few hours can bring about improvements lasting weeks or even months is not yet completely understood.
In 2009, Lipov proposed a hypothesis suggesting that chronic stress may be accompanied by an abnormal increase in nerve growth factor (NGF) and sympathetic nerve activity, and that a stellate ganglion block could temporarily interrupt this vicious cycle [6].
In 2022, Kim and colleagues offered an alternative explanation. They suggested that the procedure temporarily suppresses overactive sympathetic outputs, making it easier for the parasympathetic nervous system to regain its balance. This, in turn, positively influences the brainstem and emotional regulation networks [7].
This theory helps to explain why a localised nerve block can sometimes produce central brain effects that far outlast the duration of the anaesthetic.
Conclusion: Opening New Directions in Emotional Therapy
In summary, the stellate ganglion block was originally a traditional interventional treatment for pain. However, recent studies demonstrate that it may also hold significant clinical value for addressing emotional trauma, autonomic nervous system imbalances, and menopausal symptoms.
References:
1. Hanling SR, Hickey A, Lesnik I, Hackworth RJ, Stedje-Larsen E, Drastal CA, McLay RN. Stellate ganglion block for the treatment of posttraumatic stress disorder: a randomized, double-blind, controlled trial. Reg Anesth Pain Med. 2016 Jul-Aug;41(4):494-500.
2. Rae Olmsted KL, Bartoszek M, Mulvaney S, Arroliga M, Diaz A, Anderson E, et al. Effect of stellate ganglion block treatment on posttraumatic stress disorder symptoms: a randomized clinical trial. JAMA Psychiatry. 2020;77(2):130-138. doi:10.1001/jamapsychiatry.2019.3474.
3. Gao H, Li Y, Zhou Y, Li Y, Wang Y, Li X. Stellate ganglion blockade for the treatment of post-traumatic stress disorder: a systematic review and meta-analysis. J Psychosom Res. 2025;119:111999.
4. Lynch CS, McLay RN, Gantner E, et al. Stellate ganglion block reduces anxiety symptoms by half: a retrospective observational study. J Clin Psychiatry. 2023;84(4):22m14611.
5. Freedman RR, Allen-Taylor L, Deegan PC, Babineau DC, Lipov EG. Stellate ganglion block as a treatment for vasomotor symptoms: clinical application. Cleve Clin J Med. 2022;89(3):147-152.
6. Lipov EG, Kelty JD, Sanders VL, Turkington TG. A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD). Med Hypotheses. 2009;73(2):267-270.
7. Kim SY, Cohen SP, Rodriguez SE, McCabe J, Choi KH. Central effects of stellate ganglion block mediated by the vagus nerve? An alternate hypothesis for treating PTSD. Med Hypotheses. 2022;162:110833.
