中西医结合保守治疗异位妊娠48例

Conservative Treatment for Ectopic Pregnancy of 48 cases by Combination of Chinese Traditional and Western Medicine

目的:探讨中西医结合保守治疗异位妊娠的疗效。方法:96例异位妊娠患者随机分为观察组和对照组各48例。对照组甲氨蝶呤(MTX)50 mg.m-2,深部肌注1次。观察组在对照组的基础上采用少腹逐瘀汤加减口服,并根据人绒毛膜促性腺激素(β-HCG)水平调整处方,1剂/d,常规水煎分2次服用,疗程4周。监测生命体征、血β-HCG水平及B超监测包块变化情况,并进行输卵管通畅实验。结果:观察组保守成功率(91.66%)优于对照组(72.92%)(P<0.05);观察组β-HCG复常时间、腹痛消失时间及子宫直肠陷凹积液吸收时间均明显短于对照组(P<0.05);治疗后观察组包块小于对照组(P<0.01);观察组输卵管通畅率(89.65%)优于对照组(70.37%)(P<0.05)。结论:中西医结合保守治疗异位妊娠能促进病灶包块吸收、促进输卵管通畅、保留生育功能,且安全性高,值得临床推广使用。

Objective： To investigate the clinical efficacy of combination of Chinese traditional and western medicine on ectopic pregnancy.Method： Ninety-six subjects were randomly divided into observation group and control group（n = 48 each）.Control group was given methotrexate（MTX） 50 mg.m-2 by intramuscular injection,once.Observation group was received Shaofu Zhuyu decoction on the basis of control group,and the prescription was adjusted according to the level of human chorionic gonadotrophin（β-HCG）,1 dose daily.The decoction was prepared daily and taken 2 times（half by half）,for 4 weeks.Vital signs and serum β-HCG level were monitored,the extrauterine pregnancy package of block was monitored by B ultrasonic,and tubal patency tests were applied.Result： The success rate of observation group（91.66%） was superior to that in control group（72.92%）（P〈0.05）.The recovery duration of β-HCG,the duration of abdominal pain disappearance and the duration for absorption of uterine rectal pouch effusion in the observation group were less than those in the control group（P〈0.05）.The enclosed mass in the observation group after treatment was less than that in control group（P〈0.01）.Tubal patency rate of observation group（89.65%） was superior to that in control group（70.37%）（P〈0.05）.Conclusion： The conservative treatment of combination of Chinese traditional and western medicine for ectopic pregnancy could kill fetus,promote quick absorption of enclosed mass,maintain tubal patency,preserve the fertility.It is safe and worthy for being widely used in clinical treatment.