中药杀胚Ⅰ号方联合甲氨蝶呤治疗剖宫产瘢痕部位妊娠的临床疗效观察

Clinical efficacy of early pregnancy in cesarean section scar patients treated by traditional Chinese medicine killing embryos formula Ⅰ with methotrexate

目的探讨中药杀胚Ⅰ号方联合甲氨蝶呤(MTX)治疗剖宫产后瘢痕部位妊娠(CSP)的临床疗效。方法将44例CSP的患者,按分层随机化分组法分为观察组与对照组各22例。对照组在超声引导下将MTX局部注射到孕囊,待血HCG降至2 000 IU·L-1以下,再予清宫术;观察组在超声引导下将MTX局部注射到孕囊的基础上开始口服中药杀胚Ⅰ号方,待血HCG降至2 000 IU·L-1以下,再予清宫术,比较两组的临床疗效。结果观察组的治疗效果显著高于对照组(P<0.05);观察组的血β-HCG降低至2 000 IU·L-1以下的时间以及子宫下段超声正常时间均较对照组显著缩短(P<0.05);两组之间不良反应发生率差异无统计学意义(P>0.05)。结论中药杀胚Ⅰ号方联合MTX治疗CSP疗效显著,突显中医优势,值得临床推广应用。

Objective To investigate the efficacy of traditional Chinese medicine killing embryos formula Ⅰ combined with methotrexate（ MTX） on treating patients of early pregnancy with cesarean section scar（ CSP）. Methods Totally44 CSP patients were randomized into two groups. The control group（ n = 22） was prescribed with conventional treatment alone,injected with methotrexate（ MTX） into the gestational sac guided by ultrasound technique,then uterine curettage was carried out when β-HCG decreased to less than 2 000IU·L- 1. The treatment group（ n = 22） received conventional medical therapy plus killing embryos formula Ⅰ,then uterine curettage was carried out whenβ-HCG decreased to less than 2 000 IU·L- 1. Results The clinical efficacy rate of the treatment group was significantly higher than the control group（ P 〈 0. 05）. The time needed for the β-HCG in the treatment group decreased to less than2 000 IU·L- 1and the time needed for ultrasonic detection of lower uterine segment displaying normal were significantly shorter than those in the control group（ P 〈 0. 05）. There was no significant difference in the incidence of adverse reactions between the 2 groups.Conclusions Killing embryos formula Ⅰ combined with MTX showed favorable effect on the treatment of CSP,which is worthy of clinical promotion.