中药扶正消癥方联合西药或UAE术治疗剖宫产瘢痕妊娠的临床疗效分析

Clinical Curative Analysis of Fuzheng Xiaozheng Recipe Combined with Western Medicine or Uterine Artery Embolization in the Treatment of Cesarean Scar Pregnancy

目的:比较中药扶正消方联合西药或子宫动脉栓塞术(UAE)治疗剖宫产瘢痕妊娠(CSP)的临床疗效。方法:回顾分析2011年10月~2016年07月期间在我院诊治的39例CSP患者,根据患者在治疗过程中选择治疗手段的不同将所有患者分为观察组和对照组,观察组分为A组和B组,A组采用中药扶正消方联合西药(甲氨蝶呤肌肉注射+米非司酮口服)加清宫术,B组采用中药扶正消方联合UAE加清宫术;对照组则分为C组和D组,C组采用西药加清宫术,D组采用UAE加清宫术,对各组的治疗效果进行比较。结果:介入组(B组和D组)的清宫手术出血量、手术时间、术后血人绒毛膜促性腺激素(β-HCG)转阴时间、包块缩小≥60%时间、住院时间分别优于A组、C组,比较有统计学差异(P<0.05);中药组(A组和B组)的术后血β-HCG转阴时间、包块缩小≥60%时间、住院时间分别优于C组、D组(P<0.05);观察组的治疗成功率(95%)高于对照组(90%),但比较无统计学差异(P>0.05)。结论:中药联合西药或UAE术治疗CSP能够充分发挥中医、西医的优势,取得更好的临床疗效,可在临床上进行推广。

Objective： To analyze the clinical efficacy on cesarean scar pregnancy（ CSP） treated by traditional Chinese medicine（ TCM） Fuzheng Xiaozheng Formula with western medicine or uterine artery embolization（ UAE）. Methods： The 39 patients with CSP treated in the hospital from October 2011 to July 2016 were selected and divided into observation group and controlled group according to different ways. The observation group was subdivided into group A and group B,group A was applied to Fuzheng Xiaozheng Formula with intramuscular injection of methotrexate（ MTX）,oral mifepristone plus curettage,group B was given Fuzheng Xiaozheng Formula with UAE plus curettage. The controlled group was subdivided into group C and group D,group C was treated with MTX,mifepristone plus curettage,while group D was applied to UAE plus curettage. Clinical effect of patients in each group were observed and analyzed. Results： In comparison with A and C,the treatment of interventional therapy group（B and D） could notably reduce the blood loss,the operation time of curettage,the time of blood β-HCG level back to normal,the time of mass reducing 60%,and the duration of hospitalization,with significant difference（ P〈0. 05）. In comparison with C and D,the treatment of Chinese medicine group（ A and B） could notably reduce the time of blood β-HCG level back to normal,the time of mass reducing 60%,and the duration of hospitalization,with significant difference（ P〈0. 05）. The controlled group＇s operative success rate were 90%,the observation group＇ s were 95%,with no significant difference（ P〈0. 05）. Conclusion：The clinical effect of TCM Fuzheng Xiaozheng Formula with western medicine or UAE is significant,which can give a full play to the advantages of TCM and western medicine and can be popularized in clinical.