皂刺汤联合甲氨蝶呤治疗未破损型异位妊娠多中心回顾性研究

A Multicentre Retrospective Study of Zaoci Decoction(皂刺汤)Combined with Methotrexate in Treatment of Undamaged Ectopic Pregnancy

目的探讨研究皂刺汤联合甲氨蝶呤治疗未破损型异位妊娠的临床疗效。方法回顾性纳入2011年5月—2021年5月于北京中医药大学东方医院和泰安市中心医院住院治疗实施皂刺汤联合甲氨蝶呤的异位妊娠患者的临床资料作为观察组,选取同期实施甲氨蝶呤的异位妊娠患者的临床资料作为对照组。观察两组有效率、治疗前后血清β-hCG下降水平、包块消失程度、盆腔积液深度、住院天数、复发情况、治疗后患侧输卵管造影结果、远期宫内妊娠情况、不良反应发生情况。结果共收集到117例患者的病历资料,其中观察组69例,对照组48例。观察组总有效率100%(69/69),对照组总有效率93.75%(45/48),观察组总有效率显著高于对照组(P<0.05);治疗前后两组血清β-hCG均下降,观察组下降更为明显(P<0.05);治疗前后两组包块均减小,观察组减小更明显(P<0.05);治疗后两组患者盆腔积液均减少(P<0.05),两组差异无统计学意义(P>0.05);两组患者住院天数、复发情况及远期宫内妊娠情况差异无统计学意义(P>0.05);治疗后患侧输卵管造影结果观察组优于对照组(P<0.05);观察组不良反应发生情况显著低于对照组(P<0.05)。结论皂刺汤联合甲氨蝶呤治疗异位妊娠未破损型的患者,具有增效减毒的作用,可快速有效地降低患者血清β-hCG水平、促进包块消减、减少盆腔积液、提高保守治疗后患侧输卵管的通畅度,值得进一步研究及推广。

Objective To investigate the clinical efficacy of Zaoci Decoction(皂刺汤)combined with methotrexate in the treat⁃ment of undamaged ectopic pregnancy.Methods The clinical data of ectopic pregnancy patients who received Zaoci Decoction combined with methotrexate in Oriental Hospital of Beijing University of Chinese Medicine and Tai′an Central Hospital from May 2011 to May 2021 was retrospectively included as the observation group,and the clinical data of ectopic pregnancy patients who received methotrexate during the same period was selected as the control group.The effective rate,the decrease level of serum hu⁃man chorionic gonadotropin(β-HCG)before and after treatment,the degree of mass disappearance,the depth of pelvic effusion,the length of hospital stay,recurrence,the result of tubal angiography on the affected side,long-term intrauterine pregnancy and the occurrence of adverse reactions were observed in the two groups.Results A total of 117 patients′medical records were collect⁃ed,including 69 in the observation group and 48 in the control group.The total effective rate of observation group was 100%(69/69)and that of the control group was 93.75%(45/48),and the total effective rate of the observation group was significantly high⁃er than that of the control group(P<0.05).Serumβ-HCG decreased in both groups before and after treatment,and the de⁃crease was more obvious in the observation group(P<0.05).Before and after treatment,the lumps in the two groups were de⁃creased,and the decrease was more obvious in the observation group(P<0.05).After treatment,the pelvic fluid accumulation was decreased in both groups(P<0.05),and there was no statistical significance between the two groups(P>0.05).There were no significant differences in hospitalization days,recurrence or long-term intrauterine pregnancy between two groups(P>0.05).The results of salpingography in the observation group were better than those in the control group(P<0.05).The incidence of ad⁃verse reactions in the observation group was significantly lower than that in the control group(P<0.05).Conclusion Zaoqi De⁃coction combined with methotrexate in the treatment of patients with undamaged ectopic pregnancy has a synergistic and toxic effect,which can rapidly and effectively reduce the level of serumβ-HCG,promote mass reduction,reduce pelvic effusion and improve the patency of the affected fallopian tube after conservative treatment,worthy of further study and promotion.