化瘀消癥汤联合雷火灸治疗输卵管妊娠包块的疗效观察

Effect of Huayu Xiaozheng Decoction(化瘀消癥汤)Combined with Thunder-fire Moxibustion on Tubal Ectopic Pregnancy Mass

目的探究化瘀消癥汤联合雷火灸治疗输卵管妊娠包块的疗效观察。方法选取医院2019年1月—2021年5月收治的87例输卵管妊娠包块患者为研究对象。根据非随机将患者分为两组,对照组(46例)使用甲氨蝶呤治疗、观察组(41例)在此基础上采用化瘀消癥汤联合赵氏雷火灸法治疗。所有患者连续治疗1个月,观察两组患者输卵管妊娠包块吸收时间、腹痛消失时间、β-人绒毛膜促性腺激素(β-human chorionic gonadotropin,β-hCG)转阴时间。比较两组患者治疗前,治疗后15、30 d患者血清激素:β-hCG、孕酮(progesterone prog,P)水平与炎症因子:人糖类抗原125(carbohydrateantigen125,CA125)、白细胞介素-7(interleukin-7,IL-7)、C反应蛋白(C reactive protein,CRP)水平变化及不良反应发生率与中医证候积分。结果两组治疗前β-hCG、P、CA125、IL-7、CRP水平比较差异无统计学意义(P>0.05)。治疗15 d后观察组CA125、P、CRP水平较对照组有显著降低(P<0.05),但β-hCG、IL-7水平无统计学意义(P>0.05)。治疗30 d后观察组β-hCG、P、CA125、IL-7、CRP水平均较对照组显著降低(P<0.05)。观察组腹痛消失时间、β-hCG转阴时间、包块消失时间均显著小于对照组(P<0.05)。观察组(97.56%,40/41)总有效率显著高于对照组(84.78%,39/46)(P<0.05)。观察组(14.63%,6/41)总发生率与对照组(15.22%,7/46)差异无统计学意义(P>0.05)。治疗前两组患者中医证候积分差异无统计学意义(P>0.05)。治疗后观察组中医证候积分显著低于对照组(P<0.05)。治疗前两组患者输卵管妊娠包块最长径线差异无统计学意义(P>0.05)。治疗后15、30 d观察组输卵管妊娠包块最长径线显著小于对照组(P<0.05)。结论化瘀消癥汤联合雷火灸使用能较大幅度减少患者腹痛消失时间、β-hCG转阴时间、包块消失时间,且在降低β-hCG、P、CA125、IL-7、CRP水平效果显著。

Objective To analyze the clinical effect of Huayu Xiaozheng Decoction(化瘀消癥汤)combined with thunder-fire moxibustion on tubal ectopic pregnancy mass.Methods Eighty-seven patients with tubal ectopic pregnancy mass in the hospital from January 2019 to May 2021 were enrolled and divided into two groups according to different treatment methods.The control group(46 cases)received methotrexate treatment.Based on this,the observation group(41 cases)received Huayu Xiaozheng Decoction combined with thunder-fire moxibustion.The treatment in both groups lasted for 1 month.Then the mass absorption time,time of abdominal pain disappearance and negative conversion time ofβ-human chorionic gonadotropin(β-hCG)were observed in both groups.Meantime,the levels of serum hormonesβ-hCG and substance P,levels of inflammatory factors carbohydrate antigen 125(CA125),interleukin(IL)-6 and C-reactive protein(CRP),and the incidence of adverse reactions and TCM syndrome scores were compared.Results Before treatment,the levels ofβ-hCG,substance P,CA125,IL-7 and CRP yielded no statistical difference between two groups(P>0.05).After 15 d treatment,the observation group had significantly lower levels of CA125,substance P and CRP compared with the control group(all P<0.05),while no statistical difference was found in levels ofβ-hCG or IL-7(P>0.05).After 30 d treatment,the levels ofβ-hCG,substance P,CA125,IL-7 and CRP were significantly lower in the observation group than those in the control group(all P<0.05).The time of abdominal pain disappearance,negative conversion time ofβ-hCG and mass absorption time of the observation group were significantly shorter than those of the control group(P<0.05).The overall efficacy rate was 97.56%(40/41)in the observation group,which was significantly higher than 84.78%(39/46)in the control group(P<0.05).The adverse reaction rate was 14.63%(6/41)in the observation group and 15.22%(7/46)in the control group,with no statistical difference(P>0.05).TCM syndrome scores showed no significant difference between two groups before treatment(P>0.05),while the scores were significantly lower in the observation group than those in the control group after treatment(P<0.05).The maximum diameter of the mass yielded no statistical difference between two groups,while the maximum diameter of the mass at post-treatment 15 d and 30 d were significantly smaller in the observation group compared with those in the control group(P<0.05).Conclusion Application of Huayu Xiaozheng Decoction combined with thunder-fire moxibustion in the treatment of tubal ectopic pregnancy mass can effectively shorten the abdominal pain disappearance time,negative conversion time ofβ-hCG and mass absorption time,and reduce the levels ofβ-hCG,substance P,CA125,IL-7 and CRP in patients.