宫外孕方联合甲氨蝶呤+米非司酮对输卵管妊娠患者β-人绒毛膜促性腺激素及肌酸激酶水平的影响

Effects of Gongwaiyun Prescription combined with methotrexate and mifepristone onβ-HCG and CK levels in patients with tubal pregnancy

目的探究宫外孕方联合甲氨蝶呤+米非司酮对输卵管妊娠患者β-人绒毛膜促性腺激素(β-HCG)及肌酸激酶(CK)水平的影响。方法回顾性选取浙江省宁海县妇幼保健院2022年1月至2023年12月收治的输卵管妊娠患者126例,将研究对象按是否使用宫外孕方治疗分为观察组和对照组各63例,观察组采用宫外孕方联合甲氨蝶呤+米非司酮治疗,对照组采用甲氨蝶呤+米非司酮治疗。比较2组患者的临床疗效,血清β-HCG及CK水平,血清β-HCG恢复正常及包块消失的时间,以及不良反应情况。结果观察组总有效率为94%,对照组总有效率为76%,相比差异有统计意义(χ^(2)=4.771,P=0.021);干预后2组血清β-HCG、CK水平均下降(P<0.001),观察组干预后4 d、7 d和14 d的血清β-HCG、CK水平均低于对照组,差异有统计意义(t值分别为6.117、7.462、14.001,2.996、3.402、7.569;P均<0.001);观察组血清β-HCG恢复正常时间和包块消失时间均短于对照组,相比差异有统计意义(t=4.417、7.122,P均<0.001);观察组不良反应总发生率为49%,对照组不良反应总发生率为81%,相比差异有统计意义(χ^(2)=5.779,P=0.018)。结论宫外孕方联合甲氨蝶呤+米非司酮更有利于改善输卵管妊娠患者血清β-HCG及CK水平,缩短血清β-HCG转阴时间及包块消失时间,降低不良反应发生率,总体疗效更显著,值得临床予以推广应用。

Objective To analyze the effects of Gongwaiyun Prescription combined with methotrexate+mifepristone on beta human chorionic gonadotropin(β-HCG)and creatine kinase(CK)levels in patients with tubal pregnancy.Methods A total of 126 patients with tubal pregnancy admitted to Ninghai County Maternal and Child Health Hospital from January 2022 to December 2023 were selected and randomly divided into an observation group(63 cases)and a control group(63 cases)according to whether they were treated with Gongwaiyun Prescription or not.The observation group was treated with Gongwaiyun prescription combined with methotrexate and mifepristone,while the control group was treated with methotrexate and mifepristone alone.Statistical analysis was conducted on the clinical efficacy,serumβ-HCG and CK levels,the time for serumβ-HCG to return to normal and the disappearance of mass,as well as adverse reaction between the two groups.Results The total effective rates of the observation group and the control group were 94%and 76%,respectively,and the difference was statistically significant(χ^(2)=4.771,P=0.021).Both serumβ-HCG and CK levels significantly decreased after treatment in both groups(P<0.001).The serumβ-HCG and CK levels in the observation group at 4 d,7 d,and 14 d after treatment were significantly lower than those in the control group,and the differences were statistically significant(t=6.117,7.462,14.001,2.996,3.402,7.569,all P<0.001).The recovery time of serumβ-HCG and the time for mass disappearance in the observation group were significantly shorter than those in the control group,and the differences were statistically significant(t=4.417,7.122,all P<0.001).The total incidence of adverse reactions in the observation group was 49%,while that in the control group was 81%,and the difference was statistically significant(χ^(2)=5.779,P=0.018).Conclusion The combined use of Gongwaiyun prescription combined with methotrexate and mifepristone is more conducive to improving the serumβ-HCG and CK levels of patients with tubal pregnancy,shortening the time for serumβ-HCG to turn negative and the disappearance of mass,reducing the incidence of adverse reactions,and achieving more significant overall efficacy.Therefore,it is worthy of clinical promotion and application.