Objective: To explore the therapeutic effect and mechanism of integrated traditional Chinese and western medicine (TCM-WM) in treating ectopic pregnancy (EP). Methods: Seventy-eight patients suffering from unruptured ...Objective: To explore the therapeutic effect and mechanism of integrated traditional Chinese and western medicine (TCM-WM) in treating ectopic pregnancy (EP). Methods: Seventy-eight patients suffering from unruptured EP were divided into two groups at random in proportion of roughly 2∶1, Group Ⅰ(n=50) was treated with methotrexate (MTX) plus Ectopic Pregnancy No.2 (EP2), a Chinese medicinal decoction, Group Ⅱ (n=28) was treated with MTX alone for control. Results:In Group Ⅰ, the nonsurgical cure rate, involving side tubal patency rate and intrauterine pregnancy rate, were 98.0%, 88.0% and 80.0% respectively, the three parameters were all higher than those in Group Ⅱ (75.0%, 46.4% and 42.9% respectively). Moreover, the EP recurrence rate in Group Ⅰ was lower than that in Group Ⅱ (4.0% vs 14.2%), the serum β-hCG normalizing time and total disappearance time of EP mass in Group Ⅰ (25.0±7.8 days and 1.2±0.7 months) were shorter than those in Group Ⅱ (31.9±6.7 days and 5.6±3.7 months), also showing significant difference (P<0.05 and P<0.01 respectively). After being treated by EP2 decoction for 4-8 weeks, the hemorrheological parameters in Group Ⅰ were improved more markedly than those in Group Ⅱ. Conclusion: The TCM-WM treatment (MTX plus EP2) could effectively increase nonsurgical cure rate, tubal patency rate and intrauterine pregnancy rate, decrease EP recurrence rate, and reduce the serum β-hCG normalizing time and the total disappearance time of EP mass in treating EP.展开更多
Objective To assess the therapeutic effect of single dose methotrexate (MTX) combined with Chinese medicinal herbs on ectopic pregnancy (EP). Methods Eighty five patients with EP were prospectively treated with...Objective To assess the therapeutic effect of single dose methotrexate (MTX) combined with Chinese medicinal herbs on ectopic pregnancy (EP). Methods Eighty five patients with EP were prospectively treated with an intramuscular injection of MTX (50 mg/m 2), without citrovorum factor rescue, to destroy the embryo and villi. Meanwhile, Chinese medicinal herb, Ectopic Pregnancy Prescription 1 (EP1, Radix salviae miltiorrhizae 15 g, Radix paeoniae rubra 15 g, and Semen persicae 9 g) decoction was given orally to patients with early rupture or tubal abortion and without shock, and Ectopic Pregnancy Prescription 2 (EP2, Radix salviae miltiorrhizae 15 g, Radix paeoniae rubra 15 g, Semen persicae 9 g, Rhizoma spaarganii 6 g, and Rhizoma zedoariae 6 g) decoction to patients without rupture or with late rupture with formation of hematomas in the abdominal or pelvic cavities. Serum β subunits of human chorionic gonadotropin (hCG) were monitored regularly until they were undetectable. Gestational sac, fetal cardiac activity, EP mass absorption, etc., were observed by serial ultrasound. For patients attempting pregnancy, hysterosalpingogram was given after EP mass totally disappeared. Results One dose of MTX together with EP1 or EP2 decoction successfully treated all patients with hCG β subunit concentration ≤20 μg/L, but failed in all patients with hCG β subunit concentration≥ 40 μg/L and/or emerging fetal cardiac activity. Eighty one (95.3%) patients were successfully treated without surgery, and 4 (4.7%) required surgical treatment. Mean clearance time for serum hCG β subunit was 18.7±7.2 (range 10 59) days, and time required for total disappearance of EP mass as assessed by transvaginal sonography was 1.2±0.7 (range 0.5 5.5) months. Hysterosalpingograms in 20 patients attempting pregnancy demonstrated tubal patency on the involved side in 90.0% (18 patients). After 6 months to 1 year of follow up for the 20 patients, 15 intrauterine pregnancies were achieved, but 1 patient suffered from recurrent EP. Conclusions Combination of traditional Chinese medicine and western medicine may enlarge the scope of EP treated with MTX only, with good therapeutic efficacy. However, patients with serum hCG β subunit≥20 μg/L before treatment may require additional injection of MTX to obtain the expected decrease in hCG β subunit titer.展开更多
Objective: To explore the therapeutic effect of single-dose methotrexate (MTX) with Chinesemedicinal herbs in the treatment of ectopic pregnancy(EP). Methods: Eighty-five patients with unruptured andruptured EP were p...Objective: To explore the therapeutic effect of single-dose methotrexate (MTX) with Chinesemedicinal herbs in the treatment of ectopic pregnancy(EP). Methods: Eighty-five patients with unruptured andruptured EP were prospectively treated with an intramuscular injection of MTX (50 mg/m') without citrovorumfactor rescue to destroy embryo and villi, meanwhile, EP 1 decoction was given orally, in the case of rupturedEP with active internal hemorrhage resulted from EP mass rupture, or EP 2 decoction was given orally, In thecase of unruptured EP and ruptured EP without active internal hemorrhage resulted from EP mass rhexis andblood in the peritoneal cavity has already formed hematomas. The serum human chorionic gonadotropin (hCG)3-subunit were monitored regularly until they were undetectable. Serial B-ultrasound examinations were followedup by observing the gestational sac, fetal cardiac activity, EP mass absorption, etc. Of those who has the desireof being pregnant, after all EP mass disappeared, hysterosalpingogram may be performed. Results: The total of81 cases (95. 3 % ) were successfully treated without surgical operation, 4 cases (4. 7 % ) required surgical management of EP. The mean serum hCG 5-subunit clearance time was 18. 7 i 7. 2 days. Total disappearance of EPmass assessed by transvaginal ultrasonography, was 1. 2 1 0. 7 months. Hysterosalpingograms done on 20 patients of attempting pregnancy subsequently demonstrated tubal patency in 90. 0 % .(18 cases) on the affectedside. To date, 15 intrauterine pregnancies have occurred in this group, none of the patients were recurrent EP.Conclusions: EP were treated with integrated traditional Chinese and western medicine, it may expand the EPindication treated with MTX alone, elevate cure rate and obtain ideal efficacy without surgical intervention.展开更多
文摘Objective: To explore the therapeutic effect and mechanism of integrated traditional Chinese and western medicine (TCM-WM) in treating ectopic pregnancy (EP). Methods: Seventy-eight patients suffering from unruptured EP were divided into two groups at random in proportion of roughly 2∶1, Group Ⅰ(n=50) was treated with methotrexate (MTX) plus Ectopic Pregnancy No.2 (EP2), a Chinese medicinal decoction, Group Ⅱ (n=28) was treated with MTX alone for control. Results:In Group Ⅰ, the nonsurgical cure rate, involving side tubal patency rate and intrauterine pregnancy rate, were 98.0%, 88.0% and 80.0% respectively, the three parameters were all higher than those in Group Ⅱ (75.0%, 46.4% and 42.9% respectively). Moreover, the EP recurrence rate in Group Ⅰ was lower than that in Group Ⅱ (4.0% vs 14.2%), the serum β-hCG normalizing time and total disappearance time of EP mass in Group Ⅰ (25.0±7.8 days and 1.2±0.7 months) were shorter than those in Group Ⅱ (31.9±6.7 days and 5.6±3.7 months), also showing significant difference (P<0.05 and P<0.01 respectively). After being treated by EP2 decoction for 4-8 weeks, the hemorrheological parameters in Group Ⅰ were improved more markedly than those in Group Ⅱ. Conclusion: The TCM-WM treatment (MTX plus EP2) could effectively increase nonsurgical cure rate, tubal patency rate and intrauterine pregnancy rate, decrease EP recurrence rate, and reduce the serum β-hCG normalizing time and the total disappearance time of EP mass in treating EP.
文摘Objective To assess the therapeutic effect of single dose methotrexate (MTX) combined with Chinese medicinal herbs on ectopic pregnancy (EP). Methods Eighty five patients with EP were prospectively treated with an intramuscular injection of MTX (50 mg/m 2), without citrovorum factor rescue, to destroy the embryo and villi. Meanwhile, Chinese medicinal herb, Ectopic Pregnancy Prescription 1 (EP1, Radix salviae miltiorrhizae 15 g, Radix paeoniae rubra 15 g, and Semen persicae 9 g) decoction was given orally to patients with early rupture or tubal abortion and without shock, and Ectopic Pregnancy Prescription 2 (EP2, Radix salviae miltiorrhizae 15 g, Radix paeoniae rubra 15 g, Semen persicae 9 g, Rhizoma spaarganii 6 g, and Rhizoma zedoariae 6 g) decoction to patients without rupture or with late rupture with formation of hematomas in the abdominal or pelvic cavities. Serum β subunits of human chorionic gonadotropin (hCG) were monitored regularly until they were undetectable. Gestational sac, fetal cardiac activity, EP mass absorption, etc., were observed by serial ultrasound. For patients attempting pregnancy, hysterosalpingogram was given after EP mass totally disappeared. Results One dose of MTX together with EP1 or EP2 decoction successfully treated all patients with hCG β subunit concentration ≤20 μg/L, but failed in all patients with hCG β subunit concentration≥ 40 μg/L and/or emerging fetal cardiac activity. Eighty one (95.3%) patients were successfully treated without surgery, and 4 (4.7%) required surgical treatment. Mean clearance time for serum hCG β subunit was 18.7±7.2 (range 10 59) days, and time required for total disappearance of EP mass as assessed by transvaginal sonography was 1.2±0.7 (range 0.5 5.5) months. Hysterosalpingograms in 20 patients attempting pregnancy demonstrated tubal patency on the involved side in 90.0% (18 patients). After 6 months to 1 year of follow up for the 20 patients, 15 intrauterine pregnancies were achieved, but 1 patient suffered from recurrent EP. Conclusions Combination of traditional Chinese medicine and western medicine may enlarge the scope of EP treated with MTX only, with good therapeutic efficacy. However, patients with serum hCG β subunit≥20 μg/L before treatment may require additional injection of MTX to obtain the expected decrease in hCG β subunit titer.
文摘Objective: To explore the therapeutic effect of single-dose methotrexate (MTX) with Chinesemedicinal herbs in the treatment of ectopic pregnancy(EP). Methods: Eighty-five patients with unruptured andruptured EP were prospectively treated with an intramuscular injection of MTX (50 mg/m') without citrovorumfactor rescue to destroy embryo and villi, meanwhile, EP 1 decoction was given orally, in the case of rupturedEP with active internal hemorrhage resulted from EP mass rupture, or EP 2 decoction was given orally, In thecase of unruptured EP and ruptured EP without active internal hemorrhage resulted from EP mass rhexis andblood in the peritoneal cavity has already formed hematomas. The serum human chorionic gonadotropin (hCG)3-subunit were monitored regularly until they were undetectable. Serial B-ultrasound examinations were followedup by observing the gestational sac, fetal cardiac activity, EP mass absorption, etc. Of those who has the desireof being pregnant, after all EP mass disappeared, hysterosalpingogram may be performed. Results: The total of81 cases (95. 3 % ) were successfully treated without surgical operation, 4 cases (4. 7 % ) required surgical management of EP. The mean serum hCG 5-subunit clearance time was 18. 7 i 7. 2 days. Total disappearance of EPmass assessed by transvaginal ultrasonography, was 1. 2 1 0. 7 months. Hysterosalpingograms done on 20 patients of attempting pregnancy subsequently demonstrated tubal patency in 90. 0 % .(18 cases) on the affectedside. To date, 15 intrauterine pregnancies have occurred in this group, none of the patients were recurrent EP.Conclusions: EP were treated with integrated traditional Chinese and western medicine, it may expand the EPindication treated with MTX alone, elevate cure rate and obtain ideal efficacy without surgical intervention.
