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
目的探讨中西医结合治疗妊娠期肝内胆汁淤积(intrahepatic cholestasis of pregnancy,ICP)的效果及安全性。方法回顾性分析2020年1月至2022年6月杭州师范大学附属医院接受治疗的151例ICP患者的临床资料。按照治疗方案的不同,将所有患者...目的探讨中西医结合治疗妊娠期肝内胆汁淤积(intrahepatic cholestasis of pregnancy,ICP)的效果及安全性。方法回顾性分析2020年1月至2022年6月杭州师范大学附属医院接受治疗的151例ICP患者的临床资料。按照治疗方案的不同,将所有患者分为对照组(100例)和观察组(51例)。对照组患者给予基础疗法,即熊去氧胆酸胶囊+注射用腺苷蛋氨酸;观察组患者在对照组治疗的基础上,给予茵陈蒿汤加减方煎服,疗程为1周。比较两组患者的实验室血清指标、瘙痒情况、母婴结局及安全性。结果治疗后,两组患者的血清总胆红素、丙氨酸转氨酶、天冬氨酸转氨酶、总胆汁酸水平和瘙痒评分均显著低于本组治疗前,且观察组显著低于对照组(P<0.05)。观察组患者的瘙痒缓解率显著高于对照组,瘙痒控制时间显著短于对照组(P<0.05)。观察组患者的剖宫产、羊水浑浊、产后出血发生率均显著低于对照组,终止妊娠时的孕龄显著高于对照组(P<0.05)。治疗后,两组围产儿的脐动脉收缩期峰值和舒张末期流速比值显著低于本组治疗前,且观察组显著低于对照组(P<0.05)。两组患者治疗过程中均未发生药物过敏反应,也无胎盘早剥或死胎等严重并发症出现。结论相较于单一的西医疗法,中西医结合治疗ICP效果更好,可很大程度改善血清胆汁酸、胆红素和肝酶水平,减轻瘙痒,改善母婴结局,副作用小,具有良好安全性。展开更多
妊娠期肝内胆汁淤积症(Intrahepatic cholestasis of pregnancy,ICP)是妊娠期特有的肝脏疾病,与胎儿早产、窒息等不良孕产结局有关。西医治疗可缓解临床症状,但对生化指标及妊娠结局的改善效果欠佳。中医药治疗妊娠期肝内胆汁淤积症有...妊娠期肝内胆汁淤积症(Intrahepatic cholestasis of pregnancy,ICP)是妊娠期特有的肝脏疾病,与胎儿早产、窒息等不良孕产结局有关。西医治疗可缓解临床症状,但对生化指标及妊娠结局的改善效果欠佳。中医药治疗妊娠期肝内胆汁淤积症有独特优势,病变涉及肝、胆、脾、肾、三焦,治疗原则以清热利湿退黄、行气活血化瘀为主,现就近年来中医药治疗该病的研究做简要综述。展开更多
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.
文摘目的探讨中西医结合治疗妊娠期肝内胆汁淤积(intrahepatic cholestasis of pregnancy,ICP)的效果及安全性。方法回顾性分析2020年1月至2022年6月杭州师范大学附属医院接受治疗的151例ICP患者的临床资料。按照治疗方案的不同,将所有患者分为对照组(100例)和观察组(51例)。对照组患者给予基础疗法,即熊去氧胆酸胶囊+注射用腺苷蛋氨酸;观察组患者在对照组治疗的基础上,给予茵陈蒿汤加减方煎服,疗程为1周。比较两组患者的实验室血清指标、瘙痒情况、母婴结局及安全性。结果治疗后,两组患者的血清总胆红素、丙氨酸转氨酶、天冬氨酸转氨酶、总胆汁酸水平和瘙痒评分均显著低于本组治疗前,且观察组显著低于对照组(P<0.05)。观察组患者的瘙痒缓解率显著高于对照组,瘙痒控制时间显著短于对照组(P<0.05)。观察组患者的剖宫产、羊水浑浊、产后出血发生率均显著低于对照组,终止妊娠时的孕龄显著高于对照组(P<0.05)。治疗后,两组围产儿的脐动脉收缩期峰值和舒张末期流速比值显著低于本组治疗前,且观察组显著低于对照组(P<0.05)。两组患者治疗过程中均未发生药物过敏反应,也无胎盘早剥或死胎等严重并发症出现。结论相较于单一的西医疗法,中西医结合治疗ICP效果更好,可很大程度改善血清胆汁酸、胆红素和肝酶水平,减轻瘙痒,改善母婴结局,副作用小,具有良好安全性。
文摘妊娠期肝内胆汁淤积症(Intrahepatic cholestasis of pregnancy,ICP)是妊娠期特有的肝脏疾病,与胎儿早产、窒息等不良孕产结局有关。西医治疗可缓解临床症状,但对生化指标及妊娠结局的改善效果欠佳。中医药治疗妊娠期肝内胆汁淤积症有独特优势,病变涉及肝、胆、脾、肾、三焦,治疗原则以清热利湿退黄、行气活血化瘀为主,现就近年来中医药治疗该病的研究做简要综述。
