中药活血消癥法综合治疗包块型异位妊娠的临床研究
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摘要
目的：
采用中药活血消癥法口服配合中药浓煎灌肠综合治疗包块型异位妊娠患者,通过对其4周后短期临床疗效、中医证候疗效,血β-HCG下降至正常所需时间,盆腔包块消失所需时间,以及有生育要求患者治疗后患侧输卵管通畅情况的临床观察,探讨活血消癥中药综合治疗包块型异位妊娠的临床价值,为临床提供用药依据。
材料与方法：
对80例2009年2月至2010年1月来自泉州市中医院妇科门诊及住院的输卵管异位妊娠患者,符合纳入标准者作为研究对象。采用数字表法随机分为两组,每组40例：治疗组采用活血消癥中药口服配合灌肠综合治疗；对照组采用期待疗法,不予任何治疗。记录两组每周血β-HCG值及盆腔包块大小；血β-HCG下降至正常所需的时间、盆腔包块消失所需的时间；中医证候改善情况；及治疗后患侧输卵管的通畅情况。
结果：
(1)4周后短期临床疗效、中医证候疗效,治疗组与对照组有显著差异(P<0.05)；
(2)4周后血β-HCG值情况及其降至正常所需的时间比较,两组间差异无统计学意义(P>0.05)；
(3)4周后盆腔包块情况比较及其消失所需的时间比较,两组间差异有统计学意义(P<0.05),治疗组优于对照组；
(4)盆腔包块消失后,有生育要求患者患侧输卵管通畅情况,治疗组明显优于对照组(P<0.05);
结论：
中药活血消瘤法口服配合灌肠综合疗法治疗包块型异位妊娠,能有效促进盆腔包块吸收,缩短病程,改善及恢复患侧输卵管功能,是临床上治疗包块型异位妊娠的有效方药。
Objective
To adopt the Traditional Chinese Medicine(TMC) comprehensive Treatment of Huoxue Xiaozheng of herbal oral administration combined with enema for ectopic pregnancy sufferers and to take the clinical observation on their four weeks short-term clinical efficacy, TCM symptom efficacy, time required for serumβ-HCG dropped to normal and pelvic masses dissolving and ipsilateral tubal fluency of patients of the requirement of procreation, the clinic value of TCM Integrated treatment of huoxue xiaozhen on ectopic pregnancy would be researched and the clinical basis for medication would be provided.
Material and Method
Of 80 cases from December 2008 to February 2010 came from Quanzhou, Chinese medicine hospital of gynecology outpatient and hospitalization, those of ectopic pregnancy who met the inclusion criteria were listed as objects of study.With Digital table method, cases were divided into two groups randomly:the treatment group were treated with combined therapy of Huoxue Xiaozheng while the control group were looking forward to the expecting therapy,not to any treatment
Recorded weekly serumβ-HCG value,the pelvic mass size, time required for serumβ-HCG dropped to normal and pelvic masses dissolving,the improvement of TCM symptoms and the ipsilateral tubal fluency of patients.
Results
(1)Significant differences on short-term clinic therapeutic effects and TCM emergeed between two groups after weeks (P<0.05);
(2) Time required for serumβ-HCG dropped to normal between two groups had no statistical significance (P<0.05);
(3) Time required for pelvic masses dissolving between two groups had statistical significance(P<0.05);
(4)After pelvic masses dissolving,compared with ipsilateral tubal fluency of patients of the requirement of procreation, the treatment group was significantly better than the control group (P <0.05).
Conclusion
Traditional Chinese Medicine(TMC) Integrated Treatment of Huoxue Xiaozheng of herbal oral administration combined with enema for ectopic pregnancy sufferers is valid prescription, which can facilitate the pelvic mass absorbing efficiently, reduce the course of diseases and improve and restore the function of ipsilateral fallopian tube.
采用中药活血消癥法口服配合中药浓煎灌肠综合治疗包块型异位妊娠患者,通过对其4周后短期临床疗效、中医证候疗效,血β-HCG下降至正常所需时间,盆腔包块消失所需时间,以及有生育要求患者治疗后患侧输卵管通畅情况的临床观察,探讨活血消癥中药综合治疗包块型异位妊娠的临床价值,为临床提供用药依据。
材料与方法：
对80例2009年2月至2010年1月来自泉州市中医院妇科门诊及住院的输卵管异位妊娠患者,符合纳入标准者作为研究对象。采用数字表法随机分为两组,每组40例：治疗组采用活血消癥中药口服配合灌肠综合治疗；对照组采用期待疗法,不予任何治疗。记录两组每周血β-HCG值及盆腔包块大小；血β-HCG下降至正常所需的时间、盆腔包块消失所需的时间；中医证候改善情况；及治疗后患侧输卵管的通畅情况。
结果：
(1)4周后短期临床疗效、中医证候疗效,治疗组与对照组有显著差异(P<0.05)；
(2)4周后血β-HCG值情况及其降至正常所需的时间比较,两组间差异无统计学意义(P>0.05)；
(3)4周后盆腔包块情况比较及其消失所需的时间比较,两组间差异有统计学意义(P<0.05),治疗组优于对照组；
(4)盆腔包块消失后,有生育要求患者患侧输卵管通畅情况,治疗组明显优于对照组(P<0.05);
结论：
中药活血消瘤法口服配合灌肠综合疗法治疗包块型异位妊娠,能有效促进盆腔包块吸收,缩短病程,改善及恢复患侧输卵管功能,是临床上治疗包块型异位妊娠的有效方药。
Objective
To adopt the Traditional Chinese Medicine(TMC) comprehensive Treatment of Huoxue Xiaozheng of herbal oral administration combined with enema for ectopic pregnancy sufferers and to take the clinical observation on their four weeks short-term clinical efficacy, TCM symptom efficacy, time required for serumβ-HCG dropped to normal and pelvic masses dissolving and ipsilateral tubal fluency of patients of the requirement of procreation, the clinic value of TCM Integrated treatment of huoxue xiaozhen on ectopic pregnancy would be researched and the clinical basis for medication would be provided.
Material and Method
Of 80 cases from December 2008 to February 2010 came from Quanzhou, Chinese medicine hospital of gynecology outpatient and hospitalization, those of ectopic pregnancy who met the inclusion criteria were listed as objects of study.With Digital table method, cases were divided into two groups randomly:the treatment group were treated with combined therapy of Huoxue Xiaozheng while the control group were looking forward to the expecting therapy,not to any treatment
Recorded weekly serumβ-HCG value,the pelvic mass size, time required for serumβ-HCG dropped to normal and pelvic masses dissolving,the improvement of TCM symptoms and the ipsilateral tubal fluency of patients.
Results
(1)Significant differences on short-term clinic therapeutic effects and TCM emergeed between two groups after weeks (P<0.05);
(2) Time required for serumβ-HCG dropped to normal between two groups had no statistical significance (P<0.05);
(3) Time required for pelvic masses dissolving between two groups had statistical significance(P<0.05);
(4)After pelvic masses dissolving,compared with ipsilateral tubal fluency of patients of the requirement of procreation, the treatment group was significantly better than the control group (P <0.05).
Conclusion
Traditional Chinese Medicine(TMC) Integrated Treatment of Huoxue Xiaozheng of herbal oral administration combined with enema for ectopic pregnancy sufferers is valid prescription, which can facilitate the pelvic mass absorbing efficiently, reduce the course of diseases and improve and restore the function of ipsilateral fallopian tube.
引文
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[4]林灵珍,李琪,陆宁,等.宫外孕保守治疗性治疗60例观察[J].河南科技大学学报,2004,22(1)：19.
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[6]赵万英中西结合治疗异位妊娠研究进展[J].现代医药卫生,2005,24(21)：3405-3406.
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[10]Storall TG,Ling FW,Gray LA,et al.Methotrexate tretment of unruptured ectopiepregnancy:A report of 100 cases[J].Obstet Gyneoal,1991,77:749-753.
[11]朱亚非,似木仕.与药物保守治疗输卵管妊娠相关的循汪医学证据和评价[J].中国实用妇科与产科杂志,2007,23(11)：880-882.
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[15]谢康云,张惜阴.输卵管妊娠的期待治疗[J].中华妇产科杂志,1996,31(3)：176.
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[17]王婷婷,齐荣义,等.中西医结合治疗异位妊娠的价值[J].实用中西医结合临床,2009,9(2)：44-45.
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[19]唐洁.宫外孕的中西医结合保守治疗[J].贵阳中医学院学报,2009,1(31)：45-46.
[20]刘燕燕.米非司酮配伍中药和微波治疗异位妊娠50例临床疗效观察[J].当代医学,2009,15(19)：68-69..
[21]张永兴.药物导入加灌肠治疗包块型异位妊娠疗效评价[J].中国中医药信息杂志,2007,14(10)：70.
[22]王鹭霞,吴涢婷,仇华,等.补肾通络中药改善异位妊娠保守治疗后生殖状态的临床研究[J].中医药通报,2006,5(60)：58-59.
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[1]张雪芹,杜绍敏,卢战凯,等.异位妊娠的保守性手术方式探讨[J].中国现代妇产科学杂志,2005,2(4)：320.
[2]韩文敬,关菁.异位妊娠患者保留生育功能的处理[J].中国妇产科临床杂志,2004,5(1)：27.
[3]张玉珍主编.中医妇科学[M].新世纪(第二版)全国高等中医药院校规划教材.北京：中国中医药出版社,2007,208.
[4]田甜.陈旧性包块型异位妊娠的临床治疗研究进展[J].北京中医,2006,25(6)：374-376.
[5]周建君,王芳,马开东.异位妊娠114例临床分析[J].安徽医药,2004,8(4)：268.
[6]庄建辉,王秋瑙.中西医结合治疗异位妊娠临床分析[J].现代中西医结合杂志,2007,16(24)：3489-3490.
[7l付琴,李昱.甲氨蝶呤联合米非司酮及中药治疗异位妊娠的临床观察[J].现代中西医结合杂志,2009,18(17)：1996-1997.
[8]徐杰,刘佩珊.止孕消瘢汤联合甲氨喋呤、米非司酮治疗未破损异位妊娠的临床观察[J].中国实用医药,2009,4(10)：68-69.
[9]刘文娥,张植军.宫外孕2号方加味联合甲氨蝶呤保守治疗异位妊娠98例临床观察[J].中医药导报,2009,5(15)：13-15.
[10]周剑利,刘聪慧,等.异位妊娠内服方配合西药保守治疗异位妊娠96例[J].陕西中医,2009,3(3)：273-274.
[11]朱芬芳,彭美丽..米非司酮联合中药保守治疗异位妊娠51例疗效观察[J].全科医学临床与教育,2009,3(7)：308-309.
[12]陈安珍.米非司酮配伍中药保守治疗异位妊娠[J].中国实用医药,2008,(18)：123-125.
[13]张永兴.药物导入加灌肠治疗包块型异位妊娠疗效评价[J].中国中医药信息杂志,2007,14(10)：70.
[14]曲延波,曲涛玺,刘志红.泽泻汤灌肠促进异位妊娠保守治疗后盆腔包块吸收[J].中国民间疗法,2003,11(5)：30-31.
[15]李善霞,谢桂珍,沈岩金.中药直肠点滴对异位妊娠保守性手术后输卵管通畅情况的治疗观察[J].河南中医,2007,27(9)：50-51.
[16]王鹭霞,吴涢婷,仇华,等.补肾通络中药改善异位妊娠保守治疗后生殖状态的临床研究[J].中医药通报,2006,5(60)：58-59.
[17]刘燕燕.米非司酮配伍中药和微波治疗异位妊娠50例临床疗效观察[J].当代医学,2009,15(19)：68-69.
[18]唐洁.宫外孕的中西医结合保守治疗[J].贵阳中医学院学报,2009,1(31)：45-46.
[2]韩文敬,关菁.异位妊娠患者保留生育功能的处理[J].中国妇产科临床杂志,2004,5(1)：27.
[3]崔晓萍.宫外孕Ⅱ号方配合米非司酮的疗效评价[J].陕西中医,2004,25(11)：1031.
[4]林灵珍,李琪,陆宁,等.宫外孕保守治疗性治疗60例观察[J].河南科技大学学报,2004,22(1)：19.
[5]吴仕萍.米非司酮治疗输卵管妊娠30例分析[J].医学临床研究,2005,1：62-63.
[6]赵万英中西结合治疗异位妊娠研究进展[J].现代医药卫生,2005,24(21)：3405-3406.
[7]刘敏如,谭万信主编.中医妇产科学.第1版.北京：人民卫生出版社,2001.849.
[8]郭秀真.甲氨蝶呤和米非司酮配伍中药用于异位妊娠治疗的观察[J].临床合理用药,2009,2(2)：40-41.
[9]王莉,李娜.米非司酮治疗异位妊娠疗效观察[J].实用医技杂志,2007,14(24)：3285-3286.
[10]Storall TG,Ling FW,Gray LA,et al.Methotrexate tretment of unruptured ectopiepregnancy:A report of 100 cases[J].Obstet Gyneoal,1991,77:749-753.
[11]朱亚非,似木仕.与药物保守治疗输卵管妊娠相关的循汪医学证据和评价[J].中国实用妇科与产科杂志,2007,23(11)：880-882.
[12]夏阳,杨静.异位妊娠保守治疗进展[J].新中医,2002,34(6)：67.
[13]张玉珍主编.中医妇科学.新世纪(第二版)全国高等中医药院校规划教材.北京：中国中医药出版社,2007,208.
[14]PekkaY,BrundC,Jarlsetal.Expectant management of eetopic pregnancy obatetrles and Gynecology.1992,80(3):345.
[15]谢康云,张惜阴.输卵管妊娠的期待治疗[J].中华妇产科杂志,1996,31(3)：176.
[16]张莹.清热解毒活血化瘀法治疗陈旧性包块型异位妊娠37例[J].中医杂志,2006,47(8)：603-604.
[17]王婷婷,齐荣义,等.中西医结合治疗异位妊娠的价值[J].实用中西医结合临床,2009,9(2)：44-45.
[18]孙燕,金帆.中西医结合治疗异位妊娠57例临床观察[J].浙江中医杂志,2007,42(9)：527-528.
[19]唐洁.宫外孕的中西医结合保守治疗[J].贵阳中医学院学报,2009,1(31)：45-46.
[20]刘燕燕.米非司酮配伍中药和微波治疗异位妊娠50例临床疗效观察[J].当代医学,2009,15(19)：68-69..
[21]张永兴.药物导入加灌肠治疗包块型异位妊娠疗效评价[J].中国中医药信息杂志,2007,14(10)：70.
[22]王鹭霞,吴涢婷,仇华,等.补肾通络中药改善异位妊娠保守治疗后生殖状态的临床研究[J].中医药通报,2006,5(60)：58-59.
[23]河北医学院.中医学[M].北京：人民卫生出版社,1980.
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