复方紫草汤联合甲氨蝶呤保守治疗异位妊娠
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摘要
目的:观察复方紫草汤联合甲氨蝶呤(MTX)保守治疗异位妊娠的疗效及安全性。方法:纳入2017年6月—2018年8月本院收治住院的异位妊娠患者80例,随机分为联合治疗组和西药治疗组各40例、西药治疗组单纯给予甲氨蝶呤治疗,联合治疗组在西药治疗组基础上辅以复方紫草汤口服,2周一疗程,观察临床疗效、症状体征及不良反应。结果:联合治疗组临床有效率(92.5%)高于西药治疗组(75.0%),血β-hCG下降50%时间(5.6±1.6d)、转阴时间(21.6±6.8d)及盆腔包块消失时间(29.5±5.8d)均短于对照组,治疗期间不良反应发生率(12.5%)低于西药治疗组(32.5%)(均P<0.05)。结论:复方紫草汤能明显提高异位妊娠治愈率,缩短包块消失时间,加速患者康复。
Objective: To observe the efficacy and safety of compound zhicao decoction combined with methotrexate(MTX) for conservative treatment of women with ectopic pregnancy. Methods: 80 women with ectopic pregnancy were randomly divided into group A and group B(40 cases in each group) from June to February 2018. The women in group B were treated by MTX only for 2 weeks, and women in group A were treated by compound Zhicao decoction combined with MTX for 2 weeks. The clinical efficacy, symptoms and signs disappearance time, and the rate of adverse reaction were observed. Results: The clinical effective rate of women in group A was 92.5%, which was significant higher than that(75.0%) of women in group B(P<0.05). The time ofβ-HCG level decreased to 50% or disappearance, and pelvic mass disappearance time of women in group A were significantly shorter than those of women in group B(P<0.05). The incidence of adverse reaction of women in group A during the treatment was 12.5%, which was significant lower than that(32.5%) of women in group B(P<0.05). Conclusion: Compound Zhicao decoction can significantly improve the cure rate of women with ectopic pregnancy, shorten the disappearance time of pelvic mass, and improve the recovery of women.
Objective: To observe the efficacy and safety of compound zhicao decoction combined with methotrexate(MTX) for conservative treatment of women with ectopic pregnancy. Methods: 80 women with ectopic pregnancy were randomly divided into group A and group B(40 cases in each group) from June to February 2018. The women in group B were treated by MTX only for 2 weeks, and women in group A were treated by compound Zhicao decoction combined with MTX for 2 weeks. The clinical efficacy, symptoms and signs disappearance time, and the rate of adverse reaction were observed. Results: The clinical effective rate of women in group A was 92.5%, which was significant higher than that(75.0%) of women in group B(P<0.05). The time ofβ-HCG level decreased to 50% or disappearance, and pelvic mass disappearance time of women in group A were significantly shorter than those of women in group B(P<0.05). The incidence of adverse reaction of women in group A during the treatment was 12.5%, which was significant lower than that(32.5%) of women in group B(P<0.05). Conclusion: Compound Zhicao decoction can significantly improve the cure rate of women with ectopic pregnancy, shorten the disappearance time of pelvic mass, and improve the recovery of women.
引文
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[10] Woolnough B,Ballermann C.An Atypical Presentation of Ectopic Pregnancy With Unicornuate Uterus and Undescended Fallopian Tube.J Obstet Gynaecol Can,2018.
[11] 黄智敏,张晓艳,赵慧慧,等.中小剂量甲氨蝶呤治疗异位妊娠致急性肾功能衰竭一例[J].中华妇产科杂志,2018,(2):130-131.
[12] Ishiguro T,0000-0002-6445-4066 AO,Yamawaki K,et al.Myomectomy scar ectopic pregnancy following a cryopreserved embryo transfer.Reprod Med Biol,2018,17(4):509-513.
[2] 罗书,黄勇,关红琼.米非司酮联合甲氨蝶呤在异位妊娠治疗中的效果和安全性观察[J].中国性科学,2018,27(5):93-95.
[3] 徐丽霞,顾晴,吴晓华.异位妊娠从瘀论治再认识[J].浙江中医药大学学报,2016,40(6):475-478.
[4] 金晶,王燕,黄燕明,郎雁,等.复方米非司酮联合甲氨蝶呤治疗异位妊娠105例[J].医药导报,2016,35(06):619-621.
[5] Pak JO,Durfee JK,Pedro L,et al.Retroperitoneal Ectopic Pregnancy.Obstet Gynecol,2018.
[6] 王玉东.2016年英国皇家妇产科医师学会及早期妊娠学会《异位妊娠的诊断和管理》指南解读[J].中国实用妇科与产科杂志,2017,33(9):916-919.
[7] 柳霞.中药灌肠联合甲氨喋呤(MTX)治疗异位妊娠的临床观察[J].湖北中医杂志,2016,38(12):46-47.
[8] San LCIS,Meaney S,O'Donoghue K,et al.Ectopic pregnancy hospitalisations:A national population-based study of rates,management and outcomes.Eur J Obstet Gynecol Reprod Biol,2018,231:174-179.
[9] 王玉东,周赟.早期异位妊娠快速诊断新方法[J].中国实用妇科与产科杂志,2017,33(9):881-884.
[10] Woolnough B,Ballermann C.An Atypical Presentation of Ectopic Pregnancy With Unicornuate Uterus and Undescended Fallopian Tube.J Obstet Gynaecol Can,2018.
[11] 黄智敏,张晓艳,赵慧慧,等.中小剂量甲氨蝶呤治疗异位妊娠致急性肾功能衰竭一例[J].中华妇产科杂志,2018,(2):130-131.
[12] Ishiguro T,0000-0002-6445-4066 AO,Yamawaki K,et al.Myomectomy scar ectopic pregnancy following a cryopreserved embryo transfer.Reprod Med Biol,2018,17(4):509-513.