复方紫草汤在宫外孕保守治疗中的应用研究  

Study on the Application of Compound Zicao Decoction in Conservative Treatment of Ectopic Pregnancy

作　　者：邢恺[1] 吴国英[1] 李欣[1] 杨晓平[1] 董华山[1] 卢宁艳[1] 

机构地区：[1]富阳市中医医院妇科,浙江富阳311400

出　　处：《中华中医药学刊》2011年第12期2727-2730,I0023,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：杭州市医药卫生科技计划项目(2008B0117)

摘　　要：目的:通过研究以证实复方紫草汤在宫外孕保守治疗中的疗效与优势,以及复方紫草汤对绒毛细胞凋亡所起的作用,为在临床上推广应用提供有力的依据。方法:采用两种方法进行研究,临床应用:将72例患者随机分为两组,治疗组40例,药用复方紫草汤加甲氨蝶呤和米非司酮;对照组32例不用复方紫草汤。对比两组治疗效果。化学实验研究:将绒毛细胞置于含有不同浓度复方紫草汤溶液的培养液中培养,实验以AnnexinV-FITC细胞凋亡检测试剂盒检测不同浓度复方紫草汤溶液刺激引起绒毛细胞凋亡的情况。结果:临床应用中治疗组的治疗有效率为95.0%,与对照组的87.5%无统计学差异(P>0.05),治疗组血β-HCG下降50%、转阴性时间及盆腔包块消失时间均少于对照组,有统计学差异(P<0.05),两组患者胃肠道反应及肝功能损害情况比较(P>0.05)无显著性差异;化学实验中低浓度的复方紫草汤溶液培养液就可以观察到绒毛细胞早期凋亡,较高浓度的复方紫草汤溶液培养液则直接可引起绒毛细胞坏死或裂解。结论:复方紫草汤溶液的刺激对绒毛细胞的凋亡有明显作用。复方紫草汤联合化学药物保守治疗宫外孕疗效显著,能加快血β-HCG下降速度,缩短盆腔包块消失时间,缩短了病人住院时间,并且没有增加胃肠道反应及肝功能损害情况,使得有生育要求的患者能提早进行输卵管通畅检查,提早了下次拟受孕时间,减少了患者及家人的经济和心理负担,值得临床推广。Objectives ： To provide evidence for the clinical effect and the cutting edge of compound Zicao Decoction in conservative treatment of ectopic pregnancy, and the effect of compound Zicao Decoction on avoiding the apoptosis of villus cell, so as to extend its clinical application. Methods： Two methods were used. （ 1 ） Clinical application ： 72 patients were divided into two groups randomly. 40 cases in the treatment group were treated with compound Zicao Decoction as well as methotrexate and mifepristone. 32 cases in control group were treated with methotrexate and mifepristone only. （2） Chemical experiment： Villus ceils were cultured in solutions with compound Zicao Decoction of various concentrations. Then the apoptosis of villus cells in the different solutions were analyzed by AnnexinV -FITC. Results： In the clinical application, it was found that the therapeutic efficacy of the treatment group was 95.0%, while that of the control group was 87.5%. There was no statistically significant difference （ P 〉0.05） between the two. The β - HCG of the treatment group dropped down by 50% , and its durations for turning negative and for the disappearing of pelvic lumps were both shorter than those of the control group, with a statistically significant difference （ P 〈 0.05）. For the comparison of the gastrointestinal reaction and the damage of liver function between the two groups, there was no statistically sig- nificant difference （ P 〉 0.05）. In the chemical experiment, it was observed that the villus cells in the low - concentration compound Zicao Decoction solution experienced an early apoptosis ; whereas the villus cells in the high - concentration solution could directly go through necrosis or lysis. Conclusion： The compound Zicao Decoction solution had an evident contribution to the apoptosis of cillus cells. A combination of compound Zicao Decoction and chemical drugs could produce marked therapeutic efficacy for conservative treatment of ectopic pregnancy. It could precipi

关 键 词：宫外孕 复方紫草汤 甲氨蝶呤 米非司酮 绒毛细胞凋亡 

分 类 号：R285.6[医药卫生—中药学]