中医药治疗49例异位妊娠的疗效分析  

Therapeutic analysis on traditional Chinese medicine in 49 cases of ectopic pregnancy

作　　者：黄建琴[1] 朱芝玲[1] 

机构地区：[1]复旦大学附属妇产科医院中西医结合科,上海200090

出　　处：《复旦学报（医学版）》2014年第4期501-503,510,共4页Fudan University Journal of Medical Sciences

摘　　要：目的比较氨甲喋呤(methotrexate,MTX)联合中药治疗与单纯中药治疗异位妊娠的临床疗效。方法分析比较38例MTX联合中药治疗组患者和11例单纯中药治疗组患者前后血清人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG)水平和包块大小,治疗后随访输卵管通畅及妊娠情况。结果两组患者均治愈,治疗1周后血HCG水平下降,包块缩小(P<0.05)。MTX联合中药治疗组血HCG水平较单纯中药组下降更明显(P<0.05),治疗后两组包块缩小的差别无统计学意义(P>0.05)。随访期间,24例有生育要求。其中13例子宫行输卵管造影术(hepatic scintigraphy,HSG),术后输卵管通畅3人,妊娠人数占有生育要求者的50%(12/24)。结论符合药物保守治疗指征的异位妊娠患者采用MTX联合中药或单纯中药治疗,治愈率高,治疗后输卵管通畅和妊娠情况良好。MTX在降低血HCG水平方面较中药可能更有优势;单纯中药对促进包块局部吸收缩小可能更有优势。Objective To compare the clinical curative effect of ectopic pregnancy between methotrexate （MTX） combined with traditional Chinese medicine treatment and traditional Chinese medicine treatment.Methods The comparative analysis were made in 38 cases of MTX combined with traditional Chinesmedicine treatment group and 11 cases of alone Chinese medicine treatment group on blood human chorionic gonadotrophin （HCG） and mass size,tubal patency and pregnancy after treatment.Results All the patients were cured in the two groups.Blood HCG level decreased,and mass narrowed in size a week after treatment （P〈0.05）.Compared with MTX combined traditional chinese medicine treatment group,blood HCG in traditional Chinese medicine group decreased more significantly （P〈0.05）.Mass narrowed in size had no statistical difference between the two groups after treatment （P〉0.05）.During the period of followup,13 cases underwent hepatic scinigraphy （HSG） in 24 cases fertility requirements,which led to tubal patency in 3 cases.The pregnancy rate was 50% （12/24） in the 24 cases who had fertility requirements.Conclusions The patients of ectopic pregnancy in accordance with the conservative drug treatment indications were treated by MTX combined traditional Chinese medicine treatment or alone traditional Chinese medicine treatment with high cure rate and satisfactory tubal patency and pregnancy.MTX in reducing blood HCG-level may be more advantageous,while traditional Chinese medicine may be more advantages in local absorption of mass.

关 键 词：异位妊娠 中医药 氨甲喋呤(MTX) 

分 类 号：R714.22[医药卫生—妇产科学]