米非司酮与甲氨蝶呤联合中药保守治疗异位妊娠临床分析  

Clinical analysis of conservative treatment of ectopic pregnancy with mifepristone and methotrexate combined with traditional Chinese medicine

作　　者：李建霞[1] 纪雯[1] 蔡广彦[1] LI Jian-xia, Jl Wen, CAI Guang-yan(Department of Gynaecology, Qingdao Eighth People＇s Hospital, Qingdao 266100, Chin)

机构地区：[1]青岛市第八人民医院妇科,266100

出　　处：《中国实用医药》2018年第8期6-8,共3页China Practical Medicine

摘　　要：目的探讨米非司酮与甲氨蝶呤(MTX)联合中药保守治疗异位妊娠的效果。方法 100例符合保守治疗条件的异位妊娠患者,随机分为A组与B组,每组50例。A组采用米非司酮与甲氨蝶呤联合中药治疗,B组单用甲氨蝶呤治疗。比较两组的治疗效果。结果 A组保守治疗治愈率92.00%高于B组76.00%,差异具有统计学意义(P<0.05)。A组平均血β人绒毛膜促性腺激素(β-HCG)转阴时间(12.9±3.3)d短于B组(18.6±6.8)d,差异具有统计学意义(P<0.05)。A组平均住院时间(10.2±3.6)d短于B组(16.5±8.9)d,差异具有统计学意义(P<0.05)。两组甲氨蝶呤肌内注射次数比较差异具有统计学意义(P<0.05)。保守治疗失败者主要为血β-HCG水平较高者,两组中血β-HCG<1500 IU/L者均保守治疗成功。A组不良反应发生情况少于B组,差异具有统计学意义(P<0.05)。A组出院后4~6个月输卵管碘油造影通畅率66.67%与B组64.29%比较,差异无统计学意义(P>0.05)。结论米非司酮与甲氨蝶呤联合中药治疗异位妊娠安全、有效,适用于生命体征平稳无剧烈腹痛、血β-HCG<3000 IU/L、异位妊娠包块最大直径≤5 cm非破裂型异位妊娠,肝、肾和凝血功能正常是其适应证,可作为临床首选治疗方案。Objective To discuss the effect of conservative treatment of ectopic pregnancy with mifepristone and methotrexate（MTX） combined with traditional Chinese medicine. Methods A total of 100 patients with ectopic pregnancy conforming to conservative treatment conditions were randomly divided into group A and group B, with 50 cases in each group. Group A was treated with mifepristone and methotrexate combined with traditional Chinese medicine, and group B was treated with methotrexate only. The treatment effect in two groups was compared. Results Group A had higher cure rate of conservative treatment as 92.00% than 76.00% in group B, and the difference was statistically significant（P〈0.05）. Group A had shorter mean βhuman chorionic gonadotropin（β-HCG） negative-conversion time as（12.9±3.3） d than（18.6±6.8） d in group B, and the difference was statistically significant（P〈0.05）. Group A had shorter mean hospitalization time as（10.2±3.6） d than（16.5±8.9） d in group B, and the difference was statistically significant（P〈0.05）. Both groups had statistically significant difference in intramuscular injections of methotrexate（P〈0.05）. The patients failed in the conservative treatment were mainly with a high level of blood beta-HCG, and the two groups of patients with β-HCG 1500 IU/L were all successfully treated with conservative treatment. Group A had less occurrence of side effects than group B, and the difference was statistically significant（P〈0.05）. Group A had no statistically significant difference in oviduct iodized oil contrast rate of 4~6 months after discharge as 66.67%, comparing with 64.29% in group B（P〈0.05）. Conclusion Combination of mifepristone, methotrexate and traditional Chinese medicine is safe and effective for the treatment of ectopic pregnancy, and it is suitable for stable vital signs without severe abdominal pain, blood β-HCG 3000 IU/L, maximum diameter of ectopic pregnancy mass ≤ 5 cm nonruptured ectopic pregnancy. Normal liver, kidn

关 键 词：异位妊娠 米非司酮 甲氨蝶呤 中药 

分 类 号：R714.22[医药卫生—妇产科学]