CAJ | 학술논문

目的：探讨米非司酮联合甲氨蝶呤中药保守治疗异位妊娠的临床效果。方法选取本院2011年1月~2014年1月收治的109例异位妊娠患者作为研究对象，均为保守治疗，辩证使用中药并联合米非司酮与甲氨蝶呤治疗。根据血β-HCG水平不同将其分为A组(<1000 IU/L)39例，B组(1000~2000 IU/L)50例，C组(<2000 IU/L)20例。经药物治疗后比较3组的治疗效果及临床症状改善情况。结果3组的阴道停止流血时间、肿块消失时间、腹痛消失平均时间、血β-HCG转阴时间比较，差异有统计学意义(P<0.05)。 A组的阴道停止流血时间、肿块消失时间、腹痛消失平均时间、血β-HCG转阴时间显著短于B、C组，差异有统计学意义(P<0.05)。B组的阴道停止流血时间、肿块消失时间、腹痛消失平均时间、血β-HCG转阴时间显著短于C组，差异有统计学意义(P<0.05)。3组的愈显率比较，差异无统计学意义(P>0.05)。结论米非司酮联合甲氨蝶呤和中药对异位妊娠进行保守治疗效果显著，可有效促进胚胎机化、吸收，消除包块，恢复血β-HCG水平。根据血β-HCG水平进行治疗，其水平越低治疗效果越显著。
목적：탐토미비사동연합갑안접령중약보수치료이위임신적림상효과。방법선취본원2011년1월~2014년1월수치적109례이위임신환자작위연구대상，균위보수치료，변증사용중약병연합미비사동여갑안접령치료。근거혈β-HCG수평불동장기분위A조(<1000 IU/L)39례，B조(1000~2000 IU/L)50례，C조(<2000 IU/L)20례。경약물치료후비교3조적치료효과급림상증상개선정황。결과3조적음도정지류혈시간、종괴소실시간、복통소실평균시간、혈β-HCG전음시간비교，차이유통계학의의(P<0.05)。 A조적음도정지류혈시간、종괴소실시간、복통소실평균시간、혈β-HCG전음시간현저단우B、C조，차이유통계학의의(P<0.05)。B조적음도정지류혈시간、종괴소실시간、복통소실평균시간、혈β-HCG전음시간현저단우C조，차이유통계학의의(P<0.05)。3조적유현솔비교，차이무통계학의의(P>0.05)。결론미비사동연합갑안접령화중약대이위임신진행보수치료효과현저，가유효촉진배태궤화、흡수，소제포괴，회복혈β-HCG수평。근거혈β-HCG수평진행치료，기수평월저치료효과월현저。
Objective To explore the clinical effect of mifepristone,methotrexate combined with traditional Chinese medicine in the conservative treatment of ectopic pregnancy. Methods 109 patients with ectopic pregnancy from Jan-uary 2011 to January 2014 in our hospital were selected as research objects.All patients were treated with conservative treatment,and dialectical use traditional Chinese medicine with mifepristone and methotrexatewas applied.According to different level of serumβ-HCG,all patients were divided into group A (n=39,less than 1000 IU/L),group B (n=50,1000-2000 IU/L) and group C (n=20,more than 2000 IU/L).After drug therapy,the therapeutic effect and clinical symptoms improved condition among three groups was compared. Results There was significant difference in the time of vaginal bleeding stopping,lump disappearing,abdominal pain disappearing,and serum β-HCG converting to be negative among three groups (P<0.05).The time of vaginal bleeding stopping,lump disappearing,abdominal pain disappearing,and serumβ-HCG converting to be negative in group A was shorter than that in group B and group C,with significant difference (P<0.05).The time of vaginal bleeding stopping,lump disappearing,abdominal pain disappearing,and serum β-HCG con-verting to be negative in group B was shorter than that in group C,with significant difference (P<0.05).There was no significant difference among three groups in the cure-remarkable-effective rate (P>0.05). Conclusion The effect of mifepristone and methotrexate combined with traditional Chinese medicine in the treatment of patients with ectopic pregnancy is significiant,which can effectively promote the embryo,absorb,eliminate the bag,restore the level of blood -HCG.According to the level of serum-HCG,the lower the level of the treatment effect is more significant.