CAJ | 학술논문

目的：探讨中药生化汤联合甲氨蝶呤配伍米非司酮对剖宫产切口妊娠的治疗效果。方法将确诊为剖宫产切口妊娠并选择保守治疗的患者随机分为试验组和对照组各35例。对照组院甲氨蝶呤(MTX)采用分次给药，每1、3、5、7 d肌注50 mg,2、4、6、8 d给予亚叶酸钙0.1 g静滴解毒。试验组院在应用西药的基础上加用生化汤，比较两组清宫术中出血量、β人绒毛膜促性腺激素(β-HCG)降至正常时间、成功率、住院时间和并发症情况等。结果观察组阴道出血量(371.3±158.3)mL、血β-HCG转阴时间(52.1±18.1)d、住院时间(30.1±14.9)d、不良反应率42.9%；对照组分别为(631.6±227.9)mL、(81.6±21.3)d、(51.2±22.1)d、77.1%，两组比较差异有统计学意义(P<0.05)；观察组治疗的成功率71.4%，对照组为65.7%，两组比较差异无统计学意义(P>0.05)。结论生化汤联合甲氨蝶呤及米非司酮治疗剖宫产切口妊娠效果显著，安全性高，值得临床推广应用。
목적：탐토중약생화탕연합갑안접령배오미비사동대부궁산절구임신적치료효과。방법장학진위부궁산절구임신병선택보수치료적환자수궤분위시험조화대조조각35례。대조조원갑안접령(MTX)채용분차급약，매1、3、5、7 d기주50 mg,2、4、6、8 d급여아협산개0.1 g정적해독。시험조원재응용서약적기출상가용생화탕，비교량조청궁술중출혈량、β인융모막촉성선격소(β-HCG)강지정상시간、성공솔、주원시간화병발증정황등。결과관찰조음도출혈량(371.3±158.3)mL、혈β-HCG전음시간(52.1±18.1)d、주원시간(30.1±14.9)d、불량반응솔42.9%；대조조분별위(631.6±227.9)mL、(81.6±21.3)d、(51.2±22.1)d、77.1%，량조비교차이유통계학의의(P<0.05)；관찰조치료적성공솔71.4%，대조조위65.7%，량조비교차이무통계학의의(P>0.05)。결론생화탕연합갑안접령급미비사동치료부궁산절구임신효과현저，안전성고，치득림상추엄응용。
Objective To explore the effect of shenghua decoction combined with methotrexate and mifepristone in the treatment of caesarean incision pregnancy. Methods Diagnosed patients who voluntarily received conservative treatment were randomly divided into treatment and observation with 35 cases in each group. Control group:-methotrexate (MTX) using fractional dosing, every 1, 3, 5,7 d intramuscular injection of 50mg, 2, 4, 6, 8 d to give intravenous drip of calcium folinate 0.1g detoxification. Observation: in the application of Western medicine based on the addition of shenghua decoction and compare two sets of curettage bleeding, β-human chorionic gonadotropin (β-HCG) to normal time, success rates, length of hospital stay and complications, and so on. Re-sults Vaginal bleeding in the observation group (371.3±158.3) mL and serum β-HCG negative time (52.1 ± 18.1) d, length of hospital stay (30.1±14.9) d, adverse reaction rate is 42. 9%, respectively, in the control group (631.6 ± 227.9) mL, (81.6 ± 21.3) d, (51.2 ± 22.1) d, 77.1%, there was a significant difference between the two groups(P<0.05); treatment success 71.4% in the ob-servation group, control group was 65.7%, no significant differences between the two groups(P>0.05). Conclusion Shenghua decoc-tion combined with methotrexate and mifepristone in the treatment of caesarean incision in pregnancy is safe and effective, so it is worth spreading.