【作者】 赵锐；

【导师】 丛慧芳；

【作者基本信息】 黑龙江中医药大学 ， 中医妇科学， 2006， 硕士

【摘要】 目的:通过观察中药联合氨甲喋呤保守治疗输卵管妊娠的临床疗效,探讨一种简单、有效、安全、成功率高而又能保留患者生育能力的治疗方法。 方法:本研究将符合纳入标准的62例输卵管妊娠患者随机分为两组,各31例。对照组采用氨甲喋呤50mg/m~2单次肌注,治疗组采用氨甲喋呤单次肌注联合自拟宫外孕方口服及消癥汤保留灌肠。通过临床观察比较两组在血β-HCG降至正常时间,输卵管妊娠包块吸收时间,子宫直肠陷凹积液吸收时间,月经恢复时间,治疗后输卵管通畅率,MTX的使用疗程及毒副作用方面的差异。 结果:①治疗组治愈率(93.55%)高于对照组(74.18%)(P<0.01);②治疗组血β-HCG降至正常的时间(15.24±4.66),输卵管妊娠包块完全吸收时间(28.64±10.85),子宫直肠陷凹积液吸收时间(11.45±3.17),月经恢复时间(28.04±4.96)均短于对照组(20.48±5.44、44.44±11.59、15.13±4.39、33.43±6.47)(P<0.05);③治疗组患侧输卵管通畅率高于对照组(P<0.01);④治疗组氨甲喋呤的使用疗程及毒副反应发生率低于对照组(P<0.05)。 结论:中西医结合药物保守治疗不仅拓宽了输卵管妊娠的保守治疗指征,而且能够加速病灶吸收,缩短疗程,提高治愈率及输卵管的通畅率,最大限度的保留患者的生育能力,减少氨甲喋呤的使用疗程及毒副作用。更多还原

【Abstract】 Objective: To observe the clinical therapeutic of integration methotrexate(MTX)and traditional Chinese herb(TCH ) for tubal pregnancy.To seek a simple,safe and efficient method to cure the tubal pregnancy and preserve fertility.Methods: 62 cases of EP were divided into two groups at random. The treated group with 31 cases was employed MTX single-dose intramuscual injection and TCH (ectopic pregnancy decoction and xiaozheng decoction retention enema).The control group with 31 cases was treated by employed MTX.In the study,to observe the changes of clinical symptoms and signs,the level of serumβ-HCG andthe size of adnexal mass by abdominal ultrasound between the two groups.To compare the time of serumβ-HCG decreasing to normal level,disappearance of the adnexal masses and fluid of retrouterine excavation,the restoration of normal menstruation,the tubal patency,the treatment period of MTX and the side reaction of MTX between the groups.Results:①The success rate of the treated group which was 93.55% was greater than that of the control which was 74.18%.The difference of the two groups was significant(P<0.01). ②The average time of serum β-HCG restoring to normal level which was(15.24 ± 4.66)days,the disappearance time of the adnexal masses and fluid of retrouterine excavation which was(28.64 ± 10.85)days and ( 11.45±3.17) days,the average time of restoring menstruation which was(28.04 士 4.96)days,obviously shorter than those of the control which were respectively (20.48±5.44)days,(44.44 ± 11.59)days,(15.13±4.39) days and(33.43 dr 6.47)days.There were significant differences between the groups(P<0.05).③The tubal patency of the treatedgroup higher than control group(P<0.01).?The treatment period of MTX and rate of the. side reaction of MTX the treated group lower than control group(P<0.05).Conclusions:The therapy of integration methotrexate (MTX) and traditional Chinese herb(TCH) for treating tubal pregnancy not only widen the range of conservative treatment but also promote the absorpton of focus, increase cure rate and tubal patencyrate, preserve the fertility of patient,reduction the treatment period of MTX and relieve the side reaction of MTX.更多还原