三联疗法终止异位妊娠的临床观察

目的 选择一种安全、快捷且副反应少的终止异位妊娠(ectopic pregnancy，EP)的药物治疗方法。方法 观察组48例采用氨甲喋呤(MTX，按体表面积50mg／m^2计算用量，单次肌肉注射)+米非司酮(600mg，早晨空腹顿服，服药后禁食2h)加外孕逐瘀汤(每天1剂，连服7～10天)治疗。对照组22例仅采用MTX(用法同观察组)治疗。结果 治愈率、血β-HCG降至正常时间、EP包块吸收时间、输卵管通畅率，观察组均明显优于对照组(P<0．01)。结论 早期明确诊断和严格选择应用对象是药物保守治疗EP成功的关键。MTX+米非司酮单剂量方案配合外孕逐瘀汤治疗EP，疗效高，副反应少，可作为临床药物治疗EP的参考方案。

Clinical Observation on Triple-therapy for Terminating Ectopic Pregnancy

OBJECTIVE: To select a safe, quick and effective method for terminating ectopic pregnancy (EP) with few adverse effects. METHODS: Patients were divided into 2 groups. The observed group was treated with methotrexate (MTX, 50 mg/m2 for single dose intramuscular injection) plus RU 486 (600 mg taken orally in the morning with empty stomach, followed with fasting for 2 hrs) and Waiyun Zhuyu decoction (WZD, one dose a day for 7-10 days). The control group was only treated with MTX, with the same regimen as used in the observed group. RESULTS: The curative rate, time for blood beta-HCG recovering, lump absorption time, and tube recanalization rate in the observed group were better than those in the control group (P < 0.01). CONCLUSION; The key links for successfully treating EP with conservative drug therpy are to diagnose the disease early and clearly, and to select indicative subject strictly. The scheme of single dose administration of MTX plus RU486 combined with WZD, with its high efficacy and few adverse reaction, may be used as the first choice for referential clinical drugs administration.