中西医结合保守治疗异位妊娠两种方案临床分析

目的:探讨甲氨喋呤(MTX)两种治疗方案配合中医中药保守治疗异位妊娠的临床疗效和不良反应,指导临床用药。方法:将 130 例确诊为异位妊娠的患者,随机分 A、B 两组。 A 组 65 例,用甲氨喋呤 0.4 mg/(kg.d),肌肉注射,连用 5 d,同时配合中医中药口服;B 组 65 例,MTX 1 mg/kg,单次肌肉注射,同时配合中医中药口服。并对两组进行比较。结果:当血β-HCG<2 000 U/L,盆腔包块直径 <4 cm 时,A 组治愈率为 98.46%,B 组治愈率为 95.38%,差异无统计学意义(P >0.05)。 B 组患者轻、中度胃肠道反应及血细胞计数下降发生率明显低于 A 组,差异有统计学意义(P <0.05)。结论:对血β-HCG<2 000 U/L 的异位妊娠患者应用 MTX1 mg/kg 单次肌注配合中医中药治疗,方法简单、疗效好、副作用小,是临床治疗的优选方案。

Analysis of Two Methods in the Treatment of Ectopic Pregnancy by Combination of Chinese Traditional and Western Medicine in Clinical

Objective：To investigate the clinical efficacy and adverse reaction of two dosages of methotrexate（MTX） combined with Chinese medicine for treatment of ectopic pregnancy and guide clinical medication.Methods：130 Patients with confirmed diagnosis of ectopic pregnancy were randomly divided into A and B group.65 in A group were given MTX 0.4mg/（kg·d）,intramuscular injection for 5 days combined with Chinese medicine by oral;65 patients in B group were given a single intramuscular injection of MTX 1mg/kg and Chinese medicine by oral.The clinical efficacy and adverse reaction were observed and analyzed in two groups.Results：When the serum quantitation of β-HCG 2 000 U/L and diam of enclosed mass of pelvic cavity4 cm,the cure rate in group A was 98.46%,in group B was 95.38%.There was no significant difference（P0.05）.The incidence light、middle degree of gastrointestinal reactions and decrease of blood cell count in group B was significantly lower than that in group A.There was significant difference（P0.05）.Conclusion：It was the best treatment in clinical for the patients with ectopic pregnancy in serum quantitation of β-HCG 2 000 U/L by using a signle injection of MTX 1 mg/kg and taking Chinese Medicine orally is a simple effective method with highly successful rate and minor side effect.