局部注射甲氨喋呤配伍中药治疗输卵管妊娠的临床效果探讨

目的寻找一种能保持优良生殖状态，减少并发症、无毒副作用、简便、无损伤、药物用量小的输卵管妊娠的药物治疗方案。方法对86例未破裂或符合条件的流产型输卵管妊娠病人，按治疗方案不同分两组进行对照研究，A组彩色阴道超声引导局部注射甲氨喋呤（MTX）治疗，B组彩色阴道超声引导局部注射MTX加中药联合治疗。结果A、B两组治愈率分别为96．8％、98．1％，无显著性差异（P〉0．005）；A、B两组的生殖状态（宫内妊娠和足月活产）85．7％、97．8％，有显著性差异（P〈0．005）；A、B两组的并发症（再次输卵管妊娠）分别为7．2％、2．2％，有显著性差异（P〈0．005）；血绒毛膜促性腺激素（B—HCG）B组比A组下降明显（P〈0．005）；病灶包块缩小或消失天数B组比A组明显缩短（P〈0．005）；输卵管通畅率B组明显高于A组（P〈0．05）。结论彩色阴道超声引导局部注射MTX加中药联合治疗未破裂或符合保守治疗的流产型输卵管妊娠具有方法简便、疗效高、无毒副作用、保持优良的生殖状态和减少并发症等优点，值得临床推广应用。

The study on the clinical effect of the method of partial injection of methotrexate with Chinese native medicine treatment for curing tubal pregnancy

Objective To seek a simple,highly effective pharmactherapeutic method for curing tubal pregnancy with small dosages,which can improve fertility,reduce complication and has non-toxic side reaction nor damage.Methods To divide the 86 miscarriage tubal pregnancy patients whose oviduct did not burst or who conform to the conditions into two groups according to the treatment plan and meanwhile contrast them.For Group A,partially inject MTX with the guidence of colored vaginas supersonic wave inspection tester.For Group B partially inject MTX with the guidence of colored vaginas supersonic wave inspection tester plus Chinese native medicine union treatment.Results The cure rates Of Group A and Group B are respectively 96.8% and 98.1%,which shows no significant difference.The reproduction conditions(in palace pregnancy and full-term live birth) of the two groups are respectively 85.7%, 97.8%.The complication rates(one more tubal pregnancy) of the two groups are repectively 7.2%,2.2%.Therefore the reproduction conditions of Group B obviously surpass that of Group A(P<0.005);the complication rate of Group B are remarkably lower than that of Group A(P<0.005);The blood chorion presses the gonadotrophic hormone(beta-HCG) of Group B drops obviously(P<0.005) compared to Group A;the number of days when a package of block of a focus of infection reduces or vanishes of Group B obviously reduces(P<0.005) compared to that of Group A;The oviduct unobstructed rate of the ovidct of Group B is obviously higher than that of Group A(P<0.05).Conclusion The method of partial injection of the MTX with the guidance of colored vagina supersonic wave inspection tester plus Chinese native medicine union treatment to treat those patients whose ovidcts do not burst or who conform to the conservative treatment of the miscarriage tubal pregnancy has the advantages of being simple,highly effective.Besides the treatment course is short and it has non-toxic merit and so on side reaction,can maintenance fine reproduction condition and reduce complication.So the method is worth the clinical promotion and colored vagina supersonic guidance colored vagina supersonic guidance application.