甲氨蝶呤联合米菲司酮及中药保守治疗输卵管异位妊娠的临床观察

目的:观察甲氨蝶呤(MTX)联合米菲司酮与添加中药联合治疗未破裂型输卵管异位妊娠的疗效。方法:回顾性分析住院治疗符合药物保守治疗条件并治愈的输卵管异位妊娠83例患者。试验分为两组:A组:MTX(50 mg/m2)肌内注射并口服米非司酮,1周后复查血β-HCG如未下降正常继续重复给药。B组:在A组基础上添加中药口服。A组和B组中所有患者分别于治疗前及治疗后第4天起每隔3天检测血β-HCG,每周复查盆腔超声,同时观察有无药物不良反应出现。结果:比较A、B两组治愈时间,给药次数,血β-HCG下降速度,愈后输卵管通畅度。输卵管通畅度分别为:A组87.5%,B组97.6%,差异有统计学意义(P<0.01);B组较A组明显缩短血β-HCG降至正常所需的时间,减少给药次数(P<0.01),不良反应在两组间比较,差异无统计学意义(P>0.05)。结论:甲氨蝶呤联合米菲司酮及中药保守治疗输卵管异位妊娠疗效好、输卵管通畅度高,对于确诊为未破裂和流产的输卵管异位妊娠而又有生育要求的患者,是一种理想的治疗方案。

Clinical observation of methotrexate combined with mifepristone and traditional Chinese medicine in the treatment of tubal ectopic pregnancy

Objective To observe the efficiency of the Methotrexate(MTX) combined with Mifepristone and Traditional Chinese medicine in the treatment of unruptured tubal ectopic pregnancy.Method Retrospectively analyzed a tubal ectopic pregnancy data of 83 patients who possessed conservative treatment conditions and were cured after treatment in our hospital from the January 2010 to December 2011.The 83 patients were divided into group A and group B.The treatment method in group A was intramuscular injection of 50 mg/m2 MTX and oral administration of Mifepristone.Group A was continued to accept repeated administration normally if the level of beta-HCG blood was reviewed not to decline after a week.The treatment method in group B was adding oral administration of Chinese traditional medicine on the basis of group A.Blood β-HCG in all patients in group A and group B was tested once three days before treatment and the 4th day after treatment respectively,and the pelvic ultrasound was reviewed once a week while observing whether drug side effects occurred.Results Compared the cure time,delivery times,the declining rate of blood beta-HCG level,the tubal patency after recovery between group A and group B.Tubal patency in group A and group B was 87.5% and 97.6% respectively with a significant difference(P<0.01);Group B shortened the time of blood beta-HCG declining to normal level and reduced the times of delivery more significantly than group A(P<0.01).Side effects between the two groups had no significant difference(P>0.05).Conclusion MTX combined with Mifepristone and Chinese Traditional medicine in the treatment of unruptured tubal ectopic pregnancy is efficient,makes the tubal patency high and can be considered to be an ideal treatment plan for the diagnosis of abortive patients resulting from unruptured tubal ectopic pregnancy and having reproductive requirements.