摘要
目的探讨云南白药联合甲氨蝶呤(MTX)治疗输卵管妊娠的临床疗效及安全性,寻找保守治疗异位妊娠的最佳方案。方法 68例未破裂输卵管妊娠患者随机分为治疗组和对照组,治疗组采用云南白药联合MTX治疗,对照组仅采用MTX治疗。监测患者血β-HCG,测量包块直径,观察药物不良反应,疗程结束后评价临床疗效。结果治疗组35例,治愈33例,治愈率为94.3%;对照组33例,治愈21例,治愈率为63.6%,治疗组治愈率显著高于对照组(P<0.05)。两组在治疗后第5、10、15、20天的血β-HCG水平与治疗前比较均明显下降,差异有统计学意义(P<0.05),且治疗组在第5、10、15、20天的血β-HCG水平明显低于对照组(P<0.05)。两组在第10、15、20天的盆腔包块直径明显小于治疗前(P<0.05),且治疗组盆腔包块直径明显小于对照组(P<0.05)。治疗组胃肠道不良反应8例(22.9%),对照组不良反应24例(72.7%),两组比较差异有统计学意义(P<0.05);治疗组无肝肾功能及造血系统损害,而对照组有9例(27.3%),治疗组药物不良反应显著低于对照组,差异有统计学意义(P<0.05)。结论云南白药联合MTX治疗输卵管妊娠,增强了杀胚作用,盆腔包块吸收快,药物不良反应小,临床疗效高,值得临床推广运用。
Objective To explore the clinical effectiveness and safety of the combination of yunnan baiyao and methotrexate（MTX） in treating tubal pregnancy（TP）.Methods Totally 68 patients with unruptured TP were randomly divided into combination group（n=35） and MTX only group（n=33）.Serum β-HCG was monitored,mass diameter was measured,and the adverse reaction was observed during the treatment and the clinical effectiveness was evaluated after treatment.Results The cure rate was 94.3%（33/35） in the combination group and 63.6%（21/33） in the MTX only group（P〈0.05）.Blood β-HCG levels at days 5,10,15,and 20 were significantly lower than the pre-treatment level in both two groups,（P〈0.05）;meanwhile,they were significantly lower in the combination group than in MTX only group（P〈0.05）.The diameters of the pelvic mass at days 10,15,and 20 were significantly smaller than the pre-treatment diameters in both groups（P〈0.05）;meanwhile,they were significantly smaller in the combination group than in MTX only group（P〈0.05）.Adverse events were not in 8 patients（22.9%） in the combination group and 24（72.7%） in the MTX only group（P〈0.05）.No hepatic or renal dysfunction or hematopoietic system damage was noted in the combination group,while 9 such cases（27.3%） occurred in the MTX only group（P〈0.05）.Conclusion The combination of yunnan baiyao and MTX is effective and safe in treating TP.It enhances embryos-killing efficacy,speed up the absorption of pelvic mass,with mild side effects.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第29期3262-3264,共3页
Chinese General Practice
