摘要
目的探讨宫外孕Ⅱ号方加减联合甲氨蝶呤治疗异位妊娠(Ectopic pregnancy,EP)患者的临床疗效。方法选取2022年3月—2023年9月期间苏州市中西医结合医院收治的80例EP患者,按随机数字表法分为对照组和观察组,每组各40例。对照组给予甲氨蝶呤治疗,观察组给予宫外孕Ⅱ号方加减联合甲氨蝶呤治疗。7 d为1个疗程,用药2个疗程。观察比较两组患者治疗前后临床症状消失时间[阴道停止流血、腹痛消失、包块吸收、血清β-人绒毛膜促性腺激素(β-humanchorionic gonadotrophin,β-HCG)水平恢复正常及月经复潮时间]、血液流变学指标[活化部分凝血活酶时间(Activated partial thromboplastin time,APTT)与凝血酶时间(Thrombin time,TT)]、性激素指标[β-HCG、孕酮(Progesterone,P)及雌二醇(Estradiol 2,E_(2))]水平,并统计两组患者临床疗效及不良反应情况。结果治疗后观察组阴道停止流血时间、腹痛消失时间、包块吸收时间、血清β-HCG水平恢复及月经复潮时间均较对照组明显缩短,差异有统计学意义(P<0.05)。治疗后两组患者APTT和TT指标均较治疗前降低,差异有统计学意义(P<0.05);且观察组APTT和TT指标均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者β-HCG、P及E_(2)水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组β-HCG、P及E_(2)水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组治愈率55.00%(22/40)、总有效率95.00%(38/40)均明显高于对照组40.00%(16/40)、80.00%(32/40),差异有统计学意义(χ^(2)=4.511、10.286,P<0.05)。治疗期间,观察组不良反应发生率20.00%(8/40)与对照组17.50%(7/40)比较,差异无统计学意义(χ^(2)=0.205、P>0.05)。结论在甲氨蝶呤用药基础上联合宫外孕Ⅱ号方加减治疗异位妊娠可显著提高临床疗效,用药安全,其作用机制可能与调节患者血液流变学和激素水平有关。
Objective To explore the clinical efficacy of modified ectopic pregnancyⅡprescription combined with methotrexate in the treatment of patients with ectopic pregnancy(EP).Methods A total of 80 EP patients admitted to Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2022 to September 2023 were selected and divided into a control group and an observation group with the random number table method,with 40 patients in each group.The control group was treated with methotrexate monotherapy,while the observation group was treated with modified ectopic pregnancyⅡprescription combined with methotrexate.Seven days were regarded as one course of treatment,with two courses for treatment in this study.The following indicators in the two groups before and after treatment were observed and compared:disappearance time of various clinical symptoms[vaginal bleeding stop,abdominal pain disappearance,mass absorption,serumβ-human chorionic gonadotropin(β-HCG)level back to normal,and menstruation recovery],blood rheology[activated partial thromboplastin time(APTT)and thrombin time(TT)]levels,and hormone[β-HCG,progesterone(P),and estradiol(E_(2))]levels.The clinical efficacy and adverse reactions in the two groups were statistically analyzed.Results After treatment,the time to vaginal bleeding stop,abdominal pain disappearance,mass absorption,serumβ-HCG level recovery,and menstruation recovery was all much shorter in the observation group than in the contro group with statistically significantly differences(P<0.05).The APTT and TT of the two groups after treatment were shorter than those before treatment,and the differences were statistically significant(P<0.05).In addition,the APTT and TT of the observation group were significantly shorter than those of the control group with statistically significant differences(P<0.05).The levels ofβ-HCG,P,and E_(2) in the two groups after treatment decreased compared with those before treatment,and the differences were statistically significant(P<0.05).Furthermore,those of the observation group were lower between the two groups with statistically significant differences(P<0.05).After treatment,the curative rate of 55.00%(22/40)and the total effective rate of 95.00%(38/40)in the observation group were much higher than those[40.00%(16/40)and 80.00%(32/40)]in the control group,and the differences were statistically significant(χ^(2)=4.511 and 10.286,P<0.05).During the treatment,the incidence of adverse reactions was 20.00%(8/40)in the observation group and 17.50%(7/40)in the control group,and there was no significant difference(χ^(2)=0.205,P>0.05).Conclusion On the basis of methotrexate,the treatment of EP with modified ectopic pregnancyⅡprescription can significantly improve clinical efficacy and medication safety.Its mechanism of action may be related to regulating the patients′blood rheology and hormone levels.
作者
付瑶
陈舒婧
池晓利
申小娟
FU Yao;CHEN Shu-jing;CHI Xiao-li;SHEN Xiao-juan(Department of Gynaecology and Obstetrics,Suzhou Hospital of Integrated Traditional Chinese and Western Medicine,Suzhou Jiangsu 215000)
出处
《世界中西医结合杂志》
2024年第10期2083-2087,共5页
World Journal of Integrated Traditional and Western Medicine
基金
苏州中西医结合医院科技项目(YJ2022002)。
关键词
宫外孕Ⅱ号方加减
血液流变学
甲氨蝶呤
激素水平
异位妊娠
Modified Ectopic PregnancyⅡPrescription
Hemorheology
Methotrexate
Hormone Levels
Ectopic Pregnancy
