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目的:观察单用甲氨喋呤与甲氨喋呤联合宫外孕Ⅱ号方及双柏散治疗未破裂型异位妊娠的疗效比较。方法:将2006年6月—2009年6月于本院住院治疗符合药物保守治疗条件的异位妊娠患者120例分为两组,对照组:予单次肌肉注射MTX50mg/m2,若用药后4～7天血β-HCG下降<15%或继续升高第7天给予第2次药物肌注(50mg/m2)。治疗组:在上方案基础上加用宫外孕Ⅱ号方加减治疗,主要组成为:赤芍15g,丹参30g,桃仁10g,三棱10g,莪术10g,天花粉10g,蜈蚣3条,每日1剂,连用7天,随证加减。并配合中药外敷,予双柏散(侧柏叶、大黄、黄柏、薄荷、泽兰、延胡索)100g,为末,水蜜调,布袋包冷敷患侧,每次敷4h,每日2次。分别于治疗的第4天和第7天测血β-HCG各1次,每3～5天复查B超1次,同时观察患者的不良反应。结果:120例异位妊娠患者,治疗过程中因腹腔内出血改行手术治疗的20例,占16.67%,保守治疗总体成功率83.33%,两组成功率分别为:对照组74.3%,治疗组84.1%,差异有显著性(P<0.05);并且治疗组副反应明显比对照组少(P<0.01)。结论:MTX联合中药内服外敷治疗异位妊娠疗效好、副反应少,值得临床推广。
Objective: To observe the curative effect of methotrexate combined with methotrexate alone and in combination with ectopic pregnancy Ⅱ and Shuangbai powder in the treatment of unruptured ectopic pregnancy. Methods: From June 2006 to June 2009 in our hospital, 120 patients with ectopic pregnancy who met the criteria of conservative treatment were divided into two groups. The control group received single intramuscular injection of MTX50mg / m2, and after 4 7-day blood β-HCG decreased <15% or continue to increase on the 7th day to give the second drug intramuscular injection (50mg / m2). Treatment group: On the basis of the program plus ectopic pregnancy on the 1st plus or minus treatment, the main components are: red peony root 15g, Salvia 30g, peach kernel 10g, triangular 10g, Curcuma 10g, TCS 3, centipede 1, day 1 , Used in conjunction for 7 days, with the card addition and subtraction. And with traditional Chinese medicine topical, to Shuangbai San (Oriental Arborvitae, Rhubarb, Treats, Peppermint, Zeeland, Corydalis) 100g, for the end, water honey transfer, cloth bags cold side, each apply 4h, 2 times a day. Respectively in the treatment of the first 4 days and 7 days of beta-HCG blood test 1, every 3 to 5 days to review B-1 times, while observing the adverse reactions in patients. Results: In 120 cases of ectopic pregnancy, 20 cases (16.67%) were treated by intraperitoneal hemorrhage and the overall success rate of conservative treatment was 83.33%. The successful rates of the two groups were 74.3% in the control group, 84.1% in the treatment group, The difference was significant (P <0.05); and the side effects were significantly less than the control group (P <0.01). Conclusion: MTX combined with topical Chinese herbal medicine for external treatment of ectopic pregnancy has good curative effect and less side effects, which is worthy of clinical promotion.