黄桂灌肠剂联合米非司酮保守治疗异位妊娠疗效观察

发布时间：2018-06-12 03:32

本文选题：异位妊娠 + 保守治疗　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：观察黄桂灌肠剂联合米非司酮临床用于治疗证型为气滞血瘀证未破损型异位妊娠的临床疗效,根据患者治疗的效果、阴道出血停止时间、腹痛消失时间、附件区包块吸收时间、血β-HCG转阴时间、不良反应等,探析黄桂灌肠剂保留灌肠联合米非司酮口服保守治疗异位妊娠的疗效,为中西医结合保守治疗异位妊娠提供有利的临床依据。方法：选自于2014年01月至2016年01月在如皋市中医院妇科住院的患者,中医辨证为气滞血瘀证未破损型的异位妊娠患者,共60例。将其随机分为2组：(1)治疗组共30例,采用黄桂灌肠剂保留灌肠联合米非司酮口服保守治疗；(2)对照组共30例,采用单纯米非司酮口服保守治疗。从而观察2组患者治疗效果、阴道出血停止时间、腹痛消失时间、附件区包块吸收时间、血β-HCG转阴时间等,并观察其在治疗过程中的安全性问题及产生的不良反应。结果： (1)综合疗效的比较：治疗组患者,共30例,其中痊愈为12例,显效为8例,有效为9例,无效为1例,总有效率为96.67%,对照组患者,共30例,其中痊愈为7例,显效为6例,有效为12例,无效为6例,总有效率为80.0%,两组之间有明显差异,(P0.05)有统计学意义。(2)中医证候疗效的比较：治疗组患者,共30例,其中痊愈为13例,显效为16例,无效为1例,总有效率为96.7%,对照组患者,共30例,其中痊愈为8例,显效为14例,无效为8例,总有效率为73.3%,中医证候疗效两组之间有明显差异(P0.05),经中医证候积分比较,对照组用药后的中医证候积分为11.53±2.27,治疗组在用药后的中医证候积分为6.57±3.23,经统计学检验可知,两组之间的比较有明显差异(P0.05)。 (3)两组临床指标的比较：治疗组附件区包块吸收时间为(29.12±10.63)天、阴道出血停止时间为(5.43±2.94)天、血β-HCG转阴时间为(16.03±±4.24)天、腹痛消失时间为(5.67±±1.90)天与对照组比较均有明显差异,P0.05有统计学意义。(4)安全性比较：经观察发现,在不良反应率方面,治疗组与对照组比较没有明显的差异,(P0.05),故无统计学意义。结论：黄桂灌肠剂保留灌肠联合米非司酮口服保守治疗异位妊娠效果显著,明显优于单纯米非司酮口服治疗,值得临床广泛应用和推广。
[Abstract]:Objective: to observe the clinical effect of Huanggui enema combined with mifepristone in the treatment of ectopic pregnancy with undamaged syndrome of qi stagnation and blood stasis. The absorption time of adnexal mass, the time of blood 尾 -HCG negative conversion, adverse reactions, etc., were analyzed in order to evaluate the curative effect of Huanggui enema combined with mifepristone orally on ectopic pregnancy. To provide a favorable clinical basis for conservative treatment of ectopic pregnancy. Methods: from January 2014 to January 2016, 60 cases of ectopic pregnancy with undamaged syndrome of qi stagnation and blood stasis were selected from gynecological department of Rugao traditional Chinese Medicine Hospital. They were randomly divided into two groups: the control group (n = 30) and the control group (n = 30). The control group (n = 30) was treated with Huanggui enema combined with Mifepristone orally (n = 30). The control group (n = 30) was treated with mifepristone alone. The therapeutic effect, the time of vaginal bleeding, the time of disappearance of abdominal pain, the time of absorption of adnexal mass and the time of blood 尾 -HCG turning to negative were observed. The safety problems and adverse reactions during the treatment were also observed. Results: comparison of comprehensive curative effect: 30 cases in the treatment group, 12 cases were cured, 8 cases were effective, 9 cases were effective, 1 case was ineffective, the total effective rate was 96.67%, 30 cases in the control group, among which 7 cases were cured. There were 6 cases of marked effect, 12 cases of effective effect, 6 cases of ineffective, and 80.0% of total effective rate. There was a significant difference between the two groups (P0.05). There were statistically significant differences between the two groups. (2) there were 30 cases in the treatment group, among which 13 cases were cured and 16 cases had remarkable effect. There were 30 cases in the control group, including 8 cases of cure, 14 cases of remarkable effect, 8 cases of ineffectiveness, and 73.3% of total effective rate. There was a significant difference between the two groups in the curative effect of TCM syndrome. The TCM syndromes integral of the control group was 11.53 卤2.27, and that of the treatment group was 6.57 卤3.23. The statistical test showed that there was a significant difference between the two groups. 3) comparison of clinical indexes between the two groups: the absorptive time of adnexal mass in the treatment group was 29.12 卤10.63 days, the time of vaginal bleeding stopping was 5.43 卤2.94 days, the time of blood 尾 -HCG turning negative was 16.03 卤4.24 days. The time of disappearance of abdominal pain was 5.67 卤1.90 days compared with the control group. There was significant difference between the two groups (P0.05, P < 0.05). The safety comparison showed that there was no significant difference in the adverse reaction rate between the treatment group and the control group (P 0.05), so there was no significant difference between the treatment group and the control group, so there was no significant difference between the treatment group and the control group. Conclusion: Huanggui enema combined with mifepristone oral conservative treatment of ectopic pregnancy is significantly better than the oral treatment of mifepristone alone, and it is worthy of extensive clinical application and promotion.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R714.22

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