中药杀胚Ⅰ号方联合甲氨蝶呤治疗剖宫产瘢痕部位妊娠的临床疗效观察

摘要

目的：探讨中药杀胚Ⅰ号方联合甲氨蝶呤（MTX）治疗剖宫产后瘢痕部位妊娠（CSP）的临床疗效。方法将44例 CSP的患者，按分层随机化分组法分为观察组与对照组各22例。对照组在超声引导下将 MTX 局部注射到孕囊，待血 HCG 降至2000 IU·L －1以下，再予清宫术；观察组在超声引导下将 MTX 局部注射到孕囊的基础上开始口服中药杀胚Ⅰ号方，待血 HCG降至2000 IU·L －1以下，再予清宫术，比较两组的临床疗效。结果观察组的治疗效果显著高于对照组（P ＜0．05）；观察组的血β-HCG 降低至2000 IU·L －1以下的时间以及子宫下段超声正常时间均较对照组显著缩短（P ＜0．05）；两组之间不良反应发生率差异无统计学意义（P ＞0．05）。结论中药杀胚Ⅰ号方联合 MTX 治疗 CSP 疗效显著，突显中医优势，值得临床推广应用。%Objective To investigate the efficacy of traditional Chinese medicine killing embryos formula Ⅰ combined with methotrex-ate(MTX)on treating patients of early pregnancy with cesarean section scar(CSP).Methods Totally44 CSP patients were random-ized into two groups.The control group(n =22)was prescribed with conventional treatment alone,injected with methotrexate(MTX)in-to the gestational sac guided by ultrasound technique,then uterine curettage was carried out when β-HCG decreased to less than 2 000 IU·L -1 .The treatment group (n =22)received conventional medical therapy plus killing embryos formula Ⅰ,then uterine curettage was carried out whenβ-HCG decreased to less than 2 000 IU·L -1 .Results The clinical efficacy rate of the treatment group was sig-nificantly higher than the control group (P <0.05).The time needed for the β-HCG in the treatment group decreased to less than 2 000 IU·L -1 and the time needed for ultrasonic detection of lower uterine segment displaying normal were significantly shorter than those in the control group (P <0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups. Conclusions Killing embryos formula Ⅰ combined with MTX showed favorable effect on the treatment of CSP,which is worthy of clin-ical promotion.