活血化瘀汤联合甲氨蝶呤治疗异位妊娠的疗效观察

doi:10.11958/20212481

天津医药 ›› 2022, Vol. 50 ›› Issue (9): 988-992.doi: 10.11958/20212481

活血化瘀汤联合甲氨蝶呤治疗异位妊娠的疗效观察

贾子娟¹(), 秦志娟¹^,^△(), 刘双玉², 李冉³, 高倩⁴, 宋立芹⁵, 王立方⁵, 李瑞霞⁵

1 河北省中医院妇产科（邮编050000）
2 唐山市迁西县妇幼保健院妇产科
3 河北省宁晋县中西医结合医院妇产科
4 保定市第二中心医院产科
5 河北省隆尧县医院妇产科

收稿日期:2021-11-08 修回日期:2022-04-26 出版日期:2022-09-15 发布日期:2022-09-05
通讯作者: 秦志娟 E-mail:jiazijuan5482@foxmail.com;qinzhijuan78546@qq.com
作者简介:贾子娟（1981）,女,主治医师,主要从事妇产科学的临床研究。E-mail： jiazijuan5482@foxmail.com
基金资助:
河北省中医药管理局2019年度中医药类科研计划项目(2019035)

The effect observation of Huoxue Huayu Decoction combined with methotrexate on ectopic pregnancy

JIA Zijuan¹(), QIN Zhijuan¹^,^△(), LIU Shuangyu², LI Ran³, GAO Qian⁴, SONG Liqin⁵, WANG Lifang⁵, LI Ruixia⁵

1 Department of Obstetrics and Gynecology, Hebei Hospital of Traditional Chinese Medicine, Shijiazhuang 050000, China
2 Department of Obstetrics and Gynecology, Qianxi Maternal and Child Health Hospital
3 Department of Obstetrics and Gynecology, Ningjin Hospital of Integrated Traditional Chinese and Western Medicine
4 Department of Obstetrics of Baoding the Second Central Hospital
5 Department of Obstetrics and Gynecology, Longyao County Hospital

Received:2021-11-08 Revised:2022-04-26 Published:2022-09-15 Online:2022-09-05
Contact: QIN Zhijuan E-mail:jiazijuan5482@foxmail.com;qinzhijuan78546@qq.com

贾子娟, 秦志娟, 刘双玉, 李冉, 高倩, 宋立芹, 王立方, 李瑞霞. 活血化瘀汤联合甲氨蝶呤治疗异位妊娠的疗效观察[J]. 天津医药, 2022, 50(9): 988-992.

JIA Zijuan, QIN Zhijuan, LIU Shuangyu, LI Ran, GAO Qian, SONG Liqin, WANG Lifang, LI Ruixia. The effect observation of Huoxue Huayu Decoction combined with methotrexate on ectopic pregnancy[J]. Tianjin Medical Journal, 2022, 50(9): 988-992.

摘要/Abstract

摘要：

目的探讨分析活血化瘀汤联合甲氨蝶呤治疗异位妊娠疗效及对患者外周血血管内皮生长因子（VEGF）和miR-323-3p水平的影响。方法选择异位妊娠患者106例,按照随机数字表法分为观察组54例和对照组52例,对照组给予甲氨蝶呤联合米非司酮治疗,观察组在对照组治疗的基础上加用活血化瘀汤治疗。比较2组患者血β-人绒毛膜促性腺激素（β-HCG）水平恢复正常时间以及包块吸收时间、治疗后输卵管完全通畅率及血清VEGF、miR-323-3p变化情况。结果与对照组比较,观察组保守治疗成功率升高（92.59% vs. 78.85%）,血β-HCG恢复正常时间及包块吸收时间缩短（P<0.05）。与对照组比较,观察组治疗3个月后患侧输卵管完全通畅率升高（52.00% vs. 29.27%,P<0.05）。与治疗前比较,治疗1个月后2组患者血清VEGF水平和miR-323-3p相对表达量降低（P<0.05）;与对照组比较,治疗1个月后观察组血清VEGF水平和miR-323-3p相对表达量和不良反应发生率降低（P<0.05）。结论活血化瘀汤联合甲氨蝶呤可有效提高异位妊娠患者保守治疗成功率,有助于包块的吸收以及输卵管通畅,有效降低患者血清VEGF及miR-323-3p表达,药物安全性高。

关键词: 妊娠,异位, 中西医结合疗法, 甲氨蝶呤, 活血化瘀汤, 外周血miR-323-3p, 血管内皮生长因子

Abstract:

Objective To explore and analyze the effect of Huoxue Huayu Decoction combined with methotrexate in the treatment of ectopic pregnancy and its effect on the level of peripheral blood miR-323-3p. Methods A total of 106 patients with ectopic pregnancy were selected and divided into the observation group (n=54) and the control group (n=52) according to the random number table method. The control group was given methotrexate combined with mifetil. The observation group was additionally treated with Huoxue Huayu Decoction on the basis of the treatment of the control group. The recovery time of blood -human chorionic gonadotropin (HCG) level, the time of mass absorption, the complete patency rate of fallopian tubes after treatment and changes of serum VEGF and miR-323-3p were compared between the two groups. Results Compared with the control group, the success rate of conservative treatment was increased in the observation group (92.59% vs. 78.85%), and the time for blood β-HCG to return to normal and the time for mass absorption were shortened (P<0.05). Compared with the control group, the complete patency rate of the affected fallopian tube increased significantly after 3 months of treatment in the observation group (52.00% vs. 29.27%, P<0.05). Compared with before treatment, the relative expressions of serum VEGF and mir-323-3p decreased significantly 1 month after treatment in the two groups (P<0.05). Compared with the control group, the relative expressions of serum VEGF and miR-323-3p and adverse reactions decreased significantly 1 month after treatment in the observation group (P<0.05). Conclusion Huoxue Huayu Decoction combined with methotrexate can effectively improve the success rate of conservative treatment for patients with ectopic pregnancy, which helps the absorption of mass after treatment and patency of fallopian tubes, and can effectively reduce serum levels of VEGF and miR-323-3p in patients, indicating high drug safety.

Key words: pregnancy,ectopic, TCM WM therapy, Methotrexate, huoxue huayu decoction, miR-323-3p in peripheral blood, VEGF

中图分类号:

R714.22

图/表 6

参考文献 19

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组别	n	年龄（岁）	体质量（kg）	停经时间（d）	妊娠次数（次）	β-HCG（U/L）	包块直径（cm）
观察组	54	29.73±5.31	56.27±7.21	45.28±9.04	1.79±0.52	142.48±38.94	3.42±1.30
对照组	52	30.16±6.44	55.92±6.93	44.72±8.08	1.71±0.46	149.85±41.28	3.71±1.47
t		0.376	0.255	0.340	0.710	0.946	1.077

组别	n	年龄（岁）	体质量（kg）	停经时间（d）	妊娠次数（次）	β-HCG（U/L）	包块直径（cm）
观察组	54	29.73±5.31	56.27±7.21	45.28±9.04	1.79±0.52	142.48±38.94	3.42±1.30
对照组	52	30.16±6.44	55.92±6.93	44.72±8.08	1.71±0.46	149.85±41.28	3.71±1.47
t		0.376	0.255	0.340	0.710	0.946	1.077

组别	n	血β-HCG恢复正常时间	包块吸收时间
对照组	41	21.08±7.22	48.79±15.36
观察组	50	16.94±6.39	40.26±12.35
χ²		2.898^＊＊	2.942^＊＊

组别	n	血β-HCG恢复正常时间	包块吸收时间
对照组	41	21.08±7.22	48.79±15.36
观察组	50	16.94±6.39	40.26±12.35
χ²		2.898^＊＊	2.942^＊＊

组别	n	完全通畅	基本通畅	不通畅
对照组	41	12（29.27）	12（29.27）	17（41.46）
观察组	50	26（52.00）	16（32.00）	8（16.00）
χ²		4.786^＊	0.079	7.331^＊＊

活血化瘀汤联合甲氨蝶呤治疗异位妊娠的疗效观察

The effect observation of Huoxue Huayu Decoction combined with methotrexate on ectopic pregnancy

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组别	n		VEGF（ng/L）
组别	n		治疗前		治疗1个月		t
对照组	41		122.37±51.42		86.80±18.98		3.936^＊
观察组	50		119.74±45.28		65.84±15.27		7.841^＊＊
t			0.260		5.836^＊＊
组别		miR-323-3p
组别		治疗前		治疗1个月		t
对照组		1.048±0.392		0.782±0.216		3.806^＊
观察组		0.978±0.365		0.542±0.198		7.425^＊＊
t		0.880		5.522^＊＊

组别	n	胃肠道不适	白细胞下降	肝功能异常	合计
对照组	52	13（25.00）	5（9.62）	6（11.54）	24（46.15）
观察组	54	9（16.67）	2（3.70）	3（5.56）	14（25.93）
χ²		-	-	-	4.713^＊

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