目的就血清β–HCG含量与异位妊娠药物保守治疗方案进行临床研究。方法选取2008年1月~2012年10月收治的100例异位妊娠患者,第1天,口服25mg米非司酮,每日肌内注射1次MTX,每次50mg,疗程为3天,而每日服用3次中药,每日1付,疗程为1周,值得注意的是,不用甲基四氢叶酸解毒;若患者的血清β–HCG<200U/L,可以只用中药+米非司酮,暂不用MTX。用药后第3、5、7天对血清β–HCG进行测量,用药后第3、7天B超检查、测肝肾功、血常规,是否加用MTX按照血清β–HCG下降情况来进行决定。血清β–HCG下降>90%,则可出院后继续服用中药,血清β–HCG、B超每周监测一次,直到附件包块消失位置。结果按照患者首次用药后血β–HCG的变化规律,可以将其归纳为4型:20例(21.51%)为速降型,33例(35.48%)为缓降型,25例(26.88%)为稳定型,15例(16.13%)为上升型(包括反弹型)。与速降型、上升型相比,缓降型、稳定型的比例明显增多。首次用中药+米非司酮+MTX后,速降型需用MTX1~2次,缓降型需用MTX1~2次,稳定型需用MTX1~3次,上升型需用MTX2~4次。结论就MTX的作用效果而言,静脉注射的临床疗效要劣于肌内注射,单次用药的临床疗效要劣于多次用药,大量的临床实践证实了这一点。 Objective To study the serum β-HCG content and conservative treatment of ectopic pregnancy. Methods One hundred patients with ectopic pregnancy who were admitted from January 2008 to October 2012 were enrolled. On the first day, 25 mg of mifepristone was given orally. One MTX was injected intramuscularly once a day for 50 mg for 3 days. Take 3 times a day Chinese medicine, daily pay 1, treatment for 1 week, it is noteworthy that, without methyl tetrahydrofolate detoxification; if the patient’s serum β-HCG <200U / L, you can only use traditional Chinese medicine + Ketone, not MTX. Serum β-HCG was measured on the 3rd, 5th and 7th days after treatment, B-ultrasound examination on the 3rd and 7th days after treatment, liver and kidney function, blood routine, whether to add MTX or not according to the decline of serum β-HCG . Serum β-HCG decreased> 90%, you can continue to take medicine after discharge, serum β-HCG, B-weekly monitoring until the annex mass disappeared. Results According to the change of blood β-HCG after the first administration, the patients could be classified into 4 types: 20 cases (21.51%) were descending type, 33 cases (35.48%) were descending type and 25 cases (26.88% For stable type, 15 cases (16.13%) were ascending type (including rebound type). Compared with the downhill type, rising type, the descending type, the proportion of stable type increased significantly. The first use of traditional Chinese medicine + mifepristone + MTX, downhill type required MTX1 ~ 2 times, descending type required MTX1 ~ 2 times, stable need MTX1 ~ 3 times, rising need MTX2 ~ 4 times. Conclusion In terms of the effect of MTX, the clinical efficacy of intravenous injection is inferior to that of intramuscular injection. The clinical efficacy of single-dose administration is inferior to that of multiple-dose administration, which is confirmed by a large number of clinical trials.