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目的探讨血清β-人绒毛膜促性腺激素(β-HCG)及孕酮浓度动态变化在药物保守治疗异位妊娠中的临床意义。方法随机选取2011年6月至2016年6月间于本院收治的异位妊娠患者共450例,随机分为中药组(n=160)、中药+甲氨喋呤组(n=150)、中药+米非司酮组(n=140),分别采用中药、中药+甲氨喋呤、中药+米非司酮方法进行治疗。测定患者血清β-HCG及孕酮浓度的变化,及各组有效率。结果中药治疗组有效率为82.54%,高于中药+甲氨喋呤组的73.32%和中药+米非司酮组的63.40%,差异有统计学意义(P<0.05)。血清β-HCG值的下降幅度越大,治疗有效率越高。治疗后三组患者血清β-HCG及孕酮浓度下降幅度由高到低依次为中药组、中药+甲氨喋呤组、中药+米非司酮组,组间比较差异有统计学意义(P<0.05)。中药+甲氨喋呤组、中药+米非司酮组β-HCG值下降至50%的时间少于中药单独治疗组,中药组β-HCG值从50%再向下降至5%的时间低于中西药结合两组,差异均有统计学意义(P<0.05)。中药治疗组的患者未出现不良反应;中药+甲氨喋呤组、中药+米非司酮组分别有7、9例患者出现头晕恶心、轻微头痛的症状,均于停药后症状消失或者对症治疗后症状消失。结论药物保守治疗异位妊娠的效果与血清β-HCG及孕酮值的下降有关。其中中药单独治疗组的有效率最高,其血清β-HCG浓度下降至5%的时间最短。
Objective To investigate the clinical significance of serum β-human chorionic gonadotropin (β-HCG) and progesterone concentration in conservative treatment of ectopic pregnancy. Methods A total of 450 patients with ectopic pregnancy admitted to our hospital from June 2011 to June 2016 were randomly divided into two groups: Chinese herbal medicine group (n = 160), Chinese herbal medicine + methotrexate group (n = 150) Chinese medicine + mifepristone group (n = 140), respectively, using traditional Chinese medicine, traditional Chinese medicine + methotrexate, traditional Chinese medicine + mifepristone treatment. Determination of serum β-HCG and progesterone concentrations in patients with changes in the efficiency of each group. Results The effective rate of traditional Chinese medicine group was 82.54%, higher than that of traditional Chinese medicine + methotrexate group and 63.40% of traditional Chinese medicine + mifepristone group. The difference was statistically significant (P <0.05). Serum β-HCG decline the greater the value, the higher the effective treatment. After treatment, the levels of serum β-HCG and progesterone decreased from high to low in order of traditional Chinese medicine group, traditional Chinese medicine + methotrexate group and traditional Chinese medicine + mifepristone group, the difference was statistically significant (P <0.05). Chinese medicine + methotrexate group, Chinese medicine + mifepristone group β-HCG value decreased to 50% of the time less than the Chinese medicine alone treatment group, the Chinese medicine group β-HCG value dropped from 50% to 5% of the time The combination of Chinese and Western medicine in both groups, the difference was statistically significant (P <0.05). Chinese medicine treatment group patients did not appear adverse reactions; Chinese medicine + methotrexate group, traditional Chinese medicine + mifepristone group were 7,9 patients were dizziness, nausea, slight headache symptoms were discontinued after symptoms disappear or symptomatic Symptoms disappear after treatment. Conclusions The effect of conservative treatment of ectopic pregnancy is related to the decrease of serum β-HCG and progesterone. The traditional Chinese medicine alone treatment group, the highest efficiency, the serum β-HCG concentration decreased to 5% of the shortest time.