Based On The Real Word Study To Evaluate The Clinical Efficacy Of "Standard For Diagnosis And Treatment Of Tubal Pregnancy With Integrated Chinese And Western Medicine"

ObjectiveThis study was collected tubal pregnancy patients from the First Affiliated Hospital of Guangzhou University of Chinese Medicine and 10 cooperation hospitals of Guangdong Province from January 2015 to October2017.The study was based on "standard for diagnosis and treatment of tubal pregnancy with integrated Chinese and Western Medicine"(referred to as the "standard"),which was developed by Professor Deng Gaopi and his team.The patients were divided into traditional Chinese medicine(TCM)treatment group and Western medicine treatment group.Comparing the menopause duration,hospitalization time and cost,the impact factor score before treatment of tubal pregnancy disease(referred to as the "score"),blood human chorionic gonadotropin(β-HCG)and progesterone(P),B tubal pregnancy bag piece size and beta-HCG value after treatment,maximum diameter B the pelvic hemorrhage,in order to evaluate the effectiveness of combination of traditional Chinese and Western medicine treatment of tubal pregnancy scheme,and to analyze the possible factors influencing the success of TCM or western medicine treatment.MethodAccording to the breakthrough project of "early fallopian tube pregnancy",the key dominant disease species of Guangdong Provincial Administration of traditional Chinese medicine,the study was conducted through a large sample,multi center,retrospective and prospective "real world",collecting patients with tubal pregnancy from January 2015 to October 2017 in the First Affiliated Hospital of Guangzhou University of Chinese Medicine and Guangzhou Panyu District City Hospital of TCM,Chinese medicine hospital in Dongguan City,Futian District Hospital of TCM in Shenzhen,Baoan District Hospital of TCM in Shenzhen,Zhongshan Hospital of TCM,Maoming city hospital,Jiangmen Wuyi Hospital of TCM,Taishan City Hospital of TCM and other 9 hospitals.610 patients who conformed to the standard drug treatment were included in the study.And they were divided into the treatment of traditional Chinese medicine,traditional Chinese medicine and Western medicine treatment according to the first drug treatment.The former is divided into success group of TCM(group A,the same below),and the failure of TCM group(group B).The latter is divided into successful treatment of traditional Chinese and western medicine group(group C),and the failure of Chinese and western medicine group(group D).Data was input through the "obstetrics and Gynecology-gynecological network of traditional Chinese Medicine Online Network " of Clinical case observation platform,and it was input to the Excel table at the same time.The information includes age,score,hospitalization expenses,hospitalization time,menopause duration,the level of serum beta-HCG and progesterone,B-ultrasonic maximum diameter of tubal pregnancy package and pelvic hemorrhage,discharge beta-HCG and so on.Statistical analysis was performed using SPSS 22 software.All statistical tests were two-sided test,alpha =0.05,with P lower than 0.05 was considered statistically significant difference.Results1、There were significant differences(P<0.05)comparing group A with group B in age and serum beta-HCG when admitted.While comparing menopause duration,score,serum progesterone,B-ultrasonic maximum diameter of tubal pregnancy package and pelvic hemorrhage before treatment there were not statistically significant(P>0.05).Group C and group B had statistically significant difference in serum progesterone value at admission(P<0.05),and there was no significant difference in menopausal days,score,serum HCG level,B-ultrasonic maximum diameter of tubal pregnancy package and pelvic hemorrhage before treatment(P>0.05).2、The total effective rate of Chinese medicine treatment is 73.3%,and the Chinese and Western medicine is 63.8%.The treatment of TCM and traditional Chinese medicine and Western medicine in the treatment of the unbroken period(Taiyuan stasis type)effect is good,and the effective rate can reach 76.4%and 65.8% respectively.The total effective rate of TCM treatment was 64.9%,and the Chinese and Western medicine was 57.5%.The undamaged period(fetal stasis block type)and the disrepair period(blood stasis syndrome type)are not analyzed because of the less data.3、The length of hospital stay in group A was 9.85±5.45(days),and that in group B was 18.90±9.38(days).There was significant difference between two groups(P<0.05).There was no statistical difference between C group and D group of hospitalization time(P > 0.05).The cost of hospitalization in group A was 3922.73±1712.74(yuan),and that in group B was 8230.87 ±4400.29(yuan).The two groups were statistically different(P<0.05).The hospitalization expenses in group C were 6434.14±3301.15(yuan)and the group D was 14671.67±3504.58(yuan).The two groups were statistically different(P<0.05).Conclusion1、The level of serum beta-HCG may predict the outcome of TCM treatment.The serum progesterone level of admission may be related to the success of Chinese and Western medicine.2、Traditional Chinese medicine and Western medicine in the treatment of tubal pregnancy are effective.And unbroken period(Taiyuan stasis type)has better effect than damage period(Qi deficiency and blood stasis type).3、The hospitalization expenses and hospitalization time of the Chinese medicine group are the least.Taking other treatments after the failure of TCM treatment requires longer hospitalization and increased hospitalization costs.Although the Chinese and Western medicine failure group did not extend the length of stay,compared with the successful group,the cost of hospitalization increased significantly.