| Objective: Through the observation of the clinical efficacy of the conservative treatment of tubal pregnancy with ectopic pregnancy No.2formula plus minus methotrexate,the change of serum HCG value,TCM syndrome score and sign score of patients in the control group and the treatment group after treatment,and the reduction of pelvic mass absorption,etc.,to provide reference for clinical conservative treatment of tubal pregnancy.Methods:In this study,patients who met the inclusion criteria were randomly divided into two groups from January 2021 to November 2022.One group received ectopic pregnancy No.2 plus or minus methotrexate therapy,and the other group received methotrexate alone.Patients are required to sign informed consent to ensure the accuracy and reliability of treatment results.The treatment group was given ectopic pregnancy No.2 formula plus and minus water decoction,one dose a day,for 28 days.In addition,the single-dose regimen was used on the first day of intramuscular injection of 50mg/m2 methotrexate.The blood β-h CG level was detected at the 4th and 7th day after treatment if the decrease was greater than or equal to 15%,and the blood β-h CG level was monitored weekly until it turned negative.If the reduction is less than 15%,the liver and kidney function,blood routine and coagulation function are not abnormal.A week later,the intramuscular injection of MTX 50mg/m2 will be repeated to monitor blood β-h CG for no more than 4 courses.B-ultrasound was performed once a week to observe the size of pelvic mass,and liver and kidney function,blood routine and coagulation function were performed once a week.The control group only used methotrexate,the same usage and dose as the treatment group.Follow-up continued until bloodβ-HCG turned negative.Statistical analysis will be performed using SPSS26.0 software.The total clinical efficacy rate of the two groups after treatment,the effective rate of TCM syndrome efficacy of the two groups after treatment,the number of days to stop vaginal bleeding,TCM syndrome and sign scores before and after treatment,the number of days to disappear abdominal pain,the time for β-HCG value of the two groups to decline to normal,the decline of β-HCG value at 1,4,7,14,28 days after treatment,and the pelvic mass after treatment 7 14,28 days to reduce the situation and safety indicators.Results :Comparison of the total clinical efficacy: the total clinical efficacy of the treatment group was significantly higher than that of the control group.In the treatment group,7 cases were cured,12 cases were effective,9 cases were effective,2 cases were ineffective,and the total efficacy rate was 93.33%.In the control group,1 case was cured,3 cases were effective,19 cases were effective and 7 cases were ineffective.The total curative effect rate was only 76.67%.The difference between the two groups was statistically significant(P<0.05).Comparison of the criterion effective rate and cure rate of TCM syndrome efficacy: in the treatment group,8 cases were cured,11 cases were effective,8 cases were effective,3 cases failed,the total effective rate was 90%,the recovery rate was 26.67%;In the control group,2 cases were cured,5 cases were effective,18 cases were effective,and5 cases failed.The total effective rate was 83.33% and the cure rate was6.67%.The total curative effect of the treatment group was better than the control group,and the cure rate was higher,the difference was statistically significant(P<0.05).Comparison of clinical indexes between the two groups after treatment:1.The HCG value of the treatment group at day 4,7,14 and 28 was(1136.13±170.10),(685.17±146.50),(125.96±36.61)and(9.33±3.54)m IU/ml,respectively.The size of pelvic mass was(19.30±2.80),(14.8±2.71),(10.03±1.83)mm at 7,14 and 28 days.The disappearance time of abdominal pain was(3.10±1.06)days;Days of absence of vaginal bleeding(8.80±2.26)days;Blood HCG value decreased to the normal days(19.33±2.93);2.The HCG value of the control group at the 4th,7th,14 th and 28 th days was(1339.77±179.78),(1040.81±174.65),(209.77±60.76)and(19.76±4.88)m IU/ml,respectively.The size of pelvic mass was(20.62±2.09),(17.6±2.13),(14.47±1.98)mm at 7,14 and 28 days.The disappearance time of abdominal pain was(7.96±2.23)days;Days of absence of vaginal bleeding(18.26±3.06)days;Blood HCG decreased to normal days(25.63±3.37).The difference between the two groups was statistically significant(P<0.05).Comparison of adverse reactions: 3 patients in the treatment group had gastrointestinal reactions such as vomiting and nausea,and liver and kidney function tests were normal;In the control group,7 patients had gastrointestinal reactions such as nausea,vomiting and diarrhea,among which 1 patient was accompanied by mild oral ulcer and 3 patients had abnormal liver function.Conclusion:(1)In the treatment of unbroken tubal pregnancy,ectopic pregnancy No.2 prescription plus or minus combined with methotrexate has a significant effect,which not only can effectively improve the success rate of conservative treatment,but also has fewer side effects of oral Chinese medicine.Combined drug treatment can greatly reduce the side effects of Western medicine and has a higher safety factor.(2)The treatment of ectopic pregnancy No.2 formula plus minus plus methotrexate can reduce the number of days of vaginal bleeding,the time of abdominal pain disappearance,and the time for β-HCG value to fall to normal level.(3)The combined treatment of Chinese and Western medicine strengthened the effect of embryo killing and sterilization,was beneficial to the absorption of pelvic mass,and had a good clinical effect in improving local pain. |
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