本文選題：異位妊娠 + 保守治療　； 參考：《南京中醫(yī)藥大學(xué)》2016年碩士論文

【摘要】：目的：觀察黃桂灌腸劑聯(lián)合米非司酮臨床用于治療證型為氣滯血瘀證未破損型異位妊娠的臨床療效,根據(jù)患者治療的效果、陰道出血停止時間、腹痛消失時間、附件區(qū)包塊吸收時間、血β-HCG轉(zhuǎn)陰時間、不良反應(yīng)等,探析黃桂灌腸劑保留灌腸聯(lián)合米非司酮口服保守治療異位妊娠的療效,為中西醫(yī)結(jié)合保守治療異位妊娠提供有利的臨床依據(jù)。方法：選自于2014年01月至2016年01月在如皋市中醫(yī)院婦科住院的患者,中醫(yī)辨證為氣滯血瘀證未破損型的異位妊娠患者,共60例。將其隨機(jī)分為2組：(1)治療組共30例,采用黃桂灌腸劑保留灌腸聯(lián)合米非司酮口服保守治療；(2)對照組共30例,采用單純米非司酮口服保守治療。從而觀察2組患者治療效果、陰道出血停止時間、腹痛消失時間、附件區(qū)包塊吸收時間、血β-HCG轉(zhuǎn)陰時間等,并觀察其在治療過程中的安全性問題及產(chǎn)生的不良反應(yīng)。結(jié)果： (1)綜合療效的比較：治療組患者,共30例,其中痊愈為12例,顯效為8例,有效為9例,無效為1例,總有效率為96.67%,對照組患者,共30例,其中痊愈為7例,顯效為6例,有效為12例,無效為6例,總有效率為80.0%,兩組之間有明顯差異,(P0.05)有統(tǒng)計學(xué)意義。(2)中醫(yī)證候療效的比較：治療組患者,共30例,其中痊愈為13例,顯效為16例,無效為1例,總有效率為96.7%,對照組患者,共30例,其中痊愈為8例,顯效為14例,無效為8例,總有效率為73.3%,中醫(yī)證候療效兩組之間有明顯差異(P0.05),經(jīng)中醫(yī)證候積分比較,對照組用藥后的中醫(yī)證候積分為11.53±2.27,治療組在用藥后的中醫(yī)證候積分為6.57±3.23,經(jīng)統(tǒng)計學(xué)檢驗(yàn)可知,兩組之間的比較有明顯差異(P0.05)。 (3)兩組臨床指標(biāo)的比較：治療組附件區(qū)包塊吸收時間為(29.12±10.63)天、陰道出血停止時間為(5.43±2.94)天、血β-HCG轉(zhuǎn)陰時間為(16.03±±4.24)天、腹痛消失時間為(5.67±±1.90)天與對照組比較均有明顯差異,P0.05有統(tǒng)計學(xué)意義。(4)安全性比較：經(jīng)觀察發(fā)現(xiàn),在不良反應(yīng)率方面,治療組與對照組比較沒有明顯的差異,(P0.05),故無統(tǒng)計學(xué)意義。結(jié)論：黃桂灌腸劑保留灌腸聯(lián)合米非司酮口服保守治療異位妊娠效果顯著,明顯優(yōu)于單純米非司酮口服治療,值得臨床廣泛應(yīng)用和推廣。
[Abstract]:Objective: to observe the clinical effect of Huanggui enema combined with mifepristone in the treatment of ectopic pregnancy with undamaged syndrome of qi stagnation and blood stasis. The absorption time of adnexal mass, the time of blood 尾 -HCG negative conversion, adverse reactions, etc., were analyzed in order to evaluate the curative effect of Huanggui enema combined with mifepristone orally on ectopic pregnancy. To provide a favorable clinical basis for conservative treatment of ectopic pregnancy. Methods: from January 2014 to January 2016, 60 cases of ectopic pregnancy with undamaged syndrome of qi stagnation and blood stasis were selected from gynecological department of Rugao traditional Chinese Medicine Hospital. They were randomly divided into two groups: the control group (n = 30) and the control group (n = 30). The control group (n = 30) was treated with Huanggui enema combined with Mifepristone orally (n = 30). The control group (n = 30) was treated with mifepristone alone. The therapeutic effect, the time of vaginal bleeding, the time of disappearance of abdominal pain, the time of absorption of adnexal mass and the time of blood 尾 -HCG turning to negative were observed. The safety problems and adverse reactions during the treatment were also observed. Results: comparison of comprehensive curative effect: 30 cases in the treatment group, 12 cases were cured, 8 cases were effective, 9 cases were effective, 1 case was ineffective, the total effective rate was 96.67%, 30 cases in the control group, among which 7 cases were cured. There were 6 cases of marked effect, 12 cases of effective effect, 6 cases of ineffective, and 80.0% of total effective rate. There was a significant difference between the two groups (P0.05). There were statistically significant differences between the two groups. (2) there were 30 cases in the treatment group, among which 13 cases were cured and 16 cases had remarkable effect. There were 30 cases in the control group, including 8 cases of cure, 14 cases of remarkable effect, 8 cases of ineffectiveness, and 73.3% of total effective rate. There was a significant difference between the two groups in the curative effect of TCM syndrome. The TCM syndromes integral of the control group was 11.53 鹵2.27, and that of the treatment group was 6.57 鹵3.23. The statistical test showed that there was a significant difference between the two groups. 3) comparison of clinical indexes between the two groups: the absorptive time of adnexal mass in the treatment group was 29.12 鹵10.63 days, the time of vaginal bleeding stopping was 5.43 鹵2.94 days, the time of blood 尾 -HCG turning negative was 16.03 鹵4.24 days. The time of disappearance of abdominal pain was 5.67 鹵1.90 days compared with the control group. There was significant difference between the two groups (P0.05, P < 0.05). The safety comparison showed that there was no significant difference in the adverse reaction rate between the treatment group and the control group (P 0.05), so there was no significant difference between the treatment group and the control group, so there was no significant difference between the treatment group and the control group. Conclusion: Huanggui enema combined with mifepristone oral conservative treatment of ectopic pregnancy is significantly better than the oral treatment of mifepristone alone, and it is worthy of extensive clinical application and promotion.
【學(xué)位授予單位】：南京中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R714.22

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本文編號：2008121