[Chinese Herbs Combined Three-stage Sequential Therapy for Conservative Treatment of Ectopic Pregnancy].

ABSTRACT

Objective To observe the clinical efficacy and safety of three-stage sequential thera- py [(methotrexate + mifepristone + Gongwaiyun Recipe (GR)] for conservative treatment of ectopic pregnancy. Methods Recruited were 250 ectopic pregnancy patients, who received conservative treat- ment at Affiliated Ganzhou Hospital of Nanchang University and Ruijin Maternal & Child Health Care Hos- pital from January 2010 to December 2014. They were assigned to the observation group (153 cases) and the control group (97 cases) according to different treatment methods used. Patients in the control group were treated with Western medicine only (methotrexate + mifepristone). Those in the observation group were intramuscularly injected with methotrexate 50 mg/m² at day 1 . Then they took mifepristone 150 mg per day from day 2 to day 6, once per day for 5 successive days. Afterwards they took modified GR decoction from day 7, one dose per day. Clinical symptoms of all patients were observed. Blood levels of ß-hCG and progesterone were detected. Pelvic mass was examined in order to compare the curative effects between the two groups. Complications such as oral ulcer and gastrointestinal reactions were ob- served. Blood cells, hepatic and renal functions were monitored. The incidence of adverse reactions was compared between the two groups. Fallopian tube function was assessed by hysterosalpingography after healing. The fallopian tube patency rate was compared between the two groups. Results (1) The blood ß-hCG negative conversion time was (16. 70 ± 5. 88) days and the mass disappearance time was (4. 34 ±1. 15) weeks in the observation group, obviously shorter than those of the control group [ (22. 31 ±3. 35) days, (5. 80 ±0. 80 ) weeks , t = -7. 476, -9. 982; P <0. 01 ] in the control group. The cure rate was 98. 0% (150/153) in the observation group, and it was 73. 2% (71/97) in the control group, with statistical difference (x² =35. 730, P <0. 01). (2) The fallopian tube patency rate was 90. 7% (136/ 150) in the observation group and 78. 9% (56/97) in the control group, with statistical difference between the two groups (x² =5. 879, P <0. 05). (3) The incidence of adverse reactions The incidence of gastro- intestinal reactions was 22. 0% (33/150) in the observation group and 22. 1% (15/71 ) in the control group. The incidence of mild gastrointestinal reactions was 9. 3% (14/150) in the observation group and 8. 5% (6/71) in the control group. The incidence of oral ulcer was 8. 0% (12/150) in the observation group and 7. 0% (5/71) in the control group. The incidence of leukopenia was 2. 0% (3/150) in the observation group and 2. 8% (2/71) in the control group. There was no statistical difference in these indices aforesaid between the two groups (x² =0. 022, 0. 046, 0. 062, 0. 145; P >0. 05). Conclusion Chinese herbs com- bined three-stage sequential therapy might be a safer and more effective treatment for ectopic pregnancy patients who had requirement for pregnancy.