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目的探讨中西医结合药物治疗输卵管妊娠疗效的影响因素。方法回顾分析广州中医药大学第一附属医院自2014年1月至2015年6月因输卵管妊娠住院行中西医结合药物治疗的输卵管妊娠患者202例,根据药物治疗是否成功分为成功组130例(占64.4%)和失败组72例(占35.6%)。记录两组患者阴道流血天数、妊娠频次、人工流产史、分娩频次、剖腹产史、有无盆腔积液、异位妊娠频次、其他腹部手术史、β人绒毛促性腺激素(β-h CG)值、孕酮(P)值、治疗前休克指数(SI)、K值、停经天数、腹痛天数、自然流产频次、B超下包块最大径,采用单因素分析及非条件Logistic回归分析,探讨影响治疗输卵管妊娠疗效的可能相关因素。结果两组自然流产频次、SI、log_2β-h CG、log_2P、K值比较差异有统计学意义(P<0.05)。人工流产史(OR=3.569,95%CI=1.253~10.161)、log_2β-h CG水平(OR=2.139,95%CI=1.548~2.956)是影响药物治疗输卵管妊娠的独立因素。当β-h CG>1578.5 IU/L时中西医结合药物治疗疗效不佳。结论影响中西医结合药物治疗输卵管妊娠的主要影响因素是人工流产史、log_2β-h CG水平。
Objective To explore the influencing factors of curative effect of tubal pregnancy treated with traditional Chinese medicine and western medicine. Methods A retrospective analysis of 202 cases of tubal pregnancy patients admitted to the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine from January 2014 to June 2015 due to tubal pregnancy combined with traditional Chinese and Western medicine was divided into three groups according to the success of drug treatment: Accounting for 64.4%) and failure group of 72 patients (35.6%). The days of vaginal bleeding, the frequency of pregnancy, the history of induced abortion, the frequency of delivery, the history of caesarean section, the presence or absence of pelvic fluid, the frequency of ectopic pregnancy, the history of other abdominal operations, the β-hCG value , Progesterone (P), pre-treatment shock index (SI), K value, days of menopause, days of abdominal pain, frequency of spontaneous abortion and maximum diameter of B subsides were determined by univariate analysis and non-conditional Logistic regression analysis Therapeutic efficacy of tubal pregnancy may be related to factors. Results There was significant difference in SI, log_2β-h CG, log_2P and K between two groups (P <0.05). The history of induced abortion (OR = 3.569, 95% CI = 1.253 ~ 10.161) and log 2β-h CG level (OR = 2.139, 95% CI = 1.548-2.956) were the independent factors influencing tubal pregnancy. When β-h CG> 1578.5 IU / L, the curative effect of traditional Chinese and Western medicine was poor. Conclusion The main influencing factors of tubal pregnancy treated with TCM and WM are induced abortion history and the level of log 2 β-h CG.