Effectiveness and safety of traditional Chinese medicine decoction adjuvant with methotrexate in treatment of patients with unruptured tubal pregnancy

Abstract

Objective To explore the effectiveness and safety of traditional Chinese medicine decoction adjuvant with methotrexate in the treatment of patients with unruptured tubal pregnancy. Methods 70 patients with unruptured tubal pregnancy treated at the department of gynaecology and obstetrics of our hospital from January, 2017 to March, 2018 were divided into a control group and a research group according to random number table, 35 cases for each group. The control group were treated with methotrexate, 1 mg/kg, once per day; in addition, and the research group were treated with traditional Chinese medicine decoction 1 agent per day. Both groups were treated for two weeks and followed up for three months. The clinical efficacy, clearance time of human chorionic gonadotropin(β-HCG), and complete absorption time of adnexal mass were compared between two groups. The serum level of β-HCG, total TCM syndrome score, and diameter of adnexal mass were compared between two groups before and after treatment. The adverse reactions were observed. Results The total effective rate was significantly higher in the research group than that in control group (94.29% vs. 82.86%, χ2=5.164, P=0.035). The clearance time of β-HCG and complete absorption time of adnexal mass were significantly shorter in the research group than in the control group [(27.56±8.01)d vs. (35.24±9.62) d, t=2.847, P=0.013; (35.44±13.28) d vs. (41.36±16.20) d, t=2.492, P=0.022]. The serum level of β-HCG, total TCM syndrome score, and diameter of adnexal mass were significantly decreased in both groups after the tratment (all P<0.05). The serum level of β-HCG, total TCM syndromes score, and diameter of adnexal mass were significantly lower in the research group than in the control group after the tratment [(351.46±102.53)U/L vs. (478.96±142.71)U/L, t=2.660, P=0.017; (5.72±1.93) vs. (7.24±1.85), t=2.157, P=0.031; (0.58±0.06)cm vs. (1.04±0.08)cm, t=2.244, P=0.029]. The incidence of adverse reactions was significantly lower in the research group than in the control group (8.57% vs. 17.14%, χ2=5.637, P=0.030). Conclusions Traditional Chinese medicine decoction adjuvant with methotrexate in the treatment of patients with unruptured tubal pregnancy has synergistic effect and can rapidly decrease the serum level of β-HCG, promote the absorption of adnexal mass, and reduce adverse reactions. Key words: Tubal pregnancy; Unruptured; Traditional Chinese medicine decoction; Methotrexate; Effectiveness; Safety