Abstract: Objective To investigate the clinical effect of mifepristone combined with Xiaojia Futong decoction in the treatment of ectopic pregnancy. Methods This study was a randomized controlled trial. A total of 80 patients who underwent conservative treatment for ectopic pregnancy in Tengzhou Central People's Hospital from June to December 2023 were simply randomly divided into two groups. The age of the observation group was (30.38±4.52) years old, the duration of menopause was (35.05±17.41) days, the level of human chorionic gonadotropin (HCG) was (771.18±515.59) mIU/ml, and the ectopic pregnancy mass was (2.61±0.93) cm. The age of the control group was (29.90±5.40) years old, the duration of menopause was (40.00±15.59) days, the HCG level was (855.13±680.85) mIU/ml, and the ectopic pregnancy mass was (2.42±0.72) cm. The control group was orally administered mifepristone, 50 mg/time, twice a day, for 3 consecutive days. The observation group was given Xiaojia Futong decoction on the basis of the control group, one dose a day, 400 ml of medicine juice taken twice in the morning and evening, 7 days as 1 course of treatment (if HCG did not decrease by more than 15% on the 7th day, the second course of treatment was carried out). The clinical efficacy and serum indexes of the two groups were compared, and the occurrence of adverse reactions in the two groups were observed. t test and χ2 test were used for statistical analysis. Results In the observation group, 39 cases (97.5%) were successfully treated without operation; in the control group, 37 cases (92.5%) were successfully treated; there was no statistically significant difference in the success rate of drug treatment between the two groups (χ2 = 1.053, P=0.305). The HCG level in the observation group was lower than that in the control group on the 7th day after treatment [(422.01±249.80) mIU/ml vs. (536.56±316.20) mIU/ml], and the time for HCG to fall to normal and the disappearance time of ectopic pregnancy mass were shorter than those in the control group [(13.28±2.91) d vs. (19.03±4.43) d, (23.46±7.38) d vs. (30.38±11.73) d], with statistically significant differences (all P<0.05). Before treatment, there was no statistically significant difference in the level of vascular endothelial growth factor (VEGF), carbohydrate antigen 125 (CA125), or creatine kinase (CK) (all P>0.05); on the 7th day after treatment, the above indexes in the observation group were lower than those in the control group, with statistically significant differences (all P<0.05). There was no statistically significant difference in the incidence of adverse drug reactions between the two groups (χ2 =0.251, P=0.617). Conclusion Mifepristone combined with Xiaojia Futong decoction can promote the decrease of blood HCG level and the absorption of mass in ectopic pregnancy patients, without increasing adverse drug reactions, and the effect is significant.

Key words: Ectopic pregnancy, Mifepristone, Xiaojia Futong decoction, Vascular endothelial growth factor, Carbohydrate antigen 125, Creatine kinase

摘要： 目的　研究米非司酮联合消瘕复通汤治疗异位妊娠的临床效果。方法　本研究为随机 对照试验。以滕州市中心人民医院2023年6月至12月因异位妊娠行保守治疗的80例患者为研究对 象，简单随机分为两组。观察组年龄（30.38±4.52）岁，停经天数（35.05±17.41）d，血人绒毛膜促性腺激 素（human chorionic gonadotropin，HCG）水平（771.18±515.59）mIU/ml，异位妊娠包块大小（2.61±0.93）cm； 对照组年龄（29.90±5.40）岁，停经天数（40.00±15.59）d，血HCG水平（855.13±680.85）mIU/ml，异位妊娠 包块大小（2.42±0.72）cm。对照组口服米非司酮，50 mg每次，一天两次，连服3 d。观察组在对照组基 础上联合消瘕复通汤口服，每日一剂，400 ml药汁分早晚两次服用，7 d为 1个疗程（如果 HCG未能在 第 7天下降 15% 以上，则进行第 2个疗程的治疗）。比较两组临床疗效及血清指标变化，同时观察两 组不良反应发生情况。采用t检验、χ2 检验进行统计学分析。结果　观察组药物治疗成功未行手术者 39例（97.5%），对照组药物治疗成功者 37例（92.5%），两组药物治疗成功率比较，差异无统计学意义 （χ2 =1.053，P=0.305）。观察组治疗后第 7 天血 HCG 水平低于对照组［（422.01±249.80）mIU/ml 比 （536.56±316.20）mIU/ml］，血 HCG 降至正常时间以及异位妊娠包块消失时间短于对照组［（13.28± 2.91）d 比（19.03±4.43）d、（23.46±7.38）d 比（30.38±11.73）d］，差异均有统计学意义（均 P<0.05）。治疗 前，两组血管内皮生长因子（vascular endothelial growth factor，VEGF）、糖类抗原 125（carbohydrate antigen 125，CA125）及肌酸激酶（creatine kinase，CK）水平比较，差异均无统计学意义（均 P>0.05）；治 疗后第7天，观察组上述指标均低于对照组，差异均有统计学意义（均P<0.05）。两组药物不良反应发 生率比较差异无统计学意义（χ2 =0.251，P=0.617）。结论　米非司酮联合消瘕复通汤能够促进异位妊 娠患者血HCG下降以及异位妊娠包块吸收，不增加药物不良反应，效果显著。

关键词: 异位妊娠, 米非司酮, 消瘕复通汤, 血管内皮生长因子, 糖类抗原 125, 肌酸激酶