CN105079633B - A kind of Chinese medicine composition by stasis of blood promoting blood circulation, Xiao Disorder dissipating binds - Google Patents

Abstract

The invention provides a traditional Chinese medicine composition for removing blood stasis, promoting blood circulation, eliminating symptoms and resolving stagnation, which is used for treating ectopic pregnancy, placenta implantation and intrauterine residue. The traditional Chinese medicine composition of the present invention is composed of Sanleng, Curcuma, Raw Puhuang, Myrrh, Tuyuan, Centipede, Motherwort, Peach Kernel, Safflower, Chuanxiong, Radix Paeoniae Rubra, Danpi, Angelica, Achyranthes bidentata, Salvia, Guizhi, Poria cocos , Shengdi, Cyperus cyperi, raw rhubarb, ginger pinellia, red vine, and raw licorice are used together to make tonic in the action, life in the transformation, broken without hurting the righteous, nourishing without stagnating evil, and playing a total of blood stasis, blood circulation, and elimination The effect of dispelling stagnation can make blood stasis dispel, new blood is born, Chong Ren is harmonious, the uterus regenerates, and afterbirth comes out spontaneously. The medicine of the present invention is safe and effective in treating ectopic pregnancy, placenta accreta and intrauterine residues, has little toxic and side effects, reduces the operation rate, reduces the pain of the patient to the greatest extent, reduces the damage and economic and psychological burden of the patient, and is easy to be used by the patient. Accept and save medical resources for the society.

Description

A traditional Chinese medicine composition for dispelling blood stasis, promoting blood circulation, eliminating symptoms and resolving stagnation

technical field

The invention belongs to a traditional Chinese medicine composition, and relates to a traditional Chinese medicine composition for removing blood stasis, activating blood circulation, eliminating symptoms and resolving stagnation, and is used for treating ectopic pregnancy, placenta implantation and intrauterine residue.

Background technique

Ectopic pregnancy refers to the pregnancy in which the fertilized egg is planted outside the uterine body cavity. Placenta accreta is caused by secondary decidual dysplasia caused by primary decidual dysplasia or scratched endometrium defects. Partial or total lack of membranes, placental villi directly invade the myometrium. Due to the influence of factors such as curettage, abortion, pelvic inflammatory disease and intrauterine contraceptive ring, the incidence of ectopic pregnancy, placenta accreta and intrauterine residues gradually increased. It is worth mentioning scar pregnancy. Scar pregnancy refers to the implantation of fertilized eggs and trophoblasts in the scar of the uterus after cesarean section. Because the muscle wall of the scar is weak and there are many fibrous tissues, uterine rupture and hemorrhage are prone to occur after pregnancy. Severe complications endanger the life safety of patients. Scar pregnancy is different from cervical pregnancy. It is a more dangerous type of ectopic pregnancy. With the liberalization of the separate two-child policy, the incidence of this disease has increased significantly, and its treatment is also quite difficult. From the perspective of Chinese medicine, ectopic pregnancy, placenta accreta, and intrauterine residues all belong to the category of "blood accumulation" and "mass in the abdomen". Blockage of Chong and Ren leads to lump in the abdomen, internal resistance of blood stasis, new blood is difficult to settle, not to return to the meridian and goes indiscriminately, so that vaginal bleeding does not stop; blockage of blood vessels leads to pain in the lower abdomen. Therefore, the treatment principle of the above-mentioned diseases is promoting blood circulation to remove blood stasis, eliminating symptoms and dissipating stagnation.

In the past, Western medicine mainly used surgery or curettage, or even hysterectomy, for the above-mentioned diseases. In recent years, clinical patients have increasingly strong requirements to avoid surgical trauma and preserve fertility as much as possible. Conservative drug treatment for the above diseases has become a trend. And with the improvement of blood β-hCG sensitivity and the wide application of transvaginal ultrasound, the above diseases can be diagnosed timely and accurately, which can improve the success rate of conservative treatment. The purpose of conservative treatment is to kill the embryonic tissue, eliminate residual tissue, promote the absorption and dissipation of the mass, reduce bleeding, and preserve fertility. Western medicine conservative treatment is mostly methotrexate (MTX) injection or mifepristone oral administration.

Protecting the reproductive function of patients to the greatest extent, improving the success rate of conservative drug treatment, and reducing drug toxicity are crucial issues in the treatment of ectopic pregnancy, placenta accreta and intrauterine residue. Surgery brings great trauma to patients and destroys fertility. MTX, mifepristone, etc. can bring many adverse reactions to the body, including gastrointestinal reactions, and even liver and kidney dysfunction, bone marrow suppression and visceral dysfunction. organ failure etc.

The combination of traditional Chinese and Western medicine has become a trend in the treatment of such diseases. The combination of the two can not only exert the respective effects of the medicines, but also complement each other synergistically. Western medicine can be used to solve the weakness of traditional Chinese medicine's insufficient power to kill embryos, and it can also play the role of traditional Chinese medicine in promoting blood circulation, removing blood stasis and dissipating stagnation. The advantage is to reduce the bleeding of the embryonic stripping wound, shorten the time for serum β-hCG to return to normal and the time for mass absorption, reduce the adhesion around the lesion, increase the success rate of conservative drug treatment, and effectively preserve the reproductive function. And the combination of Chinese and Western medicine can reduce the dosage and repetition times of drugs such as MTX and mifepristone, thereby reducing drug side effects.

In the past, tubal pregnancy required surgery to remove the fallopian tube or to preserve the fallopian tube. Scar pregnancy and placenta accreta required curettage or even hysterectomy. There was no better treatment, and the incidence of surgery and sequelae could not be reduced. The side effects of western medicine, The injury and economic and psychological burden to patients are also heavy. A better treatment is urgently needed.

Contents of the invention

The object of the present invention is to provide a traditional Chinese medicine composition for removing blood stasis, promoting blood circulation, eliminating symptoms and resolving stagnation, which is used for treating ectopic pregnancy, placenta accreta and intrauterine residue.

In order to achieve the above object, the technical solution adopted by the present invention is: a traditional Chinese medicine composition for removing blood stasis, activating blood circulation, eliminating symptoms and resolving stagnation, comprising the following raw materials in parts by weight: 10-20 parts of trigonum, 10-30 parts of curcuma, raw 15-20 parts of Puhuang, 10-12 parts of Myrrh, 10-12 parts of Tuyuan, 1-3 parts of Centipede, 30-40 parts of Motherwort, 9-15 parts of peach kernel, 9-15 parts of safflower, 9-12 parts of Chuanxiong 12-15 parts of red peony root, 12-15 parts of paeonol, 12-15 parts of angelica, 10-15 parts of Sichuan Achyranthes bidentata, 15-20 parts of salvia miltiorrhiza, 9-12 parts of cassia twig, 12-15 parts of poria cocos, raw land 12-15 parts, Cyperus 10-12 parts, raw rhubarb 6-10 parts, ginger pinellia 6-9 parts, red rattan 15-20 parts, raw licorice 6-9 parts.

The above-mentioned traditional Chinese medicine composition can be made into a decoction: take the above-mentioned raw materials according to the weight of the prescription, add water to cold soak for 30-60 minutes, heat to boiling, decoct until the concentration is 3.61g/ml of crude drug, and take it warm after meals , one dose each morning and evening, each dose is 200ml.

The obtained decoction can also be further concentrated to obtain an extract, and auxiliary materials are added to make capsules, tablets, granules or pills by conventional methods. The auxiliary materials added are conventional medicinal mannitol, lactose, starch, magnesium stearate, sodium saccharin, cellulose or magnesium carbonate and the like. Made into traditional Chinese medicine preparations for treating ectopic pregnancy, placenta accreta and intrauterine residues.

The present invention's solution is as follows:

Monarch medicine: Sanleng, Curcuma, Tuyuan——Curcuma is pungent, bitter, warm in nature, and functions to promote qi, break blood and eliminate accumulation; The blood, the power of promoting qi and breaking blood, dispelling blood stasis and eliminating accumulation is better than that of Sanleng, and the power of Sanleng breaking Qi in blood, softening hard masses, and eliminating old lumps and hard accumulation is better than that of curcuma, earth element, salty and cold in nature , function of removing blood stasis and removing blood stasis, mainly treating amenorrhea due to blood stasis, postpartum stasis and abdominal pain, and mass in the abdomen due to addiction. The three eliminate accumulation and eliminate symptoms, and they are the king's medicine altogether.

Herbs: raw Puhuang, myrrh, motherwort, peach kernel, safflower, Chuanxiong, red peony root, paeonol, angelica, Sichuan Achyranthes bidentata, salvia miltiorrhiza, cassia twig, Poria cocos, centipede - Puhuang, myrrh to stop bleeding; Safflower promotes blood circulation and removes blood stasis; Ligusticum chuanxiong is a qi medicine in the blood, which is good at moving qi to invigorate blood circulation; Angelica and Danshen nourish blood and promote blood circulation to prosper meridian; walnut kernel can also laxative; motherwort promotes blood stasis, dispels bad blood, and generates new blood , promote blood stasis without hurting new blood, nourish blood without leaving stasis; Chuan Achyranthes bidentata promotes blood circulation and removes blood stasis, and introduces various medicines downward; Rejuvenate, reconcile qi and blood, "Jin Kui Yu Han Jing II Notes": Guizhi, peach kernel, paeonol, peony can remove bad blood; Poria cocos is also beneficial to the blood between the waist and umbilical cord, which is broken blood; If there is harvest, seepage, and stagnation, the pungent cinnamon sticks are scattered; the liver stores blood, and if the blood accumulates, the liver is anxious, and the sweetness of peach kernels and paeonol is used for relief; for the activation of yin qi, the acid of peony is collected; Accompanied by the infiltration of Poria cocos, etc., it will be beneficial. Modern pharmacological studies have confirmed that drugs for promoting blood circulation and removing blood stasis can dilate blood vessels, relieve vasospasm, reduce blood flow, improve local microcirculation, inhibit platelet aggregation, have certain effects on the decomposition and absorption of blood clots, and prevent the formation of hematoma masses. It can also promote the absorption and elimination of the formed mass. Centipede is an insect medicine, which has the effect of extinguishing wind, dredging collaterals and relieving pain, and has the effect of killing embryos. The insect medicine has the characteristics of flying around, searching and removing blood stasis in the collaterals, increasing the effect of killing embryos, and accelerating local blood clots and necrosis of embryonic tissue Absorption. Therefore, Puhuang, myrrh, motherwort, peach kernel, safflower, Chuanxiong, red peony root, paeonol, angelica, Sichuan achyranthes bidentata, salvia miltiorrhiza, cassia twig, poria cocos, and centipede promote blood circulation, remove blood stasis and soften firmness.

Adjuvant medicine: Shengdi, Rhizoma Cyperi, Raw Rhubarb, Ginger Pinellia, Red Teng - Shengdi, nourishing yin and cooling serum heat, can relieve the pungent and dry nature of the above-mentioned many drugs for promoting blood circulation and removing blood stasis, and can nourish yin and nourish the endometrium, and promote the absorption of blood. Repair damaged endometrium; Rhizoma Cyperi is a medicine for qi in the blood, and when qi moves, blood flows, which is more conducive to the effect of blood-activating drugs; raw rhubarb and promoting blood circulation can promote pelvic blood circulation, and is beneficial to the excretion and absorption of intrauterine residues; ginger pinellia Dispelling stagnation and stopping vomiting can alleviate the side effects of nausea and vomiting caused by western medicine; excessive bleeding time can easily cause upward infection of pathogens, red vine can clear away heat and detoxify, and use it to prevent infection; As an adjuvant.

Medication: Raw licorice - licorice is used as a messenger, which has the effects of reconciling various medicines, detoxifying, relieving spasms and relieving pain.

Combined use of various medicines can make the action nourish, transform the body to have life, break without hurting the body, nourish without stagnation, and play a total of the effects of removing blood stasis, activating blood, eliminating symptoms and dispelling stagnation, so that blood stasis can be dispelled, new blood can be stimulated, and blood can be stimulated. Ren He, the uterus regresses, and the afterbirth comes out by itself.

The present invention has following beneficial effect:

1) The safety and effectiveness of the pharmaceutical composition of the present invention in treating ectopic pregnancy, placenta accreta and intrauterine residue have been verified through clinical research. It can be used in the preparation of traditional Chinese medicine compositions for treating ectopic pregnancy, placenta accreta and intrauterine residues; studies have shown that 130 cases of ectopic pregnancy were treated with MTX+mifepristone+Chinese medicine of the present invention, and 174 cases were effective. 8 cases were ineffective, and the effective rate was 97.44%. All patients were followed up for 3 months after discharge, and the β-HCG level decreased to normal, and the mass was eliminated. The cure rate was 100%.

2) The composition of the present invention not only has remarkable curative effect, but also treats both symptoms and root causes, has little toxic and side effects, is easy to control in quality, and has low cost.

3) Reduce the operation rate, reduce the pain of the patient to the greatest extent, reduce the injury and economic and psychological burden of the patient, be easily accepted by the patient, and save medical resources for the society.

Detailed ways

The present invention will be further described below by way of examples and test examples. However, the present invention is not limited to the description of the embodiments, and those skilled in the art can make certain modifications within the protection scope of the present invention.

Embodiment 1, a traditional Chinese medicine composition for expelling blood stasis, activating blood circulation, eliminating symptoms and resolving stagnation, comprising the following raw materials in parts by weight: 10 grams of Sanleng, 10 grams of Zedoary Curcuma, 15 grams of Raw Puhuang, 10 grams of Myrrha, and 10 grams of Tuyuan gram, 1 gram of centipede, 30 grams of motherwort, 9 grams of peach kernel, 9 grams of safflower, 9 grams of Chuanxiong, 12 grams of red peony root, 12 grams of paeonol, 12 grams of angelica, 10 grams of Sichuan Achyranthes bidentata, 15 grams of salvia miltiorrhiza, 9 grams of cassia twig gram, 12 grams of Poria cocos, 12 grams of raw land, 10 grams of Cyperus cyperi, 6 grams of raw rhubarb, 6 grams of ginger pinellia, 15 grams of red rattan, and 6 grams of raw licorice.

The above-mentioned traditional Chinese medicine composition can be made into a decoction: take the above-mentioned raw materials according to the weight in the prescription, add water and soak for 30-60 minutes, heat to boiling, decoct until the concentration is 3.61g/ml of crude drug, and take it warm after meals. Take one dose each morning and evening, each dose is 200ml.

Embodiment 2, a traditional Chinese medicine composition for expelling blood stasis, activating blood circulation, eliminating symptoms and resolving stagnation, comprising the following raw materials: 15 grams of Sanleng, 15 grams of Zedoary Curcuma, 18 grams of Raw Puhuang, 11 grams of Myrrha, and 11 grams of Tuyuan , 2 grams of centipede, 35 grams of motherwort, 12 grams of peach kernel, 12 grams of safflower, 10 grams of Chuanxiong, 14 grams of red peony, 14 grams of paeonol, 14 grams of angelica, 12 grams of Sichuan Achyranthes bidentata, 18 grams of salvia miltiorrhiza, 10 grams of cassia twig , 14 grams of Poria cocos, 14 grams of raw land, 11 grams of Cyperus cyperi, 8 grams of raw rhubarb, 8 grams of ginger pinellia, 18 grams of red rattan, and 8 grams of raw licorice.

The preparation and administration method are the same as in Example 1.

Embodiment 3, a traditional Chinese medicine composition for expelling blood stasis, activating blood circulation, eliminating symptoms and dissipating stagnation, comprising the following raw materials: 20 grams of Sanleng, 30 grams of Zedoary Curcuma, 20 grams of Raw Puhuang, 12 grams of Myrrha, and 12 grams of Tuyuan , 3 grams of centipede, 40 grams of motherwort, 15 grams of peach kernel, 15 grams of safflower, 12 grams of Chuanxiong, 15 grams of red peony root, 15 grams of paeonol, 15 grams of angelica, 15 grams of Sichuan Achyranthes bidentata, 20 grams of salvia miltiorrhiza, 12 grams of cassia twig , 15 grams of Poria cocos, 15 grams of raw land, 12 grams of Cyperus cyperi, 10 grams of raw rhubarb, 9 grams of ginger pinellia, 20 grams of red vine, and 9 grams of raw licorice.

The preparation and administration method are the same as in Example 1.

Embodiment 4, a traditional Chinese medicine composition for expelling blood stasis, activating blood circulation, eliminating symptoms and resolving stagnation, comprising the following raw materials: 15 grams of Sanleng, 25 grams of Zedoary Curcuma, 20 grams of Raw Puhuang, 11 grams of Myrrha, and 12 grams of Tuyuan , 1 gram of centipede, 33 grams of motherwort, 10 grams of peach kernel, 14 grams of safflower, 11 grams of Chuanxiong, 13 grams of red peony, 12 grams of paeonol, 15 grams of angelica, 13 grams of Sichuan Achyranthes bidentata, 19 grams of salvia miltiorrhiza, 11 grams of cassia twig , 14 grams of Poria cocos, 13 grams of raw land, 11 grams of Cyperus cyperi, 9 grams of raw rhubarb, 7 grams of ginger pinellia, 18 grams of red rattan, and 8 grams of raw licorice.

The preparation and administration method are the same as in Example 1.

Embodiment 5, a traditional Chinese medicine composition for expelling blood stasis, activating blood circulation, eliminating symptoms and resolving stagnation, comprising the following raw materials: 18 grams of Sanleng, 18 grams of Curcuma, 19 grams of Raw Puhuang, 10 grams of Myrrh, and 11 grams of Tuyuan , 3 grams of centipede, 38 grams of motherwort, 10 grams of peach kernel, 11 grams of safflower, 11 grams of Chuanxiong, 14 grams of red peony, 14 grams of paeonol, 14 grams of angelica, 12 grams of Sichuan Achyranthes bidentata, 17 grams of salvia miltiorrhiza, 10 grams of cassia twig , 13 grams of Poria cocos, 13 grams of raw land, 11 grams of Cyperus cyperi, 9 grams of raw rhubarb, 7 grams of ginger pinellia, 16 grams of red rattan, and 7 grams of raw licorice.

The preparation and administration method are the same as in Example 1.

Clinical Trial Example 1: Drug Curative Effect Experiment for Treatment of Ectopic Pregnancy

1 Materials and methods

1.1 Research objects and grouping 551 patients with ectopic pregnancy diagnosed in our hospital from January 2003 to December 2011 underwent conservative treatment, aged 17-48 years, average 29.3 years old, menopause time 30-120 days, diagnosis based on medical history, Gynecological examination, blood β-hCG and B-ultrasound examination. Medication objects: 1) unruptured ectopic pregnancy or ruptured fallopian tube pregnancy, but less bleeding; 2) B-ultrasound examination of tubal pregnancy mass diameter <6.75cm; 3) stable vital signs, no signs of active internal bleeding 4) no emergency Chronic organic disease; 5) blood chorionic gonadotropin (β-hCG) ≤5000U/L or >5000U/L and the patient requires conservative drug treatment; 6) liver and kidney function and red blood cell, white blood cell, platelet count normal. The 551 patients were counted as follows according to their medication conditions: 7 cases were treated with MTX injection alone, 17 cases were treated with oral mifepristone alone, 37 cases were treated with traditional Chinese medicine alone, 73 cases were treated with MTX+mifepristone, and 73 cases were treated with MTX+Chinese medicine. 48 cases were treated with mifepristone + Chinese medicine, 57 cases were treated with MTX + mifepristone + Chinese medicine, and 312 cases were treated with MTX + mifepristone + Chinese medicine. Because most cases were treated with the combination of MTX+mifepristone+Chinese medicine, we focused on the statistical analysis of 312 patients who were treated with MTX+mifepristone+Chinese medicine. The ultrasound results indicated that the diameter of the pelvic mass was between 0.4-6.75cm (mass diameter: the average of the transverse and longitudinal diameters).

1.2 Treatment and observation methods According to the level of β-hCG and the size of the mass, choose different doses of MTX for intramuscular injection (the base dose is 50 mg/m ² ), and start taking mifepristone (25 mg tid or 50 mg bid orally) and Chinese medicine, take the medicine prepared in this embodiment 3, decoct until the concentration is 3.61g/ml of crude drug, take it warmly after meals, take one dose each morning and evening, each dose is 200ml. One month is a course of treatment, until the β-hCG drops to normal, and the longest is no more than 3 months.

1.3 Curative Effect Observation

During the treatment, closely observe the patient's vital signs, abdominal pain, vaginal bleeding, and menstrual recovery. Check serum β-hCG and B-ultrasound once a week. If β-hCG drops to normal, check B-ultrasound once every two weeks. Record the number of MTX injections. After treatment, the serum β-hCG decreased by 50%, and the B-ultrasonic examination mass shrunk. He was discharged from the hospital and continued to take traditional Chinese medicine for treatment and observation.

1.4 Efficacy Evaluation Criteria

Significant effect: vaginal bleeding and abdominal pain disappeared within 1 week, serum β-HCG decreased by >50%; serum β-HCG decreased to normal after 4 weeks; adnexal mass shrunk; pelvic effusion disappeared or decreased.

Effective: Vaginal bleeding and abdominal pain disappear within 1 week, and serum β-HCG decreases by >15%; after 4 weeks, serum β-HCG decreases by >50% or returns to normal; the adnexal mass shrinks, or the mass is stable, and the shrinkage is not obvious ; Pelvic effusion decreased.

Ineffective: During the course of treatment, acute abdominal symptoms such as decreased blood pressure, increased pulse rate, continued decrease in hemoglobin, and obvious aggravation of abdominal pain occurred; the β-HCG value increased or decreased by <15% compared with the level before treatment one week after MTX injection, and color Doppler ultrasound If the adnexal mass shows no change or increases, the pelvic effusion will increase significantly.

2 treatment results

The 551 patients were counted as follows according to their medication conditions: 7 cases were treated with MTX injection alone, 17 cases were treated with oral mifepristone alone, 37 cases were treated with traditional Chinese medicine alone, 73 cases were treated with MTX+mifepristone, and 73 cases were treated with MTX+Chinese medicine. 48 cases were treated with mifepristone + Chinese medicine, 57 cases were treated with MTX + mifepristone + Chinese medicine, and 312 cases were treated with MTX + mifepristone + Chinese medicine. The utilization rate of traditional Chinese medicine was 82.4%.

During hospitalization, among 312 patients treated with MTX+mifepristone+Chinese medicine, 130 cases were markedly effective, 174 cases were effective, and 8 cases were ineffective, with an effective rate of 97.44%.

All patients were followed up for 3 months after discharge, and the β-HCG level decreased to normal, and the mass was eliminated. The cure rate was 100%.

Clinical Trial Example 2 Curative Effect Experiment of Drugs in the Treatment of Placenta Accreta

1.1 General Information

40 cases of placenta accreta were inpatients in the obstetrics ward of our hospital from June 2013 to June 2015. Aged from 24 to 40 years old, average (27.3±3.46) years old, including 21 cases of full-term delivery, 7 cases of premature delivery, 7 cases of late miscarriage, and 5 cases of mid-term induced labor; gestational age ranged from 16 to 40 weeks, with an average of (26.6±5.3) weeks; There were 16 cases of complete placenta accreta and 24 cases of partial placenta accreta; 16 of them were transferred to our hospital because of difficulty in delivery of placenta after delivery of fetuses in other hospitals. The patients were randomly divided into a treatment group of 20 cases and a control group of 20 cases. The age, gestational week and time of taking Chinese medicine for the first time after delivery, the size of the uterus before treatment (the product of three diameters), the depth of placenta implantation (the thinnest part of the uterine muscle wall), the size of the placenta in the uterine cavity (length×width×thickness), There was no statistically significant difference in human chorionic gonadotropin (β-HCG) (P>0.05).

1.2 Treatment methods

In all cases, under the guidance of ultrasound, a 23g PTC puncture needle was used to penetrate the placental tissue of the uterus through the abdominal wall on the pubic symphysis, and 20mL (75mg) of MTX solution was evenly injected at 3 to 4 points. After injection, cover the puncture point with sterile gauze, and return to the ward after observation for 30 minutes. The treatment group took the medicine prepared in Example 2 at the same time, decocted until the concentration was 3.61g/ml of crude drug, and took it warmly after meals, one dose each morning and evening, each dose was 200ml. One month is a course of treatment. Take it until the β-hCG drops to normal, and the longest is no more than 3 months.

The control group took traditional Chinese medicine for promoting blood circulation and removing blood stasis, and modified Shenghua decoction (15 parts of angelica, 15 parts of red peony root, 20 parts of rehmannia root, 15 parts of motherwort, 15 parts of safflower, etc.), and the decoction method was the same as that of the treatment group.

During the treatment, closely observe the maternal blood pressure, pulse, respiration, uterine involution and vaginal bleeding, and repeat local injection of MTX for those whose β-HCG drops slowly (<15%) one week after the first injection of MTX. Recheck blood β-HCG and color B-ultrasound once a week, if β-HCG drops to normal, recheck B-ultrasound once every 2 weeks. After treatment, the blood β-HCG has dropped to normal, and those who have no obvious blood flow in the placenta implantation and attached uterus by ultrasound examination are discharged to the outpatient clinic for further treatment.

1.3 Observation indicators

① Placenta expulsion method and time. ②The time for blood β-HCG to drop to normal level. ③ Record the number of MTX injections. ④Secondary infection.

1.4 Efficacy Evaluation Criteria

Recovery: the placenta is completely and naturally discharged, B-ultrasound shows that the intrauterine echo is normal or there is no tissue residue, and the blood β-HCG drops to the level of non-pregnancy;

Effective: the placenta is partially excreted, B-ultrasound shows that the area of the residue in the uterine cavity is reduced, the uterus recovers, and the blood β-HCG is significantly reduced or normal;

Ineffective: No residue was discharged after 4 months of treatment, B-ultrasound showed no reduction in the area of residue in the uterine cavity, and poor recovery of uterine contraction. If it is invalid, curettage or hysteroscopic resection should be given.

2 treatment results

In the treatment group, 18 cases were cured, 1 case was effective, and 1 case was ineffective, with an effective rate of 95.0%.

In the control group, 11 cases were cured, 4 cases were effective, and 5 cases were ineffective, with an effective rate of 75.0%.

There was a statistical difference in the effective rate between the two groups (P<0.05). The results showed that the effective rate of the treatment group was significantly higher than that of the control group.

Application case 1 Placenta accreta

Zhang, female, 28 years old, was admitted to the hospital on April 19, 2013 because of "32 weeks of menopause, 5 days of fetal movement disappearance, and B-ultrasound showed fetal death in utero for 2 days". After admission, induced labor was performed, and the fetus was delivered at 6:00 pm on April 21, 2013, but the placenta was not delivered. B-ultrasound examination showed: the uterus was 11.1cm×13.8cm×7.6cm, the muscular layer echo was heterogeneous, the posterior wall of the uterus and the placental echo were detected, the size was about 8.4cm×9.8cm×5.4cm, the posterior wall muscle layer was thin, and the placenta was thick. The membranous layer is about 0.9cm. Color Doppler ultrasonography (CDFI): There are abundant blood flow signals detected between the placenta and the posterior muscular layer. On April 23, B-ultrasound-guided local injection of methotrexate (MTX) 75 mg down the placenta, followed by the drug prepared in Example 4. After 7 days of medication, B-ultrasound was re-examined: the uterus was 9.2cm×8.7cm×7.0cm, the myometrium was thickened, the residual area was 4.2cm×2.8cm, and the boundary was blurred. CDFI: no obvious blood flow signal was detected. A small amount of liquid dark area in the uterine cavity, with an inner diameter of about 0.9cm. The β-HCG dropped to 8.6mIU/ml, and the patient still had a small amount of vaginal bleeding. After the 20th day of medication, the amount of vaginal bleeding increased, accompanied by paroxysmal abdominal pain, and discharge of placental tissue, which was found to be placenta and villous tissue by pathological examination.

Application Case 2 Scar Pregnancy

Xu, female, 29 years old

The patient was admitted to the hospital on September 5, 2014 because of "menorrhea for 40+ days and a small amount of vaginal bleeding for 5 days". Usual menstrual cycle regularity, LMP: 2014-07-21. After 30+ days of menopause, the local family planning examination had a positive urine pregnancy test. No nausea or vomiting after menopause, a small amount of vaginal bleeding 5 days ago, no abdominal pain, abdominal distension. One day before, the B-ultrasound examination at the local hospital showed "pregnancy in the cervical canal". The patient was transferred to our hospital for treatment. Since the onset, diet and sleep are normal, and the stool is normal. In 2007, a cesarean section was performed in a local hospital. Specialist situation: vulva development is normal. The vagina is unobstructed, the cervix is smooth, the uterus is flat, 40+ days pregnant, soft, movable, no tenderness. There were no abnormalities in the bilateral appendage area. After admission, HCG was checked: 24863.00mIU/ml, and local injection of MTX40mg and mifepristone 50mgpobid was given under the guidance of B-ultrasound. 2014-09-13HCG: 29430.00mIU/ml, no abnormal liver function. On September 15, 2014, local injection of methotrexate 50 mg, mifepristone 50 mg pobid and the drug prepared in Example 2 was performed under the guidance of B-ultrasound. 2014-09-24 The patient reported less vaginal bleeding, no nausea, vomiting, abdominal pain, abdominal distension, eating and sleeping, and normal bowel movements. Re-examination of blood HCG8045mIU/ml, color Doppler ultrasound showed that after the treatment of cervical pregnancy, the blood flow signal around the hyperechoic mass below the internal os of the cervix was abundant, uterine effusion, and cysts in the right adnexal area. Continue to take mifepristone 50mgpobid and traditional Chinese medicine. 2014-10-05 review blood HCG1218mIU/ml. Color Doppler ultrasound: After conservative treatment of cervical pregnancy, there was a cystic solid mass above the internal os of the cervix, the size was 4.2x3.7x3.0cm, and there were dotted and striped blood flow signals in the periphery. Continue to take mifepristone 50mgpoqd and traditional Chinese medicine. 2014-10-10 Reexamination of blood HCG943.4mIU/ml, color Doppler ultrasound: After conservative treatment of pregnancy in the uterine scar, the uterine isthmus was distended, cystic solid mass, size 3.9x4.0x4.1cm, edge detection and blood flow signal. Then he was discharged from the hospital. After leaving the hospital, he continued to use mifepristone 50mgqd, and continued to take traditional Chinese medicine for outpatient observation.

Application Case 3 Tubal Pregnancy

Wang, female, 29 years old

First visit on March 22, 2013, ectopic pregnancy on February 24, 2013 (blood HCG 5650.3mIU/ml) underwent conservative treatment, MTX+mifepristone (25mg tid) and the drug treatment prepared in Example 5, blood HCG128.9mIU when discharged /ml, did not take mifepristone after discharge. Existing a small amount of vaginal bleeding, slight pain in the left lower abdomen, red tongue, white coating, slightly stringy pulse. Blood HCG200.3mIU/ml, B-ultrasound showed: mixed mass in the left adnexal area 8.0×7.9×5.6cm, ectopic pregnancy was considered. Diagnosis of ectopic pregnancy after conservative treatment. Give mifepristone 25mg tid for 6 days and the medicine prepared in Example 3. Advise to pay attention to vaginal bleeding and abdominal pain, and avoid strenuous activities, follow-up for discomfort.

On March 29, 2013, the follow-up consultation showed a small amount of vaginal bleeding and no abdominal pain. The B-ultrasound showed: a cystic and solid mass in the left adnexal area, with a size of about 7.4×6.1×5.9cm, with punctate blood flow signals at the edge. Blood HCG23.48mIU/ml. Continue to take the medicine.

The third examination on April 12, 2013 showed very little vaginal bleeding, no abdominal pain, red tongue, thin fur, and slippery pulse. Blood HCG2.82mIU/ml. B-ultrasound showed: the hypoechoic light group in the left accessory area, the size was about 5.2×4.1×3.8cm, and the intima was 1.1cm. Continue to take the medicine.

The fourth examination on April 26, 2013, lmp: 2013.4.21, now 6 days after menstruation, less menstruation, no abdominal pain. No vaginal bleeding, no abdominal pain, red tongue, thin fur, stringy and slippery pulse. B-ultrasound showed a hypoechoic light group in the left accessory area, with a size of about 2.2×2.1×1.8cm. Continue to take the medicine.

B-ultrasound on May 28, 2013: The strip-like hypoechoic area was probed above the left ovary, about 3.0cm long and 0.9cm wide, with a clear boundary. Prompt left adnexal zone hypoechoic, consider thickened fallopian tube.

Application Case 4 Cervical Pregnancy

Yu Mou, female, 29 years old

The patient was admitted to the hospital on May 12, 2015 because of "menorrhea for 3 months and a small amount of vaginal bleeding for 1+ months". Regular menstrual cycle, LMP: 2015-02-10. According to the self-report, since March 15, brown vaginal discharge with blood clots appeared, the amount was small, and no treatment was performed. On April 15th, I tested my pregnancy at home. On May 11th, I went to Yantai Yuhuangding Hospital. B-ultrasound showed: the volume of the uterine body was 5.7×5.9×5.0mm, the thickness of the endometrium was 1.4cm, and the volume of the cervix increased significantly. The visible range was about 10.8×8.2×6.4cm mass, the surrounding area almost reaches the serosa, the muscular layer is thin, and the residual cervix is not displayed. A gestational sac of 8.7×5.3cm can be seen inside, and its shape is still regular. A small fetal embryo can be seen inside. The length of head and hip is 6.7cm. The fetal heart beats regularly. The placenta is located on the upper edge of the gestational sac. The blood flow signal shows that the placental attachment muscle layer can be seen in a circular blood flow signal, and the echo between the muscle walls of the fundus of the uterus is still homogeneous, suggesting that it is consistent with cervical pregnancy, live birth, and single pregnancy (estimated gestational age 13W). The patient had no obvious abdominal pain, abdominal distension and nausea and vomiting. The diagnosis was "cervical pregnancy".

After admission, on May 13, 2015, blood was checked for β-HCG: 140472.00mIU/ml, progesterone: 39.07ng/ml, MTX100mg im, mifepristone 50mg po bid and the medicine prepared in Example 3 were given. On May 18, MTX75mg im, mifepristone 50mg po bid and the medicine prepared in Example 3 were continued to be used. On May 19th, progesterone: 16.26ng/ml, blood β-HCG: 44092.00mIU/ml, reexamination B-ultrasound showed increased cervical volume, 4.9×7.9×7.7cm, internal exploration and mixed mass, about 5.6 in size ×7.0×6.6cm, fuzzy boundary, a small amount of liquid dark area can be seen inside, the range is about 4.1×3.0×1.7cm, irregular in shape, poor internal sound transmission, surrounded by strong echo, and the boundary between strong echo and muscle layer is unclear. The muscle layer became thinner, the posterior wall was obvious, and the thickness of the thinnest part was about 0.2 cm. Mifepristone 25 mg po bid and the drug prepared in Example 3 were given. On May 20, the patient had no special discomfort, normal urine and stool, less vaginal bleeding, HCG and P levels were significantly lower than before, and was discharged from the hospital. After discharge, the patient continued to receive mifepristone 25 mg po bid and the drug prepared in Example 3. Serum β-hCG and B-ultrasound were checked once a week. On June 23, the blood β-HCG had dropped to 523.30mIU/ml. Mifepristone was stopped and only the medicine prepared in Example 3 was taken. By July 7, 2015, the blood β-HCG dropped to normal, and there was no obvious abnormality in the reexamination of gynecological B-ultrasound.

Application Case 5 Ectopic Pregnancy

Wang, female, 25 years old

The patient was admitted to the hospital on July 21, 2014 because of "51-day menopause and 3-day lower abdominal pain". B-ultrasound: Anterior uterus, endometrial thickness about 0.5cm, ovarian cyst on the left, size about 3.3*2.6cm, cystic solid mass in the left back of the uterus, size about 5.1*3.0*3.7cm. , Blood HCG: 970.400IU/mL. Gynecological examination: vulva development is normal, vagina is smooth, cervix Ⅰ° erosion, posterior fornix is not full, cervical lifting pain (+), swinging pain (-), uterus anterior, slightly larger, tenderness, thickening and tenderness in the left adnexal area, right There is no obvious abnormality in the accessory area. In November 2013, laparoscopic ligation was performed. Past menstrual regularity, moderate menstrual flow, no history of dysmenorrhea. Married at the age of 23, G3P2A0L2, 2 children born naturally, husband and children are in good health. After being admitted to the hospital, MTX75mg intramuscular injection, mifepristone 50mg bid and the drug prepared in this Example 3 were given orally. On July 25, blood β-HCG: 244.40mIU/ml, re-examination B-ultrasound showed: the uterus was flat in ultrasound, The size of the uterine body was normal, the echogenicity of the myometrium was uniform, the thickness of the endometrium was about 1.0cm, and the boundary was not clear. A solid cystic mass was detected in the left adnexal area. The size was about 8.4×5.6×4.0cm. The boundary was clear. A cystic area was found inside. The area was about 2.2×1.6cm. Close to the uterus, CDFI: its internal detection and blood flow signal. No abnormal echo was detected in the right accessory area. Ultrasound revealed a cystic-solid mass in the left adnexal region consistent with ectopic pregnancy. Change mifepristone to 25 mg bid and take the medicine prepared in Example 3 orally. Blood β-HCG showed on July 29: 159.20mIU/ml, only the medicine prepared in Example 3 was taken orally. Blood β-HCG on August 5: 95.34mIU/ml. Then he was discharged from the hospital and continued to take traditional Chinese medicine. After 2 weeks, the blood β-HCG was normal. After 4 weeks, there was no abnormality in the B-ultrasound examination.

The above is only a preferred embodiment of the present invention, it should be pointed out that for those of ordinary skill in the art, without departing from the method of the present invention, some improvements and supplements can also be made, and these improvements and supplements should also be considered Be the protection scope of the present invention.

Claims (5)

1. a kind of Chinese medicine composition by stasis of blood promoting blood circulation, Xiao Disorder dissipating binds, which is characterized in that be made of the bulk pharmaceutical chemicals of following parts by weight： 10~20 parts of trigone, 10~30 parts of curcuma zedoary, 15~20 parts of Pollen Typhae, 10~12 parts of myrrh, 10~12 parts of ground bettle, centipede 1~3 Part, 30~40 parts of motherwort, 9~15 parts of peach kernel, 9~15 parts of safflower, 9~12 parts of Rhizoma Chuanxiong, 12~15 parts of the radix paeoniae rubrathe, the root bark of tree peony 12~15 Part, 12~15 parts of Radix Angelicae Sinensis, 10~15 parts of radix cyathulae, 15~20 parts of Radix Salviae Miltiorrhizae, 9~12 parts of cassia twig, 12~15 parts of Poria cocos, Radix Rehmanniae 12~ 15 parts, 10~12 parts of rhizoma cyperi, 6~10 parts of rhubarb, 6~9 parts of pinellia, 15~20 parts of Sargent gloryvine, 6~9 parts of licorice.

2. as described in claim 1 by the Chinese medicine composition of stasis of blood promoting blood circulation, Xiao Disorder dissipating binds, which is characterized in that by following parts by weight Bulk pharmaceutical chemicals composition：20 parts of trigone, 30 parts of curcuma zedoary, 20 parts of Pollen Typhae, 12 parts of myrrh, 12 parts of ground bettle, 3 parts of centipede, motherwort 40 parts, 15 parts of peach kernel, 15 parts of safflower, 12 parts of Rhizoma Chuanxiong, 15 parts of the radix paeoniae rubrathe, 15 parts of the root bark of tree peony, 15 parts of Radix Angelicae Sinensis, 15 parts of radix cyathulae, Radix Salviae Miltiorrhizae 20 Part, 12 parts of cassia twig, 15 parts of Poria cocos, 15 parts of Radix Rehmanniae, 12 parts of rhizoma cyperi, 10 parts of rhubarb, 9 parts of pinellia, 20 parts of Sargent gloryvine, licorice 9 Part.

3. one kind is for treating ectopic pregnancy, Placenta acrreta and in utero remaining Chinese medicine preparation, which is characterized in that by claim Chinese medicine composition and auxiliary material described in 1 or 2 are made.

4. Chinese medicine preparation as claimed in claim 3, which is characterized in that it is decoction, capsule, tablet, granule or pill.

5. Chinese medicine composition described in claim 1 or 2 is preparing to treat ectopic pregnancy, Placenta acrreta and in utero remaining Application in drug.