The Researches On The Relation Between The Risk Factors Plus Illness-condition Related Factors With The Principal Syndrome Types Of Chinese Medicine In Tubal Pregnancy

Objective:This paper aims to explore the relation between the risk factors plus illness-condition related factors with the principal syndrome types of Chinese medicine in tubal pregnancy (TP), which is the Fetal Blockage (FB) Type, the Vital Qi Deficiency with Blood-Stasis (VQDBS) Type and the Collapse of Qi and Blood (CQB) Type. It also searches for the related factors that induce the rupture of TP and the crisis of the collapse of Qi and blood in the ruptured period, for the further improvement in the prognostic system of TP.Method:Through collecting the data of TP in-patients from the First Affiliated Hospital, of Guangzhou University of Chinese Medicine, the constituent ratios of the risk factors and means of the illness-condition related factors of TP were obtained. Chi-square test and t test were respectively adopted to examine the significance of the discrepancies in the constituent ratios and means, so as to explore the relation between the risk factors plus illness-condition related factors with the principal syndrome types of Chinese medicine in TP. Furthermore, with the results of the chi-square and t tests being utilized, Logistic regression was applied to find out the related factors relevant to the rupture of TP and the crisis of the collapse of Qi and blood in the ruptured period.Result:1. Risk Factors:(1) History of Childbearing:The proportion in CQB group was 52.4%, in FB group 37.3%, and in VQDBS group 37.4%. Comparing CQB group with the other two groups, the differences were statistically significant (P<0.05). There was no statistical significance in the discrepancy between FB group and VQDBS group (P>0.05).(2) History of Abortion:The proportion in CQB group was 69.3%, in FB group and VQDBS group were 59.8% and 56.4%. Comparing CQB group with the other two groups, the differences were statistically significant (P<0.05). There was no statistical significance in the discrepancy between FB group and VQDBS group (P>0.05).(3) History of Ectopic Pregnancy:The proportion in CQB group was 7.9%, in FB group 14.0%, and in VQDBS group 13.7%. Comparing CQB group with the other two groups, the differences were statistically significant (P≤.05). There was no statistical significance in the discrepancy between FB group and VQDBS group (P>0.05).(4) History of Pelvic Inflammatory Disease (PID):The proportion in FB group was 22.2%, in VQDBS group 30.8%, and in CQB group 27.3%. Comparing FB group with VQDBS group, the difference was statistically significant (P＜0.05). There was no statistical significance in the discrepancies between CQB group and the other two groups (P>0.05).(5) Using Intrauterine Device (IUD):The proportion in FB group was 6.9%, in VQDBS group 3.8%, and in CQB group 9.0%. Comparing CQB group with VQDBS group, the difference was statistically significant (P＜0.05). There was no statistical significance in the discrepancies between FB group and the other two groups (P>0.05).(6) History of Pelvic Surgery:The proportion in FB group was 12.4%, in VQDBS group 12.3%, and in CQB group 11.6%. None of the differences among the three groups was statistically significant (P>0.05).2. Illness-condition Related Factors:(1) Age:The mean of CQB group was 29.76 years old, that of FB group 29.03 years old, and of VQDBS group 27.89 years old. Comparing VQDBS group with the other two groups, the differences were statistically significant (P＜0.05). There was no statistical significance in the discrepancy between FB group and CQB group (P>0.05).(2) Menopausal Period:.The mean of FB group was 49.42 days, that of VQDBS group 47.58 days, and of CQB group 46.82 days. Comparing FB group with CQB group, the difference was statistically significant (P＜0.05).There was no statistical significance in the discrepancies between VQDBS group and the other two groups (P>0.05).(3) Serumβ-HCG Level:The mean of CQB group was 7588.1IU/L, that of FB group 6217.4IU/L, and of VQDBS group 3656.8IU/L. Comparing VQDBS group with CQB group, the difference was statistically significant (P＜0.01). There was no statistical significance in the discrepancies between FB group and the other two groups (P>0.05).(4) Serum Progesterone Level:The mean of FB group was 24.89nmol/L, that of VQDBS group 30.02nmol/L and of CQB group 22.29nmol/L. None of the differences among the three groups was statistically significant (P>0.05).(5) Maximum Diameter of Gestational Mass (Type-B Ultrasonic Measured):The mean of FB group was 3.39cm, that of VQDBS group 4.27cm, and of CQB group 4.60cm. Comparing FB group with the other two groups, the differences were statistically significant (P＜0.001). There was no statistical significance in the discrepancy between VQDBS group and CQB group (P>0.05).3. Logistic Regression:(1) Rupture Related Factors of TP:Compared with the unruptured group (the control group), differences in maximum diameter of gestational mass (type-B ultrasonic measured), childbearing history and menopausal period were statistically significant, indicating that these three factors are responsible for the rupture of TP. The regression coefficients of maximum diameter of gestational mass (type-B ultrasonic measured) and childbearing history were positive; that of menopausal period was negative. Differences in other factors showed no statistical significance (P>0.05).(2) Collapse of Qi and Blood Crisis Related Factors of the Ruptured Period in TP: Compared with VQDBS group of the ruptured period (the control group), differences in ectopic pregnancy history, age(≥28 years old) and serumβ-HCG level were statistically significant, indicating that these three factors are relevant to the crisis of the collapse of Qi and blood in the ruptured period of TP. The regression coefficients of age(≥28 years old) and serumβ-HCG level were positive; that of ectopic pregnancy history was negative. Differences in other factors showed no statistical significance (P>0.05).Conclusions:1. The constituent ratios of the five risk factors of TP-history of childbearing, abortion, ectopic pregnancy, PID and the using of IUD, differed among the FB, VQDBS, and CQB type-the three principal syndrome types of TP, which indicated that, all being the risk factors of TP, these five can possibly form diverse pathological consequences in the illness.2. Age, menopausal period, serumβ-HCG level, and maximum diameter of gestational mass(type-B ultrasonic measured), these four illness-condition related factors possessed varied means among the three major syndrome types, revealing that different levels of these four factors can indicate discrepant pathological endings in TP.3. The rupture of TP was correlated positively with maximum diameter of gestational mass (type-B ultrasonic measured) and childbearing history, but negatively with the menopausal period.4. The crisis of the collapse of Qi and blood in the ruptured period was correlated positively with age(≥28 years old) and serumβ-HCG level, but negatively with ectopic pregnancy history.