目的 探討冠心寧注射液聯(lián)合酒石酸美托洛爾片治療冠心病心絞痛的臨床療效。方法 選取2015年4月-2017年5月汝州市第一人民醫(yī)院收治的冠心病心絞痛患者110例，隨機(jī)分為對照組和治療組，每組各55例。對照組口服酒石酸美托洛爾片，初始劑量12.5 mg/次，2周后增至25 mg/次，2次/d。治療組在對照組基礎(chǔ)上靜脈滴注冠心寧注射液，20 mL加入到生理鹽水或5%葡萄糖250 mL中，1次/d。兩組患者均治療2個月。觀察兩組的臨床療效，比較兩組的血流動力學(xué)、血脂水平、生活質(zhì)量評分。結(jié)果 治療后，對照組和治療組的心絞痛改善率分別為78.2%、92.7%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，對照組和治療組的心電圖改善率分別為72.7%、89.1%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組全血高切黏度、全血低切黏度、血漿黏度、纖維蛋白原均顯著降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組總膽固醇（TC）、三酰甘油（TG）和低密度脂蛋白膽固醇（LDL-C）水平均顯著下降，而高密度脂蛋白膽固醇（HDL-C）水平顯著升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組軀體活動受限程度、心絞痛穩(wěn)定狀態(tài)、心絞痛發(fā)作情況、治療滿意程度和疾病認(rèn)知程度評分均顯著升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯高于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 冠心寧注射液聯(lián)合酒石酸美托洛爾片治療冠心病心絞痛具有較好的臨床療效，可調(diào)節(jié)血流動力學(xué)指標(biāo)和血脂水平，提高患者生活質(zhì)量，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the effect of Guanxinning Injection combined with Metoprolol Tartrate Tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (110 cases) with angina pectoris of coronary heart disease in Ruzhou First People's Hospital from April 2015 to May 2017 were randomly divided into control and treatment groups, and each group had 55 cases. Patients in the control group were po administered with Metoprolol Tartrate Tablets, starting dosage 12.5 mg/time, increased to 25 mg/time after treatment for 2 weeks, once daily. Patients in the treatment group were iv administered with Guanxinning Injection on the basis of the control group, 20 mL added into normal saline (or 5% glucose solution) 250 mL, once. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and hemodynamic, blood lipid level, quality of life score in two groups were compared. Results After treatment, the improvement rate of angina pectoris in the control and treatment groups were 78.2% and 92.7%, respectively, and there was difference between two groups (P<0.05). After treatment, the improvement rate of electrocardiogram in the control and treatment groups were 72.7% and 89.1%, respectively, and there was difference between two groups (P<0.05). After treatment, whole blood high shear viscosity, whole blood low shear viscosity, plasma viscosity, and fibrinogen in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TC, TC, and LDL-C in two groups were significantly decreased, but the levels of HDL-C in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the scores of physical activity restriction, angina pectoris stability, angina pectoris attack, treatment satisfaction, and angina pectoris awareness in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). Conclusion Guanxinning Injection combined with Metoprolol Tartrate Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can regulate hemodynamic indexes and blood lipid level, and increase quality of life, which has a certain clinical application value.