目的 探討丹參多酚酸鹽聯(lián)合尼可地爾治療冠心病心絞痛的臨床效果。方法 選取2016年1月-2017年12月北京市和平里醫(yī)院收治的146例冠心病心絞痛患者，隨機(jī)分為對(duì)照組和治療組，每組各73例。對(duì)照組口服尼可地爾片，5 mg/次，3次/d。治療組在對(duì)照組基礎(chǔ)上靜脈滴注注射用丹參多酚酸鹽，200 mg加入生理鹽水250 mL中充分稀釋后給藥，1次/d。兩組均連續(xù)治療2周。觀察兩組的臨床療效，比較兩組治療前后硝酸甘油用量、心絞痛發(fā)作次數(shù)、每次持續(xù)時(shí)間。比較兩組治療前后低密度脂蛋白膽固醇（LDL-C）、高密度脂蛋白膽固醇（HDL-C）、紅細(xì)胞比容（HCT）、紅細(xì)胞聚集指數(shù)（EAI）、肌鈣蛋白T（cTnT）、白細(xì)胞介素（IL）1β、IL-18、一氧化氮（NO）、超氧化物歧化酶（SOD）、西雅圖心絞痛量表（SAQ）各項(xiàng)評(píng)分的變化情況。結(jié)果 治療后，對(duì)照組和治療組患者的總有效率分別為82.19%、93.15%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者硝酸甘油用量較治療前明顯減少，心絞痛發(fā)作次數(shù)、每次持續(xù)時(shí)間均明顯減少，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組硝酸甘油用量、心絞痛發(fā)作次數(shù)、每次持續(xù)時(shí)間均明顯少于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組治療后LDL-C、HCT、EAI、cTnT、IL-1β、IL-18水平較治療前均顯著降低，但HDL-C、NO、SOD、SAQ評(píng)分升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組LDL-C、HCT、EAI、cTnT、IL-1β、IL-18水平顯著低于對(duì)照組，HDL-C、NO、SOD、SAQ評(píng)分高于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 丹參多酚酸鹽聯(lián)合尼可地爾治療冠心病心絞痛具有較好的臨床療效，可明顯改善患者胸悶、胸部絞痛、心電圖等癥狀體征，調(diào)節(jié)血脂代謝和血液流變學(xué)狀態(tài)，抑制炎癥反應(yīng)，調(diào)控氧化應(yīng)激，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of salvianolate combined with nicorandil in treatment of coronary heart disease with angina pectoris. Methods Patients (146 cases) with coronary heart disease with angina pectoris in Beijing Hepingli Hospital from January 2016 to December 2017 were randomly divided into control (73 cases) and treatment (73 cases) groups. Patients in the control group were po administered with Nicorandil Tablets, 5 mg/time, three times daily. Patients in the treatment group were iv administered with Salvianolate for injection on the basis of the control group, 200 mg added to normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the changes of nitroglycerin amount, angina attacks frequency and duration in two groups before and after treatment were compared. The changes of LDL-C, HDL-C, HCT, EAI, cTnT, IL-1β, IL-18, NO, SOD, SAQ score in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 82.19% and 93.15%, respectively, and there was difference between two groups (P < 0.05). After treatment, the nitroglycerin amount, angina attacks frequency and duration in the two groups were significantly reduced, and the difference was statistically significant in the same group (P < 0.05). After treatment, the nitroglycerin amount, angina attacks frequency and duration in the treatment group were lower than those in the treatment group, and there was difference between two groups (P < 0.05). After treatment, LDL-C, HCT, EAI, cTnT, IL-1β, and IL-18 in two groups significantly reduced, but HDL-C, NO, SOD, and SAQ scores significantly increased, and the difference was statistically significant in the same group (P < 0.05). After treatment, LDL-C, HCT, EAI, cTnT, IL-1β, and IL-18 in the treatment group were higher than those in the control group, but HDL-C, NO, SOD, and SAQ scores were lower than those in the control group, and there was difference between two groups (P < 0.05). Conclusions Salvianolate combined with nicorandil has remarkable clinical effect in treatment of coronary heart disease with angina pectoris, and can obviously improve the symptoms such as chest tightness, chest colic and electrocardiogram, and regulate blood lipid metabolism and hemorheology, also can inhibit inflammatory response and regulate oxidative stress, which has a certain clinical application value.