目的 研究通心舒膠囊聯(lián)合尼可地爾片治療冠心病心絞痛的臨床療效。方法 選取2017年12月-2019年5月在華中阜外醫(yī)院治療的冠心病心絞痛患者92例為研究對(duì)象，將所有患者隨機(jī)分為對(duì)照組和治療組，每組各46例。對(duì)照組患者口服尼可地爾片，1片/次，3次/d；治療組在對(duì)照組治療的基礎(chǔ)上口服通心舒膠囊，2粒/次，3次/d。兩組患者均連續(xù)口服4周。觀察兩組的臨床療效和心電圖療效，比較兩組的臨床癥狀、心功能指標(biāo)、心肌酶指標(biāo)、血液流變學(xué)指標(biāo)。結(jié)果 治療后，對(duì)照組和治療組的臨床療效總有效率分別為78.26%、93.48%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，對(duì)照組和治療組的心電圖療效總有效率分別為80.43%、93.48%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組心絞痛持續(xù)時(shí)間、發(fā)作次數(shù)顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；并且治療組心絞痛持續(xù)時(shí)間、發(fā)作次數(shù)明顯低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者左室收縮末期內(nèi)徑（LVESD）、左室舒張末期內(nèi)徑（LVEDD）明顯降低，左室射血分?jǐn)?shù)（LVEF）明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者心功能指標(biāo)明顯優(yōu)于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者血清酸激酶MB型同工酶（CK-MB）、肌酸激酶（CK）水平顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組患者血清心肌酶指標(biāo)水平明顯低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者全血黏度（WBV）、血漿黏度（PV）、纖維蛋白原（FIB）水平均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；并且治療組患者血液流變學(xué)指標(biāo)水平明顯低于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 通心舒膠囊聯(lián)合尼可地爾片治療冠心病心絞痛具有較好的臨床療效，可改善臨床癥狀、心功能指標(biāo)、心肌酶指標(biāo)、血液流變學(xué)指標(biāo)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To study the clinical effect of Tongxinshu Capsules combined with Nicorandil Tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (92 cases) with angina pectoris of coronary heart disease in Fuwai Central China Cardiovascular Hospital from December 2017 to May 2019 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were po administered with Nicorandil Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Tongxinshu Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies and electrocardiographic efficacies were evaluated, and clinical symptoms, cardiac function indexes, myocardial enzyme indexes, and hemorheological indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.26% and 93.48%, respectively, and there was difference between two groups (P<0.05). After treatment, the electrocardiographic efficacies in the control and treatment groups were 80.43% and 93.48%, respectively, and there was difference between two groups (P<0.05). After treatment, the duration and frequency of angina pectoris in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the clinical symptoms in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, LVESD and LVEDD in two groups were significantly decreased, but LVEF in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the cardiac function 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 levels of CK-MB and CK in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the myocardial enzyme 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 WBV, PV, and FIB in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the hemorheological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tongxinshu Capsules combined with Nicorandil Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can improve clinical symptoms, cardiac function indexes, myocardial enzyme indexes, and hemorheological indexes, which has a certain clinical application value.

R972

河南省科技發(fā)展計(jì)劃項(xiàng)目（142102310132）