目的 探討鹽酸伊伐布雷定片聯(lián)合酒石酸美托洛爾片治療穩(wěn)定型心絞痛的臨床療效。方法 選取2019年9月—2020年4月天津市第二醫(yī)院收治的84例穩(wěn)定型心絞痛患者為研究對(duì)象。所有患者均口服酒石酸美托洛爾片，25 mg/次，2次/d。治療4周后靜息心率<70次/min的患者為對(duì)照組（34例），對(duì)照組繼續(xù)口服酒石酸美托洛爾片，25 mg/次，2次/d。靜息心率≥70次/min的患者繼續(xù)口服上述劑量酒石酸美托洛爾片的基礎(chǔ)上口服鹽酸伊伐布雷定片，5 mg/次，2次/d，根據(jù)患者心率變化調(diào)整用藥量，最大耐受度7.5 mg/次，2次/d。治療12周后心率<70次/min的患者為治療組（38例）。兩組患者均連續(xù)治療12周。觀察兩組的臨床療效，比較兩組靜息和最大運(yùn)動(dòng)量時(shí)心率、心絞痛發(fā)作情況和生活質(zhì)量評(píng)分。結(jié)果 治療后，治療組總有效率為92.11%，高于對(duì)照組的79.41%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組靜息心率、最大運(yùn)動(dòng)量時(shí)心率均較治療前明顯降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；治療后，治療組最大運(yùn)動(dòng)量時(shí)心率較對(duì)照組降低更顯著，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者發(fā)作頻率、持續(xù)時(shí)間、硝酸甘油消耗量均較治療前顯著下降，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組發(fā)作頻率、持續(xù)時(shí)間、硝酸甘油消耗量較對(duì)照組下降更顯著，差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組西雅圖心絞痛量表（SAQ）中各維度評(píng)分較治療前均顯著升高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組SAQ中除對(duì)疾病的認(rèn)識(shí)外，其他各維度評(píng)分均顯著高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 鹽酸伊伐布雷定片聯(lián)合酒石酸美托洛爾片治療穩(wěn)定型心絞痛療效良好，可能明顯降低患者的心率，改善患者的心絞痛發(fā)作情況，保護(hù)心臟功能，提高患者的生活質(zhì)量。

Objective To explore the clinical effect of Ivabradine Hydrochloride Tablets combined with Metoprolol Tartrate Tablets in treatment of stable angina pectoris. Methods Patients (84 cases) with stable angina pectoris in Tianjin Second Hospital from September 2019 to April 2020 were selected as research subjects. All patients were treated with Metoprolol Tartrate Tablets, 25 mg/time, twice daily. After 4 weeks of treatment, patients with resting heart rate less than 70 times/min were selected as the control group (34 cases). Patients with resting heart rate ≥ 70 times/min were po administered with Ivabradine Hydrochloride Tablets on the basis of the control group, 5 mg/time, twice daily, adjusted the dosage according to the change of heart rate, and the maximum tolerance could be given 7.5 mg/time, twice a day. Patients whose heart rates were less than 70 times/min after 12 weeks of treatment were selected as treatment group (38 cases). Patients in the control group were po administered with Metoprolol Tartrate Tablets, 25 mg/time, twice daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and resting heart rate and maximal exercise rate, the attack of angina pectoris, and quality of life score in two groups were compared. Results After treatment, the total effective rate of the treatment group was 92.11%, which was higher than 79.41% of the control group, and the difference was statistically significant (P<0.05). After treatment, the resting heart rate and maximum exercise heart rate of two groups were significantly lower than before treatment, and the difference was statistically significant (P<0.05). After treatment, the maximum exercise heart rate of the treatment group was significantly lower than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the frequency, duration and nitroglycerin consumption of angina pectoris in two groups were significantly lower than those before treatment (P<0.05), and the frequency, duration and nitroglycerin consumption of the treatment group were significantly lower than those of the control group (P<0.05). After treatment, the scores of each dimension in SAQ of two groups were significantly higher than those before treatment (P<0.05), and the scores of other dimensions in SAQ of the treatment group were significantly higher than those of the control group (P<0.05). Conclusion Ivabradine Hydrochloride Tablets combined with Metoprolol Tartrate Tablets has good effect in the treatment of stable angina pectoris, can significantly reduce the heart rate of patients, improve the attack of angina pectoris, protect the heart function and improve the quality of life of patients.

R972