目的 探討燈盞生脈膠囊聯(lián)合尼可地爾片治療冠心病心絞痛的臨床療效。方法 選取2020年1月—2021年3月平煤神馬醫(yī)療集團總醫(yī)院治療的124例冠心病心絞痛患者為研究對象，按照隨機數(shù)字方法分為對照組（62例）和治療組（62例）。對照組患者口服尼可地爾片，5 mg/次，3次/d。治療組患者在對照組基礎(chǔ)上口服燈盞生脈膠囊，2粒/次，3次/d。兩組患者均連續(xù)治療14 d。觀察對比兩組患者的臨床療效、心電圖療效、心絞痛發(fā)作次數(shù)及持續(xù)時間。同時比較兩組治療前后SF-36量表評分、基質(zhì)金屬蛋白酶相關(guān)指標(biāo)、炎性因子水平、氧化應(yīng)激指標(biāo)的變化情況。結(jié)果 治療后，治療組總有效率是95.16%，顯著高于對照組的79.03%（P<0.05）。治療后，治療組心電圖療效總有效率是95.16%，顯著高于對照組的80.65%（P<0.05）。治療后，兩組心絞痛發(fā)作次數(shù)及心絞痛持續(xù)時間均顯著降低（P<0.05），且治療后治療組心絞痛發(fā)作情況改善優(yōu)于對照組（P<0.05）。治療后兩組SF-36量表評分均升高（P<0.05）；治療后治療組SF-36量表評分高于對照組（P<0.05）。治療后，兩組患者白細(xì)胞介素-18（IL-18）、腫瘤壞死因子（TNF-α）、可溶性細(xì)胞間黏附分子（sICAM-1）均較治療前顯著降低（P<0.05）；治療后，治療組炎癥因子水平低于對照組（P<0.05）。治療后，兩組超氧化物歧化酶（SOD）均較治療前顯著升高，但脂質(zhì)過氧化物（LPO）、丙二醛（MDA）均降低（P<0.05）；治療后，治療組SOD水平較對照組升高，LPO、MDA水平較對照組降低（P<0.05）。治療后，兩組基質(zhì)金屬蛋白酶抑制因子1（TIMP-1）均有所升高，但基質(zhì)金屬蛋白酶-9（MMP-9）有所降低（P<0.05）；治療后，治療組TIMP-1水平高于對照組，但MMP-9水平低于對照組（P<0.05）。結(jié)論 燈盞生脈膠囊聯(lián)合尼可地爾片治療可以提高冠心病心絞痛患者臨床療效，有效改善患者心絞痛發(fā)作次數(shù)及心絞痛持續(xù)時間，提高日常生活質(zhì)量，改善炎性反應(yīng)、氧化應(yīng)激反應(yīng)，值得臨床廣泛應(yīng)用。

Objective To investigate the clinical effect of Dengzhan Shengmai Capsules combined with nicorandil in treatment of coronary heart disease angina pectoris. Methods A total of 124 patients with coronary heart disease angina pectoris admitted to General Hospital of Pingmei Shenma Medical Group were selected as the research objects from January 2020 to March 2021, and divided into control group (62 cases) and treatment group (62 cases) according to the random number method. Patients in the control group were po administered with Nicorandil Tablets, 5 mg/time, three times daily. Patients in the treatment group were po administered with Dengzhan Shengmai Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 14 d. After treatment, clinical efficacy, ECG efficacy, angina attack frequency and duration were observed and compared between the two groups. Meanwhile, SF-36 scale score, matrix metalloproteinase-related indexes, inflammatory factor levels and oxidative stress indexes of the two groups were compared before and after treatment. Results After treatment, the total effective rate of treatment group was 95.16%, significantly higher than 79.03% of control group (P<0.05). After treatment, the total effective rate of ECG in the treatment group was 95.16%, significantly higher than 80.65% in the control group (P<0.05). After treatment, the number of angina attacks and duration of angina pectoris in both groups were significantly decreased (P<0.05), and the improvement of angina pectoris attacks in the treatment group was better than that in the control group (P<0.05). After treatment, the SF-36 score in both groups increased (P<0.05). After treatment, the SF-36 score of the treatment group was higher than that of the control group (P<0.05). After treatment, IL-18, TNF-α, and sICAM-1 in two groups were significantly decreased before treatment (P<0.05). After treatment, the level of inflammatory factors in the treatment group was lower than that in the control group (P<0.05). After treatment, SOD in both groups was significantly increased compared with before treatment, but LPO and MDA were decreased (P<0.05). After treatment, SOD level in the treatment group was higher than that in the control group, while LPO and MDA levels were lower than that in the control group (P<0.05). After treatment, TIMP-1 was increased in both groups, but MMP9 was decreased (P<0.05). After treatment, TIMP-1 level in the treatment group was higher than that in the control group, but MMP9 level was lower than that in the control group (P<0.05). Conclusions Dengzhan Shengmai Capsules combined with Nicorandil Tablets can improve the clinical efficacy of patients with angina pectoris of coronary heart disease, and can effectively improve the frequency and duration of angina pectoris, improve the quality of daily life, and improve the inflammatory response and oxidative stress response, which is worthy of widespread clinical application.

R972