目的 觀察心悅膠囊聯(lián)合琥珀酸美托洛爾緩釋片治療冠心病心絞痛的臨床療效。方法 選取2018年4月—2021年2月鄭州大學(xué)第一附屬醫(yī)院收治的136例冠心病心絞痛患者作為觀察對(duì)象，根據(jù)隨機(jī)數(shù)字表法分為對(duì)照組（68例）和治療組（68例）。對(duì)照組口服琥珀酸美托洛爾緩釋片，1片/次，1次/d。治療組患者在對(duì)照組治療的基礎(chǔ)上口服心悅膠囊，2粒/次，3次/d。兩組治療療程均為4周。觀察兩組臨床療效、心電圖療效，比較兩組心絞痛癥狀、心功能指標(biāo)、心肌損傷指標(biāo)、血液流變學(xué)指標(biāo)。結(jié)果 治療后，治療組的臨床療效總有效率為94.12%，高于對(duì)照組的80.88%，治療組的心電圖療效總有效率為92.65%，高于對(duì)照組的76.47%，組間對(duì)比差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組心絞痛發(fā)作頻率降低、持續(xù)時(shí)間縮短（P<0.05），與對(duì)照組相比，治療后治療組心絞痛發(fā)作頻率降低、持續(xù)時(shí)間縮短更顯著（P<0.05）。治療后，兩組左心室射血分?jǐn)?shù)（LVEF）、心排血量（CO）較治療前升高（P<0.05），與對(duì)照組相比，治療后治療組的LVEF、CO升高更顯著（P<0.05）。治療后，兩組全血低切黏度、全血高切黏度、血漿黏度、纖維蛋白原較治療前降低（P<0.05）。與對(duì)照組相比，治療后治療組全血低切黏度、全血高切黏度、血漿黏度、纖維蛋白原降低更顯著（P<0.05）。治療后，兩組肌酸激酶同工酶（CK-MB）、心肌肌鈣蛋白I（cTnI）、腦鈉肽（BNP）水平較治療前降低（P<0.05），與對(duì)照組相比，治療后治療組CK-MB、cTnI、BNP水平降低更顯著（P<0.05）。結(jié)論 心悅膠囊聯(lián)合琥珀酸美托洛爾緩釋片治療冠心病心絞痛具有較好的臨床療效，能夠改善血液流變學(xué)、心功能，減輕心肌損傷，安全性好。

Objective To observe the therapeutic effect of Xinyue Capsules combined with Metoprolol Succinate Sustained-release Tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (136 cases) with angina pectoris of coronary heart disease in the First Affiliated Hospital of Zhengzhou University from January 2013 to February 2015 were randomly divided into the control group (68 cases) and the treatment group (68 cases). Patients in the control group were po administered with Metoprolol Succinate Sustained-release Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Xinyue 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 electrocardiogram efficacies were evaluated, and the symptoms of angina pectoris, the cardiac function indexes, the myocardial injury indexes, and the hemorheological indexes in two groups were compared. Results After treatment, the clinical effective rate in the treatment group was 94.12%, which was higher than 80.88% in the control group, and the electrocardiogram effective rate in the treatment group was 92.65%, which was higher than 76.47% in the control group, and there was significant difference between the groups (P < 0.05). After treatment, the attack frequency and duration of angina pectoris in two groups were decreased (P < 0.05). And compared with the control group, the attack frequency of angina pectoris was lower in the treatment group, and the duration of angina pectoris in the treatment group was significantly shortened (P< 0.05). After treatment, the LVEF and CO in two groups were higher than those before treatment (P < 0.05). And compared with the control group, the LVEF and CO in the treatment group increased more significantly after treatment (P < 0.05). After treatment, the whole blood low shear viscosity, whole blood high shear viscosity, plasma viscosity, and fibrinogen in two groups were lower than those before treatment (P < 0.05). And compared with the control group, the whole blood low shear viscosity, whole blood high shear viscosity, plasma viscosity, and fibrinogen in the treatment group decreased more significantly after treatment (P < 0.05). After treatment, the levels of CK-MB, cTnI, and BNP in two groups were lower than those before treatment (P < 0.05). And compared with the control group, the levels of CK-MB, cTnI, and BNP in the treatment group decreased more significantly after treatment (P < 0.05). Conclusion Xinyue Capsules combined with Metoprolol Succinate Sustained-release Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can improve hemorheology and cardiac function, reduce myocardial injury, with good safety.

R972

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201601082）