目的 探討麝香通心滴丸聯(lián)合鹽酸伊伐布雷定片治療老年穩(wěn)定型心絞痛的臨床療效。方法 選擇2020年3月—2021年3月在鄭州市第九人民醫(yī)院治療的104例穩(wěn)定型心絞痛老年患者，根據(jù)用藥的差別分為對(duì)照組和治療組，每組各52例。對(duì)照組口服鹽酸伊伐布雷定片，5 mg/次，2次/d；治療2周后，若靜息心率持續(xù)＞60次/min，7.5 mg/次，2次/d；若靜息心率持續(xù)＜50次/min，每次2.5 mg，2次/d；若心率在50~60次/min，維持每次5 mg，2次/d。治療組在對(duì)照組基礎(chǔ)上口服麝香通心滴丸，2丸/次，3次/d。兩組患者均治療8周。觀察兩組患者臨床和心電圖療效，比較治療前后兩組患者血管內(nèi)皮功能，SAQ、GSES和Duke評(píng)分及左室射血分?jǐn)?shù)（LVEF）水平。結(jié)果 經(jīng)治療，對(duì)照組和治療組療效總有效率分別為82.69%、98.08%（P＜0.05）。經(jīng)治療，對(duì)照組和治療組在心電圖療效總有效率分別為84.62%、98.08%（P＜0.05）。治療后，兩組內(nèi)皮素-1（ET-1）和血管性血友病因子（vWF）水平明顯降低，而血管內(nèi)皮生長(zhǎng)因子（VEGF）和一氧化氮（NO）水平明顯升高（P＜0.05），且治療組血管內(nèi)皮功能明顯好于對(duì)照組（P＜0.05）。治療后，兩組患者SAQ、GSES和Duke評(píng)分均顯著上升，LVEF水平明顯升高（P＜0.05），且治療組患者量表積分和LVEF明顯高于對(duì)照組（P＜0.05）。結(jié)論 麝香通心滴丸聯(lián)合鹽酸伊伐布雷定片治療老年穩(wěn)定型心絞痛可有效改善患者血管內(nèi)皮功能，改善心肌缺血程度，提高左室射血分?jǐn)?shù)。

Objective To investigate the effect of Shexiang Tongxin Dropping Pills combined with ivabradine hydrochloride in treatment of elderly stable angina pectoris.Methods Patients (104 cases) with stable angina pectoris in Ninth People's Hospital of Zhengzhou from March 2020 to March 2021 were divided into control and treatment group based on different treatments, and each group had 52 cases. Patients in the control group were po administered with Ivabradine Hydrochloride Tablets, 5 mg/time, twice daily, if resting heart rate continues more than 60 times/min after 2 weeks, 7.5 mg/time, twice daily, if resting heart rate continues less than 50 times/min, 2.5 mg/time, twice daily, if the heart rate was 50 — 60 times/min, maintain 5 mg/time, twice daily. Patients in the treatment group were po administered with Shexiang Tongxin Dropping Pills on the basis of the control group, 2 pills/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical and ECG evaluation were evaluated, the endothelial function, the scores of SAQ, GSES, and Duke and the levels of LVEF in two groups before and after treatment were compared.Results After treatment, the clinical effective rates of the control group and the treatment group were 82.69% and 98.08%, respectively (P < 0.05). After treatment, the ECG effective rates of the control group and the treatment group were 84.62% and 98.08%, respectively (P < 0.05). After treatment, the levels of serum ET-1 and vWF were significantly decreased, while the levels of VEGF and NO were significantly increased in two groups (P < 0.05), and the vascular endothelial function in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the scores of SAQ, GSES, and Duke and the level of LVEF in two groups were significantly increased, and the scores and LVEF in the treatment group were significantly higher than those in the control group (P < 0.05).Conclusion Shexiang Tongxin Dropping Pills combined with ivabradine in treatment of elderly stable angina pectoris can effectively improve the vascular endothelial function, improve the degree of myocardial ischemia and increase the left ventricular ejection fraction.

R972

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（201702333）