目的 探討紫丹活血片聯(lián)合硝苯地平治療血管痙攣性心絞痛的臨床療效。方法 選擇2019年6月—2021年6月開封市中心醫(yī)院收治的180例血管痙攣性心絞痛患者，隨機分為對照組和治療組，每組各90例。對照組口服硝苯地平片，10 mg/次，3次/d。治療組在對照組的基礎上口服紫丹活血片，100 mg/次，3次/d。兩組連續(xù)治療15 d。觀察兩組患者臨床療效，比較治療前后兩組患者癥狀緩解時間，心絞痛發(fā)作次數(shù)和持續(xù)時間，血清因子白細胞介素-6（IL-6）、腫瘤壞死因子-α（TNF-α）、基質(zhì)金屬蛋白酶-9（MMP-9）和C反應蛋白（CRP）水平，及不良反應情況。結果 治療后，治療組臨床有效率為98.89%，明顯高于對照組的87.78%（P<0.05）。治療后，治療組癥狀緩解時間均明顯早于對照組（P<0.05）。治療后，兩組心絞痛發(fā)作次數(shù)、持續(xù)時間均明顯降低（P<0.05），且治療組明顯低于對照組（P<0.05）。治療后，兩組血清因子IL-6、TNF-α和CRP水平明顯下降，而MMP-9水平明顯升高（P<0.05），且治療后治療組血清因子水平明顯好于對照組（P<0.05）。治療組不良反應發(fā)生率明顯低于對照組（5.56%vs 12.22%，P<0.05）。結論 紫丹活血片與硝苯地平聯(lián)合治療血管痙攣性心絞痛，明顯提高臨床療效，癥狀得以有效改善，對心絞痛發(fā)作頻次及血管炎性反應都有效降低。

Objective To explore the clinical effect of Zidan Huoxue Tablets combined with nifedipine in treatment of vasospasm angina pectoris. Methods Patients (180 cases) with vasospasm angina pectoris in Kaifeng Central Hospital from June 2019 to June 2021 were randomly divided into control and treatment group, and each group had 90 cases. Patients in the control group were po administered with Nifedipine Tablets, 10 mg/time, three times daily. Patients in the treatment group were po administered with Zidan Huoxue Tablets on the basis of the control group, 100 mg/time, three times daily. Patients in two groups were treated for 15 d. After treatment, the clinical evaluation was evaluated, the improvement time of symptom, the frequency and duration of angina pectoris, the levels of serum IL-6, TNF-α, MMP-9, and CRP and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 98.89%, which was significantly higher than 87.78% of the control group (P < 0.05). After treatment, the relief time of symptom in the treatment group was significantly earlier than that in the control group (P < 0.05). After treatment, the frequency and duration of angina pectoris in two groups were significantly decreased (P< 0.05), and which in the treatment group was significantly lower than that in the control group (P < 0.05). After treatment, the levels of serum factors IL-6, TNF-α and CRP in the two groups were significantly decreased, while the level of MMP-9 were significantly increased (P < 0.05), and the level of serum factors in the treatment group was significantly better than that in the control group (P < 0.05). The adverse reaction rate in the treatment group was significantly lower than that in the control group (5.56% vs 12.22%, P < 0.05). Conclusion The combined treatment of Zidan Huoxue Tablets and nifedipine can enhances the efficacy, improves the symptoms, and effectively reduces the frequency of angina pectoris and vasculitis.

R972

河南省醫(yī)學科技攻關計劃項目（LHGJ20191170）