目的 觀察心可寧膠囊聯(lián)合氯吡格雷治療不穩(wěn)定型心絞痛的臨床療效。方法 選取2020年9月—2023年9月北京中醫(yī)藥大學(xué)孫思邈醫(yī)院收治的100例不穩(wěn)定型心絞痛患者，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各50例。對(duì)照組口服硫酸氫氯吡格雷片，2片/次，1次/d。治療組在對(duì)照組基礎(chǔ)上口服心可寧膠囊，2粒/次，3次/d。兩組均連續(xù)治療6周。觀察兩組的臨床療效，比較兩組治療前后心絞痛發(fā)作的持續(xù)時(shí)間、次數(shù)，在花生四烯酸（AA）、二磷酸腺苷（ADP）誘導(dǎo)下血小板聚集率，血清超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-6（IL-6）、同型半胱氨酸（Hcy）、血管內(nèi)皮生長(zhǎng)因子（VEGF）、內(nèi)皮縮血管肽-1（ET-1）水平。結(jié)果 治療后，治療組總有效率是94.0%，顯著高于對(duì)照組的78.0%（P＜0.05）。治療后，兩組心絞痛發(fā)作的持續(xù)時(shí)間、次數(shù)均顯著降低（P＜0.05）；治療后治療組心絞痛持續(xù)時(shí)間、次數(shù)低于對(duì)照組（P＜0.05）。治療后，兩組AA、ADP誘導(dǎo)下的血小板聚集率均較治療前顯著降低（P＜0.05）；治療后，治療組血小板聚集率低于對(duì)照組（P＜0.05）。治療后，兩組hs-CRP、IL-6、Hcy、ET-1水平均較治療前降低，而VEGF水平升高（P＜0.05）；治療后，治療組血清因子指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。結(jié)論 心可寧膠囊聯(lián)合氯吡格雷對(duì)不穩(wěn)定型心絞痛的治療效果較好，能夠緩解臨床癥狀，抑制血小板聚集，降低炎性因子水平，改善血管內(nèi)皮功能，且安全性較好。

Objective To investigate the clinical efficacy of Xinkening Capsules combined with clopidogrel in treatment of unstable angina pectoris. Methods A total of 100 patients with unstable angina pectoris treated in Sun Simiao Hospital of Beijing University of Chinese Medicine from September 2020 to September 2023 were selected and divided into control group and treatment group according to random number table method, with 50 cases in each group. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 2 tablets/time, once daily. Patients in the treatment group were po administered with Xinkening Capsules on the basis of the control group, 2 grains/time, three times daily. Both groups were treated continuously for 6 weeks. The clinical efficacy of the two groups were observed, and the duration and frequency of angina pectoris attacks before and after treatment, and the platelet aggregation rate induced by arachidonic acid (AA) and adenosine diphosphate (ADP) between the two groups, serum levels of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), homocysteine (Hcy), vascular endothelial growth factor (VEGF), and endothelial vasoconstricting peptide-1 (ET-1) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 94.0%, which was significantly higher than that of the control group (78.0%, P < 0.05). After treatment, the duration and frequency of angina pectoris attacks in both groups were significantly decreased (P < 0.05). After treatment, the duration and frequency of angina pectoris in the treatment group were lower than those in the control group (P < 0.05). After treatment, the platelet aggregation rate induced by AA and ADP was significantly decreased in both groups compared with that before treatment (P < 0.05). After treatment, the platelet aggregation rate in treatment group was lower than that in control group (P < 0.05). After treatment, the levels of hs-CRP, IL-6, Hcy and ET-1 in both groups were decreased compared with before treatment, but the levels of VEGF were increased (P < 0.05). After treatment, the improvement of serum factor index in treatment group was better than that in control group (P < 0.05). Conclusion Xinkening Capsules combined with clopidogrel has good effect in treatment of unstable angina pectoris, and can alleviate clinical symptoms, inhibit platelet aggregation, reduce inflammatory factors, which can improve vascular endothelial function with good safety.

R972

陜西省中醫(yī)藥科研項(xiàng)目(JCPT054)