目的 探討通心絡(luò)膠囊聯(lián)合替格瑞洛片治療非ST段抬高型急性冠脈綜合征的臨床療效。方法 選擇2016年1月-2017年1月在青海省心腦血管病?？漆t(yī)院收治的非ST段抬高型急性冠脈綜合征患者106例作為研究對象，采用隨機(jī)數(shù)字表法將所有患者分為對照組和治療組，每組各53例。對照組口服替格瑞洛片，首次劑量2片，此后1片/次，2次/d。治療組在此基礎(chǔ)上口服通心絡(luò)膠囊，4粒/次，3次/d。兩組患者均連續(xù)治療2個月。觀察兩組的臨床療效，比較兩組的癥狀緩解情況、炎性因子、心肌酶譜指標(biāo)、左心功能參數(shù)、主要不良心血管事件（MACE）。結(jié)果 治療后，對照組和治療組的總有效率分別為75.5%、92.5%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組硝酸甘油用量、心絞痛發(fā)作頻率、心絞痛發(fā)作持續(xù)時間均顯著下降，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組超敏C反應(yīng)蛋白（hs-CRP）、腫瘤抑制因子-α（TNF-α）、白細(xì)胞介素-6（IL-6）、白細(xì)胞介素-8（IL-8）水平均顯著下降，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組肌酸激酶（CK）、氨基末端腦鈉肽前體（NT-proBNP）、肌酸磷酸激酶同工酶（CK-MB）和肌鈣蛋白T（cTnT）水平均顯著降低，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組左心房內(nèi)徑（LADD）、左心室舒張末內(nèi)徑（LVEDD）、左心室收縮末內(nèi)徑（LVESD）明顯降低，左心室射血分?jǐn)?shù)（LVEF）明顯增高，同組治療前后比較差異具有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的改善程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，對照組和治療組的MACE發(fā)生率分別為13.2%、3.8%，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 通心絡(luò)膠囊聯(lián)合替格瑞洛片治療非ST段抬高型急性冠脈綜合征具有較好的臨床療效，可改善臨床癥狀，調(diào)節(jié)炎性因子和心肌酶譜指標(biāo)水平，降低MACE發(fā)生率，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical efficacy of Tongxinluo Capsules combined with Ticagrelor Tablets in treatment of non-ST segment elevation acute coronary syndrome. Methods Patients (106 cases) with non-ST segment elevation acute coronary syndrome in Qinghai Cardio Cerebrovascular Disease Specialist Hospital from January 2016 to February 2017 were randomly divided into control and treatment groups, and each group had 53 cases. Patients in the control group were po administered with Ticagrelor Tablets, 2 tablets for the first time, then 1 tablet/time, twice daily. Patients in the treatment group were po administered with Tongxinluo Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies were evaluated, and symptomatic remission, inflammatory factors, myocardial enzyme spectrum indexes, left ventricular function parameters, and MACE in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 75.5% and 92.5%, respectively, and there was difference between two groups (P < 0.05). After treatment, the levels of hs-CRP, TNF-α, IL-6, and IL-8 in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of CK, NT-proBNP, CK-MB, and cTnT in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, LADD, LVEDD, and LVESD in two groups were significantly decreased, but the LVEF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the incidence of MACE in the control and treatment groups were 13.2% and 3.8%, respectively, and there was difference between two groups (P < 0.05). Conclusion Tongxinluo Capsules combined with Ticagrelor Tablets has clinical curative effect in treatment of non-ST segment elevation acute coronary syndrome, can improve clinical symptoms, regulate the levels of inflammatory factor and myocardial enzyme spectrum index, decrease the incidence of MACE, which has a certain clinical application value.