目的 探討三味檀香膠囊聯(lián)合阿替洛爾治療心絞痛的臨床療效。方法 2018年4月-2019年4月在武漢大學(xué)人民醫(yī)院進(jìn)行治療的94例心絞痛患者，根據(jù)用藥差異分成對照組和治療組，每組各47例。對照組患者口服阿替洛爾片，起始12.5 mg/次，2次/d，根據(jù)需要及耐受量可增至50 mg/次，2次/d。治療組患者在對照組基礎(chǔ)上口服三味檀香膠囊，0.6 g/次，3次/d。兩組均經(jīng)4周治療后進(jìn)行效果比較。觀察兩組的臨床療效，比較兩組治療前后臨床癥狀改善時間、相關(guān)評分、血液流變學(xué)指標(biāo)和血清學(xué)指標(biāo)的變化情況。結(jié)果 治療后，對照組和治療組臨床有效率分別為80.85%和95.74%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組心絞痛發(fā)作次數(shù)顯著降低，持續(xù)時間顯著縮短，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組患者心絞痛發(fā)作次數(shù)顯著低于對照組，持續(xù)時間顯著短于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組SF-36量表積分、SAQ積分均顯著增高，而臨床癥狀積分均顯著降低（P<0.05）；治療后，治療組SF-36量表積分、SAQ積分顯著高于對照組，而臨床癥狀積分顯著低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組全血黏度（WBV）、血漿黏度（PV）、纖維蛋白原（FIB）和血小板黏附率（PAR）水平均降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組這些血液流變學(xué)指標(biāo)顯著低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組血清脂蛋白磷脂酶A2（Lp-PLA2）、重組人可溶性CD40配體（sCD40L）、S100鈣結(jié)合蛋白A12（S100A12）、髓過氧化物酶（MPO）、白細(xì)胞介素-6（IL-6）水平均降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；治療后，治療組這些血清學(xué)指標(biāo)顯著低于對照組，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 三味檀香膠囊聯(lián)合阿替洛爾治療心絞痛具有較好的臨床療效，可明顯改善患者臨床癥狀，改善機體血液流變學(xué)指標(biāo)，降低血清學(xué)指標(biāo)水平，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effect of Sanwei Tanxiang Capsules combined with atenolol in treatment of angina pectoris. Methods Patients (94 cases) with angina pectoris in Renmin Hospital of Wuhan University from April 2018 to April 2019 were divided into control group (47 cases) and treatment group (47 cases) according to the difference of medication. Patients in the control group were po administered with Atenolol Tablets, started at 12.5 mg/time, twice daily, and this could be increased to 50 mg/time as required and tolerated. Patients in the treatment group were po administered with Sanwei Tanxiang Capsules on the basis of the control group, 0.6 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the clinical symptom improvement time, correlation scores, hemorheology indexes and serological indexes in two groups were compared. Results After treatment, the effective rate of the control group was 80.85%, significantly lower than that of the treatment group (95.74%, P<0.05). The frequency and duration of angina pectoris were significantly reduced in the two groups, and there were differences in the same group (P<0.05). After treatment, the frequency of angina pectoris in the treatment group was significantly lower than that in the control group, and the duration was significantly shorter than that in the control group, and there were differences between two groups (P<0.05). After treatment, SF-36 score and SAQ score were significantly increased in both groups, while the clinical symptoms scores were significantly decreased (P<0.05). After treatment, SF-36 score and SAQ score in the treatment group were significantly higher than those in the control group, while the clinical symptoms scores were significantly lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, WBV, PV, FIB, and PAR in two groups were significantly decreased, and there were differences in the same group (P<0.05). After treatment, those hemorheological indexes in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). After treatment, Lp-PLA2, sCD40L, S100A12, MPO, and IL-6 in the control group were significantly decreased, and there were differences in the same group (P<0.05). After treatment, the serological indexes in the treatment group were lower than those in the control group, and there were differences between two groups (P<0.05). Conclusion Sanwei Tanxiang Capsules combined with atenolol has good clinical effect in treatment of angina pectoris, and can significantly improve the clinical symptoms of patients, improve hemorheology indicators of the body, and reduce the level of serological indicators, which has a certain clinical application value.

R972