目的 探討銀杏葉片聯(lián)合富馬酸比索洛爾片治療冠心病心絞痛的臨床療效。方法 選取2018年1月-2019年6月在天津市寧河區(qū)醫(yī)院就診的116例冠心病心絞痛患者作為研究對象，將全部患者按照隨機數(shù)字表法分為對照組和治療組，每組各58例。對照組口服富馬酸比索洛爾片，2.5 mg/次，1次/d。治療組在對照組治療的基礎上口服銀杏葉片，0.2 g/次，3次/d。兩組患者連續(xù)治療3個月。觀察兩組的心絞痛療效和心電圖療效，比較兩組的心功能指標、臨床癥狀、氧化應激指標、心肌損傷標志物。結果 治療后，對照組和治療組的心絞痛療效總有效率分別為79.31%、93.10%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，對照組和治療組的心電圖療效總有效率分別為68.97%、84.48%，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組左室射血分數(shù)（LVEF）、心輸出量均明顯升高，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組的LVEF、心輸出量均明顯高于對照組，兩組差異有統(tǒng)計學意義（P<0.05）。治療后，兩組心絞痛發(fā)作次數(shù)、每次發(fā)作持續(xù)時間、硝酸甘油用量均顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組心絞痛發(fā)作次數(shù)、每次發(fā)作持續(xù)時間、硝酸甘油用量均明顯低于對照組，兩組差異有統(tǒng)計學意義（P<0.05）。治療后，兩組的超氧化物歧化酶（SOD）、谷胱甘肽過氧化物酶（GSH-Px）水平均顯著升高，丙二醛（MDA）水平顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組的SOD、GSH-Px水平均明顯高于對照組，MDA水平明顯低于對照組，兩組差異有統(tǒng)計學意義（P<0.05）。治療后，兩組肌酸激酶同工酶（CK-MB）、腦鈉肽（BNP）、心肌肌鈣蛋白Ⅰ（cTnⅠ）水平均顯著降低，同組治療前后比較差異有統(tǒng)計學意義（P<0.05）；且治療組CK-MB、BNP、cTnI水平均明顯低于對照組，兩組差異有統(tǒng)計學意義（P<0.05）。結論 銀杏葉片聯(lián)合富馬酸比索洛爾片治療冠心病心絞痛具有較好的臨床療效，可改善臨床癥狀，降低氧化應激反應，減輕心肌損傷，提高心功能，具有一定的臨床推廣應用價值。

Objective To investigate the clinical efficacy of Yinxingye Tablets combined with Bisoprolol Fumarate Tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (116 cases) with angina pectoris of coronary heart disease in Tianjin Ninghe Hospital from January 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 58 cases. Patients in the control group were po administered with Bisoprolol Fumarate Tablets, 2.5 mg/time, once daily. Patients in the treatment group were po administered with Yinxingye Tablets on the basis of the control group, 0.2 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, clinical symptoms, oxidative stress indexes, and markers of myocardial injury in two groups were compared. Results After treatment, the curative effect of angina pectoris in the control and treatment groups were 79.31% and 93.10%, respectively, and there was difference between two groups (P<0.05). After treatment, the electrocardiogram efficacies in the control and treatment groups were 68.97% and 84.48%, respectively, and there was difference between two groups (P<0.05). After treatment, LVEF and cardiac output in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the cardiac function indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the frequency of angina pectoris, the duration of each attack, and the dosage of nitroglycerin in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the clinical symptoms 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 SOD and GSH-Px in two groups were significantly increased, but the levels of MDA in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of SOD and GSH-Px in the treatment group were significantly higher than those in the control group, but the levels of MDA were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CK-MB, BNP, and cTnⅠ in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the markers of myocardial injury in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yinxingye Tablets combined with Bisoprolol Fumarate Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can improve clinical symptoms, reduce oxidative stress response, reduce myocardial injury, and improve cardiac function, which has a certain clinical application value.

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