目的 探討心達(dá)康滴丸聯(lián)合鹽酸地爾硫卓片治療冠心病心絞痛的臨床療效。方法 選擇2018年7月—2019年7月在武漢市江夏區(qū)中醫(yī)醫(yī)院治療的冠心病心絞痛患者94例，根據(jù)用藥的差別分成對(duì)照組（47例）和治療組（47例）。對(duì)照組口服鹽酸地爾硫卓片，30 mg/次，3次/d；治療組在對(duì)照組基礎(chǔ)上口服心達(dá)康滴丸，18粒/次，3次/d。兩組患者均經(jīng)4周治療。觀察兩組患者臨床療效，同時(shí)比較治療前后兩組患者心絞痛發(fā)作次數(shù)和持續(xù)時(shí)間，臨床癥狀積分、SAQ和GQOLI-74評(píng)分，血清C反應(yīng)蛋白（CRP）、S100鈣結(jié)合蛋白A12（S100A12）、白細(xì)胞介素-18（IL-18）、妊娠相關(guān)血清蛋白A（PAPP-A）、內(nèi)皮素-1（ET-1）和肌鈣蛋白I（CTnI）水平及心功能。結(jié)果 治療后，對(duì)照組和治療組臨床有效率分別為80.85%和97.87%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者心絞痛發(fā)作次數(shù)及持續(xù)時(shí)間都顯著改善降低（P<0.05），且治療組比對(duì)照組改善更顯著（P<0.05）。治療后，兩組患者SAQ積分和GQOLI-74評(píng)分均明顯升高，而臨床癥狀積分明顯降低（P<0.05），且治療組這些評(píng)分明顯好于對(duì)照組（P<0.05）。治療后，兩組患者血清CRP、S100A12、IL-18、PAPP-A、ET-1、CTnI水平均明顯降低（P<0.05），且治療組明顯低于對(duì)照組（P<0.05）。治療后，兩組患者左心室射血分?jǐn)?shù)（LVEF）和心排血量（CO）均升高，而左室收縮末期內(nèi)徑（LVESD）明顯降低（P<0.05），且治療組LVEF、CO和LVESD比對(duì)照組改善更明顯（P<0.05）。結(jié)論 心達(dá)康滴丸聯(lián)合鹽酸地爾硫卓片治療冠心病心絞痛可明顯改善患者臨床癥狀，改善生活質(zhì)量，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To explore the clinical efficacy of Xindakang Dropping Pills combined with diltiazem in treatment of angina pectoris of coronary heart disease. Methods Patients (94 cases) with angina pectoris of coronary heart disease in Wuhan Jiangxia District Hospital of TCM from July 2018 to Juny 2019 were divided into control (47 cases) and treatment (47 cases) groups based on different treatments. Patients in the control group were po administered with Diltiazem Hydrochloride Tablets, 30 mg/time, three times daily. Patients in the treatment group were po administered with Xindakang Dropping Pills on the basis of the control group, 18 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the frequency and duration of angina pectoris, clinical symptom scores, SAQ and GQOLI-74 scores, the serum levels of CRP, S100A12, IL-18, PAPP-A, ET-1 and CTnI, and cardiac function indexes in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and in the control and treatment groups was 80.85% and 97.87% respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups was significantly decreased (P<0.05), and which in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the SAQ and GQOLI-74 scores in two groups were significantly increased (P<0.05), but the clinical symptom scores were significantly decreased (P<0.05), and these scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum levels of CRP, S100A12, IL-18, PAPP-A, ET-1 and CTnI in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the LVEF and CO levels in two groups were significantly increased (P<0.05), but the LVESD levels were significantly decreased (P<0.05), and the LVEF, CO and LVESD in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Xindakang Dropping Pills combined with diltiazem in treatment of angina pectoris of coronary heart disease can significantly improve the clinical symptoms, the quality of life, which has a certain clinical application value.

R972