目的 探討冠脈通片聯(lián)合硫酸氫氯吡格雷片治療冠心病心絞痛的臨床療效。方法 選取2019年5月-2020年5月在天津市南開(kāi)區(qū)中醫(yī)醫(yī)院治療的冠心病心絞痛患者94例，根據(jù)就診順序分為對(duì)照組（47例）和治療組（47例）。對(duì)照組口服硫酸氫氯吡格雷片，75 mg/次，1次/d；治療組在對(duì)照組的基礎(chǔ)上口服冠脈通片，1.8 g/次，3次/d。兩組患者均經(jīng)4周治療。觀察兩組患者心絞痛和心電圖療效，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，及血清血小板顆粒膜蛋白-140（GMP-140）、可溶性細(xì)胞間黏附分子-1（sICAM-1）、纖溶酶原激活劑抑制物-1（PAI-1）、白細(xì)胞三烯E4（LTB4）、髓過(guò)氧化物酶（MPO）、脂聯(lián)素（APN）、血小板黏附率（PAR）、血漿黏度（PV）、纖維蛋白原（FIB）、全血黏度（WBV）、磷酸肌酸激酶（CK）、磷酸肌酸酶同工酶（CK-MB）、乳酸肌氫酶（LDH）和羥丁酸脫氫酶（HBDH）水平。結(jié)果 治療后，對(duì)照組心絞痛和心電圖有效率分別為80.65%和82.98%，均分別顯著低于治療組的95.74%和97.87%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組心絞痛發(fā)作次數(shù)和持續(xù)時(shí)間均顯著下降（P<0.05），且治療組下降更明顯（P<0.05）。治療后，兩組血清GMP-140、sICAM-1、PAI-1、LTB4、MPO、PV、WBV、PAR、FIB、CK、CK-MB、LDH、HBDH水平均顯著下降（P<0.05），而APN顯著升高（P<0.05），且治療組這些血清學(xué)指標(biāo)改善更明顯（P<0.05）。結(jié)論 冠心病心絞痛患者給予氯吡格雷治療的同時(shí)口服冠脈通片可促進(jìn)心絞痛癥狀改善，有利于心肌酶譜及血清GMP-140、sICAM-1、PAI-1、LTB4、MPO、APN水平改善，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Guangmaitong Tablets combined with clopidogrel tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (94 cases) with angina pectoris of coronary heart disease in Tianjin Nankai District Hospital of TCM from May 2019 to May 2020 were divided into control (47 cases) and treatment (47 cases) groups based on visiting sequence. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Guangmaitong Tablets on the basis of the control group, 1.8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the angina pectoris and electrocardiogram efficacy were evaluated, and the frequency and duration of angina pectoris, the serum levels of GMP-140, sICAM-1, PAI-1, LTB4, MPO, APN, PV, WBV, PAR, FIB, CK, CK-MB, LDH and HBDH in two groups before and after treatment were compared. Results After treatment, the angina pectoris and electrocardiogram efficacy in the control group were 80.65% and 82.98%, which were significantly lower than 95.74% and 97.87% in the treatment group, 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 was significantly lower than that in the control group (P<0.05). After treatment, the serum levels of GMP-140, sICAM-1, PAI-1, LTB4, MPO, PV, WBV, PAR, FIB, CK, CK-MB, LDH and HBDH in two groups were significantly decreased (P<0.05), but the APN levels were significantly increased (P<0.05), and these serological indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Oral administration with Guanmaitong Tablets can improve the symptoms of angina pectoris in patients with angina pectoris of coronary heart disease treated with clopidogrel, and is conducive to the improvement of myocardial enzyme spectrum and the serum GMP-140, sICAM-1, PAI-1, LTB4, MPO, APN levels, which has a certain clinical application value.

R972