目的 探討冠心蘇合丸聯(lián)合替格瑞洛治療冠心病心絞痛的臨床研究。方法 選取2018年3月—2020年3月在南陽市第二人民院心血管科治療的112例冠心病心絞痛患者，根據(jù)隨機數(shù)字法分為對照組（56例）和治療組（56例）。對照組口服替格瑞洛片，起始劑量2片/次，維持劑量1片/次，2次/d。治療組在對照組的基礎上咀嚼冠心蘇合丸，1丸/次，2次/d。兩組連續(xù)治療12個月。觀察兩組患者臨床療效，比較治療前后兩組患者心絞痛發(fā)作頻率、發(fā)作持續(xù)時間、心功能指標左心室射血分數(shù)（LVEF）、心臟每搏輸出量（SV）和心輸出量（CO），血清因子白細胞介素6（IL-6）、超敏C反應蛋白（hs-CRP）、血管內(nèi)皮生長因子（VEGF）、內(nèi)皮素-1（ET-1）水平及不良反應。結(jié)果 治療后，治療組總有效率為96.43%顯著高于對照組的76.78%（P<0.05）。治療后，兩組心絞痛發(fā)作頻率、發(fā)作持續(xù)時間指標均明顯低于治療前（P<0.05）；治療后，治療組心絞痛發(fā)作情況改善優(yōu)于對照組（P<0.05）。治療后，治療組患者心功能LVEF、SV、CO指標明顯高于對照組（P<0.05）；治療后，治療組患者IL-6、hs-CRP、ET-1均明顯低于對照組，而VEGF指標明顯高于對照組（P<0.05）；治療組患者不良反應發(fā)生率明顯低于對照組（P<0.05）。結(jié)論 冠心蘇合丸聯(lián)合替格瑞洛治療冠心病心絞痛療效明顯，能有效改善臨床癥狀，降低炎性因子，心功能改善顯著，且安全有效。

Objective To investigate the clinical effect of Guanxin Suhe Pills combined with ticagrelor in treatment of angina pectoris of coronary heart disease. Methods Patients (112 cases) with angina pectoris of coronary heart disease in Nanyang Second General Hospital from March 2018 to March 2020 were randomly divided into control (56 cases) and treatment (56 cases) groups. Patients in the control group were po administered with Ticagrelor Tablets, the initial dose was 2 tablets/time, and the maintenance dose was 1 tablets/time, twice daily. Patients in the treatment group chewed Guanxin Suhe Pills on the basis of the control group, 1 pill/time, twice daily. Patients in two groups were treated for 12 months. After treatment, the clinical efficacy was evaluated, and the attack frequency and duration of angina pectoris, cardiac function index of LVEF, SV and CO, serum factors of IL-6, hs-CRP, ET-1 and VEGF levels, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.43%, which was significantly higher than that of the control group (76.78%, P<0.05). After treatment, the attack frequency and duration of angina pectoris in both groups were significantly lower than those before treatment (P<0.05). After treatment, the improvement of angina attack in the treatment group was better than that in the control group (P<0.05). After treatment, the indexes of LVEF, SV, and CO of cardiac function in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the indexes of IL-6, hs-CRP, and ET-1 in the treatment group were significantly lower than those in the controlgroup, while the index of VEGF in the treatment group was significantly higher than that in the control group (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion Guanxin Suhe Pills combined with Ticagrelor Tablets is effective in treatment of angina pectoris of coronary heart disease, which can effectively improve clinical symptoms, reduce inflammatory factors, improve cardiac function significantly, and which is safe and effective.

R972

河南省醫(yī)學科技攻關(guān)項目（2018020986）