目的 研究腦心通膠囊聯(lián)合尼可地爾治療微血管性心絞痛的應(yīng)用價(jià)值。方法 選取2020年1月—2021年12月北京中醫(yī)藥大學(xué)房山醫(yī)院收治的106例微血管性心絞痛患者為研究對(duì)象，按照隨機(jī)數(shù)字表法分為對(duì)照組和治療組，每組各53例。對(duì)照組口服尼可地爾片，5mg/次，3次/d。治療組在對(duì)照組基礎(chǔ)上口服腦心通膠囊，1.2g/次，3次/d。兩組患者治療6周。觀察兩組患者臨床療效，比較治療前后兩組患者中醫(yī)癥候積分，冠脈血流動(dòng)力學(xué)指標(biāo)，血清學(xué)標(biāo)記物過氧化物酶體增殖物激活受體α（PPAR-α）、肌紅蛋白（MYO）和血友病因子（vWF）水平。結(jié)果 治療后，治療組總有效率為92.45%，明顯高于對(duì)照組患者（75.47%，P＜0.05）。治療后，兩組胸痛胸悶、神疲乏力、頭暈?zāi)肯?、面色少華積分均有顯著降低（P＜0.05），且治療后治療組中醫(yī)癥候積分均低于對(duì)照組（P＜0.05）。治療后，兩組患者收縮期最大流速（PSV）、舒張末期血流速度（EDV）、搏動(dòng)指數(shù)（PI）水平顯著升高（P＜0.05），而阻力指數(shù)（RI）水平明顯降低（P＜0.05），且治療后，治療組冠脈血流動(dòng)力學(xué)指標(biāo)改善優(yōu)于對(duì)照組（P＜0.05）。治療后，兩組患者PPAR-α、MYO、vWF水平均顯著降低（P＜0.05），且治療組患者各項(xiàng)血清學(xué)指標(biāo)水平均低于對(duì)照組（P＜0.05）。結(jié)論 腦心通膠囊聯(lián)合尼可地爾治療微血管性心絞痛的臨床療效顯著，能夠顯著降低患者中醫(yī)癥候，增加患者冠脈血流，抑制血清PPAR-α、MYO、vWF的水平，且不良反應(yīng)發(fā)生率較低。

Objective To study the clinical efficacy of Naoxintong Capsules combined with nicorandil in treatment of microvascular angina pectoris. Methods Patients (106 cases) with microvascular angina pectoris in Fangshan Hospital Beijing University of Chinese Medicine from January 2020 to December 2021 were randomly divided into control and treatment group, and each group had 53 cases. Patients in the control group were po administered with Nicorandil Tablets, 5 mg/time, three times daily. Patients in the treatment group po administered with Naoxintong Capsules on the basis of the control group, 1.2 g/time, three times daily. Patients in two groups were treated for 6 weeks. After treatment, the clinical evaluation was evaluated, the TCM symptom scores, coronary hemodynamics, the levels of serum markers PPAR-α, MYO, and vWF in two groups before and after treatment were compared. Results After treatment, the clinical effective rate of the treatment group was 92.45%, which was significantly higher than that of the control group (75.47%, P<0.05). After treatment, the scores of chest pain and chest tightness, fatigue, dizziness and pale face were significantly decreased in both groups (P<0.05), and the scores of TCM symptoms in the treatment group were lower than those in the control group (P<0.05). After treatment, the maximum systolic flow velocity (PSV), end-diastolic flow velocity (EDV) and pulsatile index (PI) levels in both groups were significantly increased (P<0.05), while the resistance index (RI) level was significantly decreased (P<0.05). After treatment, the improvement of coronary hemodynamic indexes in the treatment group was better than that in the control group (P<0.05). After treatment, the levels of PPAR-α, MYO and vWF in two groups were significantly decreased (P<0.05), and the levels of serological indexes in the treatment group were lower than those in the control group (P<0.05). Conclusion The clinical effect of Naoxintong Capsules combined with nicorandil in treatment of microvascular angina pectoris is significant, can significantly reduce the TCM symptoms of patients, increase coronary blood flow, inhibit the expression of serum PPAR-α, MYO, vWF, and the incidence of adverse reactions is low.

R972

北京市中醫(yī)藥科技發(fā)展資金項(xiàng)目（JJ2019-25）