目的 探討銀盞心脈滴丸聯(lián)合富馬酸比索洛爾治療冠心病穩(wěn)定型心絞痛的臨床療效。方法 選取2021年1月—2022年4月在平煤神馬醫(yī)療集團總醫(yī)院診治的108例冠心病穩(wěn)定型心絞痛患者，按照隨機數(shù)字方法分為對照組（54例）和治療組（54例）。對照組口服富馬酸比索洛爾片，5 mg/次，1次/d。治療組在對照組基礎(chǔ)上口服銀盞心脈滴丸，10粒/次，3次/d。兩組患者均連續(xù)治療4周。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)作情況、6 min步行總距離，西雅圖心絞痛量表評分及心肌缺血總負(fù)荷（TIB）、R-R間期的標(biāo)準(zhǔn)差（SDNN）、每5 min R-R間期均值的標(biāo)準(zhǔn)差（SDANN）、相鄰R-R間期標(biāo)準(zhǔn)差的平均值（RMSSD）、Q-T離散度（QTd）、單核細胞趨化蛋白-1（MCP-1）、白細胞介素-6（IL-6）、基質(zhì)金屬蛋白酶-9（MMP-9）和脂蛋白相關(guān)磷脂酶A₂（Lp-PLA₂）水平。結(jié)果 治療后，對照組和治療組總有效率分別為85.19%、96.29%，兩組比較差異存在統(tǒng)計學(xué)意義（P＜0.05）。治療后，兩組患者心絞痛發(fā)作次數(shù)較治療前有顯著下降，6 min步行總距離明顯提高（P＜0.05），且治療組患者改善更明顯（P＜0.05）。治療后，兩組患者治療滿意程度（TS）、軀體活動受限程度（PL）、心絞痛穩(wěn)定狀態(tài)（AS）、心絞痛發(fā)作頻率（AF）、疾病的認(rèn)識（DP）評分均較治療前顯著提高（P＜0.05），且治療組患者提高的更明顯（P＜0.05）。治療后，兩組患者TIB、QTd、MCP-1、IL-6、MMP-9和Lp-PLA₂水平均較治療前顯著下降，而SDANN、SDNN和RMSSD水平均較治療前顯著提高（P＜0.05），且治療組患者這些指標(biāo)水平改善的更明顯（P＜0.05）。結(jié)論 銀盞心脈滴丸聯(lián)合富馬酸比索洛爾治療冠心病穩(wěn)定型心絞痛患者具有良好的臨床療效，可有效改善患者癥狀，提高運動耐力。

Objective To explore the clinical effect of Yinzhan Xinmai Dropping Pills combined with bisoprolol in treatment of stable angina pectoris of coronary heart disease.Methods Patient (108 cases) with stable angina pectoris of coronary heart disease in General Hospital of Pingmei Shenma Group from January 2021 to April 2022 were divided into control (54 cases) and treatment (54 cases) group according to random number method. Patient in the control group was po administered with Bisoprolol Fumarate Tablets, 5 mg/time, once daily. Patient in the treatment group were po administered with Yinzhan Xinmai Dropping Pills on the basis of the control group, 10 grains/time, three times daily. Patient in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the angina attacks, 6 min walking distance, Seattle Angina Scale scores, and the levels of TIB, SDANN, SDNN, RMSSD, QTd, MCP-1, IL-6, MMP-9 and Lp-PLA2 in two groups before and after treatment were compared. Results After treatment, the clinical effective rates of the control group and the treatment group were 85.19% and 96.29%, respectively, and there was significant difference between the two groups (P < 0.05). After treatment, the number of angina pectoris attacks in two groups was significantly lower than that before treatment, and the total walking distance of 6 min was significantly increased (P < 0.05), and the improvement of the indicators in the treatment group was more obvious (P < 0.05). After treatment, the scores of PL, AS, AF, TS, and DP in two groups were significantly higher than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of TIB, QTd, MCP-1, IL-6, MMP-9, and Lp-PLA2 in two groups were significantly lower than those before treatment, while the levels of SDANN, SDNN, and RMSSD were significantly increased (P < 0.05), and the level of these indicators in the treatment group was improved more significantly (P < 0.05). Conclusion Yinzhan Xinmai Dropping Pills combined with bisoprolol fumarate has a good clinical effect in the treatment of coronary heart disease patients with stable angina pectoris, which can effectively improve patients' symptoms and exercise endurance.

R972

河南省醫(yī)學(xué)科技攻關(guān)計劃（201702086）