目的 探討腦心通膠囊聯(lián)合替格瑞洛片治療冠心病心絞痛的臨床療效。方法 選取2020年9月—2022年10月火箭軍特色醫(yī)學(xué)中心收治的102例冠心病心絞痛患者，依據(jù)隨機(jī)數(shù)字表法將所有患者分為對(duì)照組和治療組，每組各51例。對(duì)照組口服替格瑞洛片，初始劑量2片/次，2次/d，持續(xù)1周后，劑量調(diào)整為1片/次，2次/d。治療組在對(duì)照組基礎(chǔ)上口服腦心通膠囊，4粒/次，3次/d。兩組患者連續(xù)治療8周。觀察兩組的臨床療效，比較兩組的心絞痛發(fā)作頻率、每次持續(xù)時(shí)間以及心絞痛疼痛程度、心功能指標(biāo)、血清氧化應(yīng)激指標(biāo)和血清心肌損傷標(biāo)志物。結(jié)果 治療后，治療組的總有效率為92.16%，明顯高于對(duì)照組的總有效率76.47%，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的心絞痛發(fā)作頻率、每次持續(xù)時(shí)間均顯著降低（P<0.05），治療組的心絞痛發(fā)作頻率、每次持續(xù)時(shí)間低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的視覺(jué)模擬評(píng)分法（VAS）評(píng)分均顯著降低（P<0.05），治療組的VAS評(píng)分低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的左心室射血分?jǐn)?shù)（LVEF）、心搏量（SV）均顯著升高（P<0.05），且治療組的LVEF、SV明顯高于對(duì)照組（P<0.05）。治療后，兩組的血清髓過(guò)氧化物酶（MPO）、脂質(zhì)過(guò)氧化物（LPO）水平均顯著降低，血清谷胱甘肽過(guò)氧化物酶（GSH-Px）水平顯著升高（P<0.05）；治療組的血清MPO、LPO水平低于對(duì)照組，血清GSH-Px水平高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的血清心肌肌鈣蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）、肌紅蛋白（MYO）水平顯著降低（P<0.05）；治療組的血清cTnI、CK-MB、MYO水平明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 腦心通膠囊聯(lián)合替格瑞洛片可進(jìn)一步提高冠心病心絞痛的療效，改善心功能，顯著減輕心絞痛癥狀和氧化應(yīng)激反應(yīng)，降低心肌細(xì)胞損傷。

Objective To investigate the clinical effect of Naoxintong Capsules combined with Ticagrelor Tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (102 cases) with angina pectoris of coronary heart disease in Rocket Army Characteristic Medical Center from September 2020 to October 2022 were divided into control and treatment groups according to the random number table method, and each group had 51 cases. Patients in the control group were po administered with Ticagrelor Tablets, starting dosage 2 tablets/time, twice daily, after 1 week, and the dose was adjusted to 1 tablet, twice daily. Patients in the treatment group were po administered with Naoxintong Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and the frequency and duration of angina pectoris, the pain degree of angina pectoris, the cardiac function indexes, the serum oxidative stress indicators, and the serum markers of myocardial injury in two groups were compared. Results After treatment, the total effective rate of the treatment group was 92.16%, which was significantly higher than that of the control group (76.47%), with a statistically significant difference between the groups (P < 0.05). After treatment, the frequency and duration of angina pectoris in two groups were significantly reduced (P < 0.05). The frequency and duration of angina pectoris in the treatment group were lower than those in the control group, with a statistically significant difference (P< 0.05). After treatment, the VAS scores of two groups were significantly reduced (P < 0.05), and the VAS scores of the treatment group were lower than those of the control group, with a statistically significant difference (P < 0.05). After treatment, LVEF and SV in two groups were significantly increased (P < 0.05), and LVEF and SV in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the serum levels of MPO and LPO in two groups were significantly decreased, but the serum level of GSH-Px was significantly increased (P < 0.05). The serum levels of MPO and LPO in the treatment group were lower than those in the control group, but the serum levels of GSH-Px in the treatment group were higher than those in the control group (P< 0.05). After treatment, the serum levels of cTnI, CK-MB, and MYO in two groups were significantly decreased (P < 0.05). The serum levels of cTnI, CK-MB, and MYO in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Naoxintong Capsules combined with Ticagrelor Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can improve cardiac function, significantly reduce angina pectoris symptoms and oxidative stress reaction, and reduce myocardial cell damage.

R972

北京市自然科學(xué)基金資助項(xiàng)目（7222229）