目的 观察葛根素注射液辅助治疗不稳定型心绞痛的临床疗效，并探讨其代谢组学作用机制。方法 选取2015年1月-2016年1月天津市第五中心医院收治的不稳定型心绞痛患者148例，随机分为对照组（68例）和治疗组（80例）。对照组给予常规治疗，包括口服拜阿司匹林肠溶片，100 mg/次，1次/d；口服阿托伐他汀钙片，20 mg/次，1次/d；口服酒石酸美托洛尔片，25 mg/次，2次/d；口服单硝酸异山梨酯片，20 mg/次，1次/d。治疗组在常规治疗基础上静脉滴注葛根素注射液，500 mg加入到5%葡萄糖或生理盐水250 mL中，1次/d。两组均治疗2周。观察两组的临床疗效，比较两组的一氧化氮（NO）、内皮素-1（ET-1）、白细胞介素-6（IL-6）、白细胞介素-10（IL-10）、C反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）、内脂素水平和代谢生物标记物分析。结果 治疗后，对照组和治疗组的临床症状疗效总有效率分别为59.7%、87.5%，心电图疗效总有效率分别为54.41%、81.25%，两组比较差异有统计学意义（P<0.05）。治疗后，两组ET-1、IL-6、TNF-α和内脂素水平均显著下降，而NO、IL-10水平均显著升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的改善程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组正、负离子模式下代谢色谱图和血清样本比较差异具有统计学意义（P<0.05）。治疗后，治疗组色氨酸明显高于对照，而溶血磷脂1、溶血磷脂2、花生四烯酸和次黄嘌呤明显低于对照组，两组比较差异有统计学意义（P<0.05）。结论 葛根素注射液可从舒张血管、减轻炎症反应、稳定斑块及保护心肌细胞等多个方面起到辅助治疗不稳定型心绞痛的作用。

Objective To observe the clinical effect of Puerarin Injection in treatment of unstable angina pectoris, and explore its mechanisms. Methods Patients (148 cases) with unstable angina pectoris in Tianjin Fifth Central Hospital from January 2015 to January 2016 were randomly divided into the control group (68 cases) and the treatment group (80 cases). Patients in the control group were given conventional therapy, including oral administration of Aspirin Enteric-coated Tablets, 100 mg/time, once daily; oral administration of Atorvastatin Calcium Tablets, 20 mg/time, once daily; oral administration of Metoprolol Tartrate Tablets, 25 mg/time, twice daily; oral administration of Isosorbide Mononitrate Tablets, 20 mg/time, once daily. Patients in the treatment group were iv administered with Puerarin Injection on the basis of the control group, 500 mg added into 5% glucose solution or normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and NO, ET-1, IL-6, IL-10, CRP, TNF-α, visfatin, and metabolic biomarker analysis in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 59.7% and 87.5%, respectively, the electrocardiogram curative effects in the control and treatment groups were 54.41% and 81.25%, respectively, and there was difference between two groups (P<0.05). After treatment, the levels of ET-1, IL-6, TNF-α, and visfatin in two groups were significantly decreased, but the levels of NO and IL-10 in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, metabolic chromatograms and serum samples at positive and negative ion modes were significant difference between two groups (P<0.05). After treatment, tryptophan in the treatment group was significantly higher than that in the control group, but lysophosphatidic 1, lysophosphatidic 2, arachidonic acid, and hypoxanthine in two groups in the treatment group were lower than those in the control group, and there was difference between two groups (P<0.05). Conclusion Puerarin Injection can play an important role in adjuvant therapy of unstable angina pectoris by relaxing blood vessels, reducing inflammation reaction, stabilizing plaques and protecting cardiomyocytes.