目的 探讨心脉通胶囊联合曲美他嗪治疗不稳定型心绞痛的临床效果。方法 选取2016年7月—2019年7月渭南市中心医院收治的不稳定型心绞痛患者130例，随机分成对照组（65例）和治疗组（65例）。对照组进餐同时口服盐酸曲美他嗪片，20 mg/次，3次/d。治疗组在对照组基础上口服心脉通胶囊，3粒/次，3次/d。两组患者均连续治疗4周。观察两组患者临床疗效，同时比较治疗前后两组患者心绞痛发作情况、心肌缺血总负荷（TIB）、SAQ评分，及血清髓过氧化物酶（MPO）、血清N末端B型利钠肽原（NT-proBNP）和血管内皮生长因子（VEGF）水平。结果 治疗后，对照组心绞痛和心电图疗效分别为81.54%和70.77%，而治疗组的心绞痛和心电图疗效分别为93.85%和86.15%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者心绞痛发作频率和持续时间，以及硝酸甘油消耗量、ST段下移幅度和TIB均显著下降（P<0.05），且治疗组的改善效果均显著优于对照组（P<0.05）。治疗后，两组患者SAQ中各维度评分及其总分均显著升高（P<0.05），且治疗组SAQ中除DP外，其他各维度评分及总分均显著高于对照组（P<0.05）。治疗后，两组患者血清MPO、NT-proBNP、VEGF浓度均显著降低（P<0.05）；且治疗组比对照组下降更显著（P<0.05）。结论 心脉通胶囊联合曲美他嗪治疗不稳定型心绞痛的整体疗效良好，能明显改善患者心绞痛发作情况，保护心脏功能，逆转病情，提高患者生命质量。

Objective To investigate the clinical effect of Xinmaitong Capsules combined with trimetazidine in treatment of unstable angina pectoris. Methods Patients (130 cases) with unstable angina pectoris in Weinan Central Hospital from July 2016 to July 2019 were randomly divided into control (65 cases) and treatment (65 cases) groups. Patients in the control group were po administered with Trimetazidine Hydrochloride Tablets during the meal, 20 mg/time, three times daily. Patients in the treatment group were po administered with Xinmaitong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, and the angina pectoris attack, TIB, SAQ scores, and the serum level of MPO, NT-proBNP and VEGF in two groups before and after treatment were compared. Results After treatment, the therapeutic efficacy of angina pectoris and electrocardiogram efficacy in the control group were 81.54% and 70.77%, which were significantly lower than 93.85% and 86.15% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina, consumption of nitroglycerin, ST segment down range and TIB in two groups were significantly decreased (P<0.05), and the improvement effect of these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the scores of all dimensions and total scores in SAQ in two groups were significantly increased (P<0.05), and these scores except DP in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the serum level of MPO, NT-proBNP and VEGF in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion Xinmaitong Capsules combined with trimetazidine in treatment of unstable angina pectoris has a good overall curative effect, can obviously improve the attack of angina pectoris, protect cardiac function, reverse the disease and improve the quality of life of patients.

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