目的 探讨杏灵分散片联合伊伐布雷定治疗稳定型心绞痛的临床研究。方法 选取2018年9月—2019年10月在濮阳市安阳地区医院治疗的150例稳定性心绞痛患者，随机分成对照组（75例）和治疗组（75例）。对照组患者口服盐酸伊伐布雷定片，5 mg/次，2次/d；治疗组患者在对照组基础上口服杏灵分散片，1片/次，3次/d，两组患者连续治疗2周。观察两组患者临床疗效，比较治疗前后两组患者西雅图心绞痛（SAQ）量表评分，血清生化指标内皮素-1（ET-1）、降钙素基因相关肽（CGRP）和可溶性CD40配体（sCD40L），血清炎性因子白细胞介素6（IL-6）、C反应蛋白（CRP）和肿瘤坏死因子α（TNF-α）及不良反应情况。结果 治疗后，治疗组临床总有效率97.33%，显著高于对照组的86.67%（P<0.05）。治疗后，两组患者心绞痛稳定状态、躯体活动受限度、治疗满意程度、心绞痛发作情况、疾病认识程度评分均高于治疗前水平（P<0.05）；治疗组SAQ量表评分高于对照组（P<0.05）。治疗后，两组患者血清ET-1、sCD40L水平均显著降低，但血清CGRP水平升高（P<0.05）；治疗后，治疗组血清生化指标优于对照组（P<0.05）。治疗后，两组患者血清IL-6、CRP、TNF-α水平均显著降低（P<0.05）；治疗后，治疗组血清炎性因子水平低于对照组（P<0.05）。治疗组不良反应总发生率为6.67%，明显低于对照组的13.33%（P<0.05）。结论 杏灵分散片联合伊伐布雷定治疗稳定型心绞痛临床疗效显著，可以有效改善患者心绞痛症状，有效较低血脂及炎性因子水平，不良反应发生率低，患者的生活质量得到显著提高。

Objective To explore the clinical effect of Xingling Dispersible Tablets combined with ivabradine in treatment of stable angina pectoris. Methods Patients (150 cases) with stable angina pectoris in Anyang District Hospital of Puyang from September 2018 to October 2019 were randomly divided into control (75 cases) and treatment (75 cases) groups. Patients in the control group were po administered with Ivabradine Hydrochloride Tablets, 5 mg/time, twice daily. Patients in the treatment group were po administered with Xingling Dispersible Tablets on the basis of the control group, 1 tablet/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the SAQ scale score, blood lipid indexes ET-1, sCD40L, and CGRP, serum inflammatory factor levelsIL-6, CRP, and TNF-α, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate in the treatment group was 97.33%, which was significantly higher than 86.67% in the control group (P<0.05). After treatment, angina stable state, physical activity limit, treatment satisfaction, angina attack and disease awareness scores in two groups were all higher than those before treatment (P<0.05). The SAQ score in treatment group was higher than that in control group (P<0.05). After treatment, serum ET-1 and sCD40L levels in two groups were significantly decreased, but serum CGRP level was increased (P<0.05). After treatment, the serum biochemical indexes of treatment group were better than those of control group (P<0.05). After treatment, the levels of serum IL-6, CRP and TNF-α in two groups were significantly decreased (P<0.05). After treatment, the level of serum inflammatory factors in treatment group was lower than that in control group (P<0.05). The total incidence of adverse reactions in the treatment group was 6.67%, which was significantly lower than 13.33% in the control group (P<0.05). Conclusion Xingling Dispersible Tablets combined with ivabradine is effective in the treatment of stable angina pectoris, which can effectively improve the symptoms of angina pectoris, lower blood lipids and inflammatory factors, lower the incidence of adverse reactions, and significantly improve the quality of life of patients.

R972

河南省医学科技攻关计划项目（2018020855）