目的 探究麝香保心丸联合替格瑞洛片治疗冠心病心绞痛的临床疗效。方法 选择2019年11月—2021年2月在济源市人民医院就诊治疗的102例冠心病心绞痛患者，按照入院先后顺序将所有患者分为对照组和治疗组，每组各51例。对照组口服替格瑞洛片，90 mg/次，2次/d。治疗组在对照组的基础上口服麝香保心丸，45 mg/次，3次/d。两组患者均连续治疗2个月。观察两组患者的临床疗效、心电图疗效，比较两组治疗前后的心绞痛发作状况、心功能指标、血清炎性因子。结果 治疗后，治疗组患者的心绞痛疗效、心电图疗效总有效率均高于对照组，组间比较有差异（P＜0.05）。治疗后，两组患者的发作频率、发作持续时间均显著降低，同组比较有差异（P＜0.05）；并且治疗组的发作频率、发作持续时间较对照组改善明显，组间比较有差异（P＜0.05）。治疗后，两组患者的左心室射血分数（LVEF）显著降低，心输出量（CO）、每搏输出量（SV）显著升高，同组比较有差异（P＜0.05）；并且治疗组患者的LVEF显著低于对照组，CO、SV显著高于对照组，组间比较有差异（P＜0.05）。治疗后，两组患者的白细胞介素-6（IL-6）、同型半胱氨酸（Hcy）、缺血修饰白蛋白（IMA）水平均显著降低，同组比较有差异（P＜0.05）；并且治疗组患者IL-6、Hcy、IMA水平均明显低于对照组，组间比较有显著差异（P＜0.05）。结论 麝香保心丸联合替格瑞洛片治疗冠心病心绞痛具有较好的临床疗效，可改善患者临床症状，提高患者的心功能，降低炎性反应，安全性较好，具有一定临床应用价值。

Objective To explore the clinical study of Shexiang Baoxin Pills 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 Jiyuan Shi People's Hospital from November 2019 to February 2021 were randomly divided into control and treatment groups, and each group had 51 cases. Patients in the control group were po administered with Ticagrelor Tablets, 90 mg/time, twice daily. Patients in the treatment group were po administered with Shexiang Baoxin Pills on the basis of the control group, 45 mg/time, three times daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacies of angina pectoris and ECG were evaluated, and the attack status of angina pectoris, cardiac functions, and serum inflammatory factors in two groups were compared.Results After treatment, the total effective rates of angina pectoris and ECG in the treatment group were higher than those in the control group, and there was a difference between the groups (P < 0.05). After treatment, the attack frequency and duration of two groups were significantly lower than those of the control group (P < 0.05), and the attack frequency and duration of the treatment group were significantly improved than those of the control group (P < 0.05). After treatment, the LVEF of two groups were significantly decreased, but the CO and SV of two groups were significantly increased, and there was a significant difference in the same group (P < 0.05). The LVEF of the treatment group was significantly lower than that of the control group, but the CO and SV of the treatment group were significantly higher than those of the control group (P < 0.05). After treatment, the levels of IL-6, Hcy, and IMA in two groups were significantly decreased, and there was a significant difference in the same group (P < 0.05). And the levels of IL-6, Hcy, and IMA in the treatment group were significantly lower than those in the control group (P < 0.05).Conclusion Shexiang Baoxin Pills combined with Ticagrelor Tablets has curative effect in treatment of angina pectoris of coronary heart disease, can improve patients' clinical symptoms, improve patients' cardiac function, and reduce inflammatory reaction, with good safety, which has a certain clinical application value.

R972

国家自然科学基金面上项目（81373610）；济源市科技攻关项目（17023013）