目的 探讨银盏心脉滴丸联合富马酸比索洛尔治疗冠心病稳定型心绞痛的临床疗效。方法 选取2021年1月—2022年4月在平煤神马医疗集团总医院诊治的108例冠心病稳定型心绞痛患者，按照随机数字方法分为对照组（54例）和治疗组（54例）。对照组口服富马酸比索洛尔片，5 mg/次，1次/d。治疗组在对照组基础上口服银盏心脉滴丸，10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，比较治疗前后两组患者心绞痛发作情况、6 min步行总距离，西雅图心绞痛量表评分及心肌缺血总负荷（TIB）、R-R间期的标准差（SDNN）、每5 min R-R间期均值的标准差（SDANN）、相邻R-R间期标准差的平均值（RMSSD）、Q-T离散度（QTd）、单核细胞趋化蛋白-1（MCP-1）、白细胞介素-6（IL-6）、基质金属蛋白酶-9（MMP-9）和脂蛋白相关磷脂酶A₂（Lp-PLA₂）水平。结果 治疗后，对照组和治疗组总有效率分别为85.19%、96.29%，两组比较差异存在统计学意义（P＜0.05）。治疗后，两组患者心绞痛发作次数较治疗前有显著下降，6 min步行总距离明显提高（P＜0.05），且治疗组患者改善更明显（P＜0.05）。治疗后，两组患者治疗满意程度（TS）、躯体活动受限程度（PL）、心绞痛稳定状态（AS）、心绞痛发作频率（AF）、疾病的认识（DP）评分均较治疗前显著提高（P＜0.05），且治疗组患者提高的更明显（P＜0.05）。治疗后，两组患者TIB、QTd、MCP-1、IL-6、MMP-9和Lp-PLA₂水平均较治疗前显著下降，而SDANN、SDNN和RMSSD水平均较治疗前显著提高（P＜0.05），且治疗组患者这些指标水平改善的更明显（P＜0.05）。结论 银盏心脉滴丸联合富马酸比索洛尔治疗冠心病稳定型心绞痛患者具有良好的临床疗效，可有效改善患者症状，提高运动耐力。

Objective To explore the clinical effect of Yinzhan Xinmai Dropping Pills combined with bisoprolol in treatment of stable angina pectoris of coronary heart disease.Methods Patient (108 cases) with stable angina pectoris of coronary heart disease in General Hospital of Pingmei Shenma Group from January 2021 to April 2022 were divided into control (54 cases) and treatment (54 cases) group according to random number method. Patient in the control group was po administered with Bisoprolol Fumarate Tablets, 5 mg/time, once daily. Patient in the treatment group were po administered with Yinzhan Xinmai Dropping Pills on the basis of the control group, 10 grains/time, three times daily. Patient in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, and the angina attacks, 6 min walking distance, Seattle Angina Scale scores, and the levels of TIB, SDANN, SDNN, RMSSD, QTd, MCP-1, IL-6, MMP-9 and Lp-PLA2 in two groups before and after treatment were compared. Results After treatment, the clinical effective rates of the control group and the treatment group were 85.19% and 96.29%, respectively, and there was significant difference between the two groups (P < 0.05). After treatment, the number of angina pectoris attacks in two groups was significantly lower than that before treatment, and the total walking distance of 6 min was significantly increased (P < 0.05), and the improvement of the indicators in the treatment group was more obvious (P < 0.05). After treatment, the scores of PL, AS, AF, TS, and DP in two groups were significantly higher than those before treatment (P < 0.05), especially in the treatment group (P < 0.05). After treatment, the levels of TIB, QTd, MCP-1, IL-6, MMP-9, and Lp-PLA2 in two groups were significantly lower than those before treatment, while the levels of SDANN, SDNN, and RMSSD were significantly increased (P < 0.05), and the level of these indicators in the treatment group was improved more significantly (P < 0.05). Conclusion Yinzhan Xinmai Dropping Pills combined with bisoprolol fumarate has a good clinical effect in the treatment of coronary heart disease patients with stable angina pectoris, which can effectively improve patients' symptoms and exercise endurance.

R972

河南省医学科技攻关计划（201702086）