目的 探讨脑心通胶囊联合替格瑞洛片治疗冠心病心绞痛的临床疗效。方法 选取2020年9月—2022年10月火箭军特色医学中心收治的102例冠心病心绞痛患者，依据随机数字表法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，初始剂量2片/次，2次/d，持续1周后，剂量调整为1片/次，2次/d。治疗组在对照组基础上口服脑心通胶囊，4粒/次，3次/d。两组患者连续治疗8周。观察两组的临床疗效，比较两组的心绞痛发作频率、每次持续时间以及心绞痛疼痛程度、心功能指标、血清氧化应激指标和血清心肌损伤标志物。结果 治疗后，治疗组的总有效率为92.16%，明显高于对照组的总有效率76.47%，组间比较差异有统计学意义（P<0.05）。治疗后，两组的心绞痛发作频率、每次持续时间均显著降低（P<0.05），治疗组的心绞痛发作频率、每次持续时间低于对照组，差异有统计学意义（P<0.05）。治疗后，两组的视觉模拟评分法（VAS）评分均显著降低（P<0.05），治疗组的VAS评分低于对照组，差异有统计学意义（P<0.05）。治疗后，两组的左心室射血分数（LVEF）、心搏量（SV）均显著升高（P<0.05），且治疗组的LVEF、SV明显高于对照组（P<0.05）。治疗后，两组的血清髓过氧化物酶（MPO）、脂质过氧化物（LPO）水平均显著降低，血清谷胱甘肽过氧化物酶（GSH-Px）水平显著升高（P<0.05）；治疗组的血清MPO、LPO水平低于对照组，血清GSH-Px水平高于对照组，差异有统计学意义（P<0.05）。治疗后，两组的血清心肌肌钙蛋白I（cTnI）、肌酸激酶同工酶（CK-MB）、肌红蛋白（MYO）水平显著降低（P<0.05）；治疗组的血清cTnI、CK-MB、MYO水平明显低于对照组，差异有统计学意义（P<0.05）。结论 脑心通胶囊联合替格瑞洛片可进一步提高冠心病心绞痛的疗效，改善心功能，显著减轻心绞痛症状和氧化应激反应，降低心肌细胞损伤。

Objective To investigate the clinical effect of Naoxintong Capsules 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 Rocket Army Characteristic Medical Center from September 2020 to October 2022 were divided into control and treatment groups according to the random number table method, and each group had 51 cases. Patients in the control group were po administered with Ticagrelor Tablets, starting dosage 2 tablets/time, twice daily, after 1 week, and the dose was adjusted to 1 tablet, twice daily. Patients in the treatment group were po administered with Naoxintong Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and the frequency and duration of angina pectoris, the pain degree of angina pectoris, the cardiac function indexes, the serum oxidative stress indicators, and the serum markers of myocardial injury in two groups were compared. Results After treatment, the total effective rate of the treatment group was 92.16%, which was significantly higher than that of the control group (76.47%), with a statistically significant difference between the groups (P < 0.05). After treatment, the frequency and duration of angina pectoris in two groups were significantly reduced (P < 0.05). The frequency and duration of angina pectoris in the treatment group were lower than those in the control group, with a statistically significant difference (P< 0.05). After treatment, the VAS scores of two groups were significantly reduced (P < 0.05), and the VAS scores of the treatment group were lower than those of the control group, with a statistically significant difference (P < 0.05). After treatment, LVEF and SV in two groups were significantly increased (P < 0.05), and LVEF and SV in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, the serum levels of MPO and LPO in two groups were significantly decreased, but the serum level of GSH-Px was significantly increased (P < 0.05). The serum levels of MPO and LPO in the treatment group were lower than those in the control group, but the serum levels of GSH-Px in the treatment group were higher than those in the control group (P< 0.05). After treatment, the serum levels of cTnI, CK-MB, and MYO in two groups were significantly decreased (P < 0.05). The serum levels of cTnI, CK-MB, and MYO in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Naoxintong Capsules combined with Ticagrelor Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can improve cardiac function, significantly reduce angina pectoris symptoms and oxidative stress reaction, and reduce myocardial cell damage.

R972

北京市自然科学基金资助项目（7222229）