目的 探讨地奥心血康软胶囊联合酒石酸美托洛尔片治疗冠心病心绞痛的临床疗效。方法 纳入2023年3月—12月新乡医学院第一附属医院140例冠心病心绞痛患者，按照随机数字表法将所有研究对象分为对照组和治疗组，各组70例。对照组口服酒石酸美托洛尔片，25 mg/次，2次/d。治疗组在对照组的基础上口服地奥心血康软胶囊，1粒/次，3次/d。两组均治疗4周。比较两组的临床疗效、心绞痛症状、心功能指标、血清血管内皮细胞功能因子和炎症因子指标。结果 治疗后，对照组的总有效率为81.43%；治疗组的总有效率为94.29%，组间比较差异显著（P＜0.05）。治疗后，两组心绞痛发作频率、VAS评分均显著降低（P＜0.05），且治疗组的心绞痛发作频率、VAS评分低于对照组（P＜0.05）。治疗后，两组每搏输出量（SV）、心脏指数（CI）、心输出量（CO）和左室射血分数（LVEF）均显著升高（P＜0.05），且治疗组的SV、CI、CO和LVEF高于对照组（P＜0.05）。治疗后，两组血清内皮素1（ET-1）、血管紧张素II（Ang-II）水平均显著降低，而血清一氧化氮（NO）水平显著升高（P＜0.05），且治疗组的血清ET-1、Ang-II水平低于对照组，而血清NO水平显著高于对照组（P＜0.05）。治疗后，两组血清白细胞介素-6（IL-6）、肿瘤坏死因子（TNF-α）和超敏C反应蛋白（hs-CRP）水平均显著降低（P＜0.05），且治疗组血清IL-6、TNF-α和hs-CRP水平显著低于对照组（P＜0.05）。结论 地奥心血康软胶囊联合酒石酸美托洛尔片治疗冠心病心绞痛的临床疗效显著，能显著改善冠心病心绞痛患者的临床症状，可能与改善血管内皮细胞功能、降低机体炎症因子水平有关。

Objective To investigate the clinical efficacy of Di'ao Xinxuekang Soft Capsule combined with Metoprolol Tartrate Tablets in treatment of angina pectoris of coronary heart disease. Methods A total of 140 patients with angina pectoris of coronary heart disease from March to December, 2023 in First Affiliated Hospital of Xinxiang Medical University were enrolled and divided into control group and treatment group according to random number tablet method, and each group had 70 cases. Patients in the control group were po administered with Metoprolol Tartrate Tablets, 25 mg/time, twice daily. Patients in the treatment group were po administered Di'ao Xinxuekang Soft Capsules on the basis of the control group, 1 capsule/time, three times daily. Both groups were treated for 4 weeks. The clinical efficacy, angina symptoms, cardiac function indicators, serum vascular endothelial cell function factors, and inflammatory factors were compared between the two groups. Results After treatment, the total effective rate of the control and treatment group were 81.43% and 94.29%, respectively, with statistical significance between two groups (P < 0.05). After treatment, the frequency of angina pectoris and VAS scores in both groups were significantly decreased (P < 0.05), and the frequency of angina pectoris and VAS scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, SV, CI, CO, and LVEF in both groups were significantly increased (P < 0.05), and SV, CI, CO, and LVEF in the treatment group were higher than those in the control group (P < 0.05). After treatment, the levels of serum ET-1 and Ang-II in both groups were significantly decreased, while the level of serum NO was significantly increased (P < 0.05). The levels of serum ET-1 and Ang-II in the treatment group were lower than those in the control group, while the level of serum NO was significantly higher than that in the control group (P < 0.05). After treatment, the levels of IL-6, TNF-α, and hs-CRP in both groups were significantly decreased (P < 0.05), and the levels of IL-6, TNF-α, and hs-CRP in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Di'ao Xinxuekang Soft Capsule combined with Metoprolol Tartrate Tablets can significantly improve the clinical symptoms and cardiac function in patients with angina pectoris of coronary heart disease, which may be related to improving the function of vascular endothelial cells and decreasing the expression of inflammatory factors.

R972

河南省医学科技攻关计划项目（LHGJ20220588）