目的 研究通心舒胶囊联合尼可地尔片治疗冠心病心绞痛的临床疗效。方法 选取2017年12月-2019年5月在华中阜外医院治疗的冠心病心绞痛患者92例为研究对象，将所有患者随机分为对照组和治疗组，每组各46例。对照组患者口服尼可地尔片，1片/次，3次/d；治疗组在对照组治疗的基础上口服通心舒胶囊，2粒/次，3次/d。两组患者均连续口服4周。观察两组的临床疗效和心电图疗效，比较两组的临床症状、心功能指标、心肌酶指标、血液流变学指标。结果 治疗后，对照组和治疗组的临床疗效总有效率分别为78.26%、93.48%，两组比较差异有统计学意义（P<0.05）。治疗后，对照组和治疗组的心电图疗效总有效率分别为80.43%、93.48%，两组比较差异有统计学意义（P<0.05）。治疗后，两组心绞痛持续时间、发作次数显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；并且治疗组心绞痛持续时间、发作次数明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）明显降低，左室射血分数（LVEF）明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组患者心功能指标明显优于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者血清酸激酶MB型同工酶（CK-MB）、肌酸激酶（CK）水平显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组患者血清心肌酶指标水平明显低于对照组，两组比较差异有统计学意义（P<0.05）。治疗后，两组患者全血黏度（WBV）、血浆黏度（PV）、纤维蛋白原（FIB）水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；并且治疗组患者血液流变学指标水平明显低于对照组，两组比较差异有统计学意义（P<0.05）。结论 通心舒胶囊联合尼可地尔片治疗冠心病心绞痛具有较好的临床疗效，可改善临床症状、心功能指标、心肌酶指标、血液流变学指标，具有一定的临床推广应用价值。

Objective To study the clinical effect of Tongxinshu Capsules combined with Nicorandil Tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (92 cases) with angina pectoris of coronary heart disease in Fuwai Central China Cardiovascular Hospital from December 2017 to May 2019 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were po administered with Nicorandil Tablets, 1 tablet/time, three times daily. Patients in the treatment group were po administered with Tongxinshu Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacies and electrocardiographic efficacies were evaluated, and clinical symptoms, cardiac function indexes, myocardial enzyme indexes, and hemorheological indexes in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 78.26% and 93.48%, respectively, and there was difference between two groups (P<0.05). After treatment, the electrocardiographic efficacies in the control and treatment groups were 80.43% and 93.48%, respectively, and there was difference between two groups (P<0.05). After treatment, the duration and frequency of angina pectoris in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the clinical symptoms in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, LVESD and LVEDD in two groups were significantly decreased, but LVEF in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05). And the cardiac function indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CK-MB and CK in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the myocardial enzyme indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of WBV, PV, and FIB in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the hemorheological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Tongxinshu Capsules combined with Nicorandil Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can improve clinical symptoms, cardiac function indexes, myocardial enzyme indexes, and hemorheological indexes, which has a certain clinical application value.

R972

河南省科技发展计划项目（142102310132）