目的 探讨心可舒片联合阿托伐他汀钙片治疗不稳定型心绞痛的临床疗效。方法 选取2018年3月-2019年7月在天津市宁河区医院就诊的84例不稳定型心绞痛患者为研究对象，将全部患者根据随机数字表法分为对照组和治疗组，每组各有42例。对照组口服阿托伐他汀钙片，20 mg/次，1次/d。治疗组在对照组基础上口服心可舒片，4片/次，3次/d。两组患者连续治疗6个月。观察两组的临床疗效，比较两组的临床症状改善、血脂、血液流变学、血清因子水平。结果 治疗后，对照组和治疗组的心绞痛疗效总有效率分别为76.19%、92.86%，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61.90%、69.05%，两组比较差异有统计学意义（P<0.05）。治疗后，两组心绞痛发作频率、持续时间均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的发作频率、持续时间明显低于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组的总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）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）；且治疗组的LDL-C水平明显低于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组的全血黏度、血浆黏度、纤维蛋白原（FIB）、D-二聚体水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的全血黏度、血浆黏度、FIB、D-二聚体水平明显低于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组的C-反应蛋白（CRP）、内皮素-1（ET-1）、同型半胱氨酸（Hcy）水平均明显降低，一氧化氮（NO）水平明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的血清因子水平明显优于对照组，两组差异有统计学意义（P<0.05）。结论 心可舒片联合阿托伐他汀钙片治疗不稳定型心绞痛具有较好的临床疗效，可减轻心绞痛症状，降低炎症因子水平，提高血管内皮功能，改善血液流变学和血脂水平，具有一定的临床应用价值。

Objective To investigate the clinical efficacy of Xinkeshu Tablets combined with Atorvastatin Calcium Tablets in treatment of unstable angina pectoris. Methods Patients (84 cases) with unstable angina pectoris in Tianjin Ninghe Hospital from March 2018 to July 2019 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were po administered with Xinkeshu Tablet on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and improvement of clinical symptoms, blood lipid levels, hemorheology, and serum factor levels in two groups were compared. Results After treatment, the curative effect of angina pectoris in the control and treatment groups were 76.19% and 92.86%, and the electrocardiogram effect in the control and treatment groups were 61.90% and 69.05%, respectively, and there was difference between two groups (P < 0.05). After treatment, the frequency and duration 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, the level of TG, TC, and LDL-C in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the levels of LDL-C in the treatment group were significantly lower than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of whole blood viscosity, plasma viscosity, FIB, and D-dimer in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the hemorheology 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 CRP, ET-1, and Hcy in two groups were significantly decreased, but the levels of NO in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the serum factor levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xinkeshu Tablet combined with Atorvastatin Calcium Tablets has clinical curative effect in treatment of unstable angina pectoris, can alleviate the symptoms of angina pectoris, reduce the level of inflammatory factors, improve the function of vascular endothelium, and improve the level of Hemorheology and blood lipids, which has a certain clinical application value.

R972