目的 探讨银杏叶片联合富马酸比索洛尔片治疗冠心病心绞痛的临床疗效。方法 选取2018年1月-2019年6月在天津市宁河区医院就诊的116例冠心病心绞痛患者作为研究对象，将全部患者按照随机数字表法分为对照组和治疗组，每组各58例。对照组口服富马酸比索洛尔片，2.5 mg/次，1次/d。治疗组在对照组治疗的基础上口服银杏叶片，0.2 g/次，3次/d。两组患者连续治疗3个月。观察两组的心绞痛疗效和心电图疗效，比较两组的心功能指标、临床症状、氧化应激指标、心肌损伤标志物。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79.31%、93.10%，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68.97%、84.48%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组左室射血分数（LVEF）、心输出量均明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组的LVEF、心输出量均明显高于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组心绞痛发作次数、每次发作持续时间、硝酸甘油用量均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组心绞痛发作次数、每次发作持续时间、硝酸甘油用量均明显低于对照组，两组差异有统计学意义（P<0.05）。治疗后，两组的超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）水平均显著升高，丙二醛（MDA）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）；且治疗组的SOD、GSH-Px水平均明显高于对照组，MDA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，两组肌酸激酶同工酶（CK-MB）、脑钠肽（BNP）、心肌肌钙蛋白Ⅰ（cTnⅠ）水平均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组CK-MB、BNP、cTnI水平均明显低于对照组，两组差异有统计学意义（P<0.05）。结论 银杏叶片联合富马酸比索洛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，降低氧化应激反应，减轻心肌损伤，提高心功能，具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of Yinxingye Tablets combined with Bisoprolol Fumarate Tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (116 cases) with angina pectoris of coronary heart disease in Tianjin Ninghe Hospital from January 2018 to June 2019 were randomly divided into control and treatment groups, and each group had 58 cases. Patients in the control group were po administered with Bisoprolol Fumarate Tablets, 2.5 mg/time, once daily. Patients in the treatment group were po administered with Yinxingye Tablets on the basis of the control group, 0.2 g/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, clinical symptoms, oxidative stress indexes, and markers of myocardial injury in two groups were compared. Results After treatment, the curative effect of angina pectoris in the control and treatment groups were 79.31% and 93.10%, respectively, and there was difference between two groups (P<0.05). After treatment, the electrocardiogram efficacies in the control and treatment groups were 68.97% and 84.48%, respectively, and there was difference between two groups (P<0.05). After treatment, LVEF and cardiac output 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 higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the frequency of angina pectoris, the duration of each attack, and the dosage of nitroglycerin 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 levels of SOD and GSH-Px in two groups were significantly increased, but the levels of MDA in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the levels of SOD and GSH-Px in the treatment group were significantly higher than those in the control group, but the levels of MDA were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of CK-MB, BNP, and cTnⅠ in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the markers of myocardial injury in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Yinxingye Tablets combined with Bisoprolol Fumarate Tablets has clinical curative effect in treatment of angina pectoris of coronary heart disease, can improve clinical symptoms, reduce oxidative stress response, reduce myocardial injury, and improve cardiac function, which has a certain clinical application value.

R972