目的 探讨血府逐瘀联合非洛地平治疗老年冠心病心绞痛患者的安全性与有效性。方法 选取2018年6月—2019年12月在天津医科大学第二医院治疗的老年冠心病心绞痛患者145例，随机分成对照组（72例）和治疗组（73例）。对照组患者口服非洛地平缓释片，1片/次，1次/d；治疗组患者在对照组基础上口服血府逐瘀胶囊，6粒/次，2次/d。两组患者均连续治疗2个月。观察两组患者临床疗效和心电图疗效，同时比较治疗前后两组患者心绞痛发作次数、硝酸甘油用量、西雅图心绞痛评分，心功能指标左室射血分数（LVEE）、左室收缩末期内径（LVESD）和左室收缩末期容积（LVESV），血清肌酸激酶同工酶（CK-MB）、N-端脑利钠肽前体（NT-proBNP）和可溶性CD105（sCD105）水平及不良反应情况。结果 治疗后，对照组临床总有效率和心电图有效率分别为83.33%、81.94%，均明显低于治疗组的95.89%、97.26%（P<0.05）。治疗后，两组患者心绞痛发作次数和硝酸甘油用量显著下降，而西雅图心绞痛评分明显升高（P<0.05）；且治疗组各指标相较于对照组改善更显著（P<0.05）。治疗后，两组患者心功能指标LVEE明显升高（P<0.05），而LVESD和LVESV明显降低（P<0.05），且治疗组各指标相较于对照组改善的更为显著（P<0.05）。治疗后，两组患者血清CK-MB、NT-proBNP、sCD105水平显著降低（P<0.05），且治疗组比对照组降低更明显（P<0.05）。治疗期间，对照组不良反应发生率为11.11%，明显高于治疗组的2.74%，两组比较差异具有统计学意义（P<0.05）。结论 血府逐瘀胶囊联合非洛地平治疗老年冠心病心绞痛疗效显著，能够显著改善患者的心绞痛症状，促进血清生化指标的平衡，具有一定的临床推广应用价值。

Objective To investigate the safety and effectiveness of Xuefu Zhuyu Capsules combined with felodipine in treatment of senile coronary heart disease angina pectoris. Methods Patients (145 cases) with coronary heart disease angina pectoris in the Second Hospital of Tianjin Medical University from June 2018 to December 2019 were randomly divided into control (72 cases) and treatment (73 cases) groups. Patients in the control group were po administered with Felodipine Sustained Release Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Xuefu Zhuyu Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy and ECG efficacy were evaluated, and the frequency of angina pectoris episodes, the amount of nitroglycerin, and the angina pectoris scale scores, the cardiac function related indicators of LVEE, LVESD and LVESV, the serum biochemical indicators of CK-MB, NT-proBNP and sCD105, and the adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and ECG efficacy in the control group were 83.33% and 81.94%, which were significantly lower than 95.89% and 97.26% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the frequency of angina pectoris episodes and the amount of nitroglycerin in two groups were significantly decreased, but the angina pectoris scale scores were significantly increased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the cardiac function related indicator of LVEE in two groups were significantly increased, but the LVESD and LVESV were significantly decreased (P<0.05), and these indexes in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the serum biochemical indicators of CK-MB, NT-proBNP and SCD105 in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, the adverse reactions rate in the control group was 11.11%, which was significantly higher than 2.74% in treatment the group, with significant difference between two groups (P<0.05). Conclusion Xuefu Zhuyu Capsules combined with felodipine has significant curative effect on senile coronary heart disease angina pectoris, can significantly improve the symptoms of angina pectoris and promote the balance of serum biochemical indicators, which has a certain clinical application value.

R972