目的 探讨通脉养心丸联合盐酸替罗非班治疗不稳定型心绞痛的临床疗效。方法 回顾性分析2018年10月-2020年10月在驻马店市中心医院治疗的122例不稳定型心绞痛患者临床资料，根据治疗方案的差异分成对照组（61例）和治疗组（61例）。对照组给予盐酸替罗非班氯化钠注射液，初始计量0.4 μg/（kg·min），用药30 min后，继续以0.1 μg/（kg·min）的速率维持滴注。治疗组在对照组基础上口服通脉养心丸，40丸/次，2次/d。两组均治疗10 d。观察两组的临床疗效，比较两组治疗前后心功能指标、血清学指标和凝血指标的变化情况。结果 治疗后，治疗组治疗的总有效率是98.36%，远高于对照组（81.97%，P<0.05）。经治疗，两组患者心输出量（CO）、每搏量（SV）、射血分数（EF）均显著提高（P<0.05）；治疗后，治疗组患者心功能指标显著高于对照组（P<0.05）。经治疗，两组患者血清半乳糖凝集素-3（Gal-3）、血清Ⅰ型胶原羧基端吡啶并啉交联肽（ICTP）、可溶性生长刺激基因表达蛋白2（sST2）、人可溶性细胞黏附分子（sICAM-1）、血清炎症脂肪细胞因子五聚素3（PTX-3）水平均显著下降（P<0.05）；且治疗后治疗组血清学指标低于对照组（P<0.05）。经治疗，两组患者纤维蛋白原（FIB）、D-二聚体（D-D）水平均显著下降（P<0.05）；且治疗后，治疗组FIB、D-D低于对照组（P<0.05）。结论 通脉养心丸联合盐酸替罗非班治疗不稳定型心绞痛可有效提高患者临床疗效，改善患者心功能和血清学指标，有利于调节凝血指标，有一定的临床推广应用价值。

Objective To investigate the effect of Tongmai Yangxin Pills combined with tirofiban in treatment of unstable angina pectoris. Methods Retrospective analysis was performed on the clinical data of 122 patients with unstable angina treated in Zhumadian Central Hospital from October 2018 to October 2020. The patients were divided into control group (61 cases) and treatment group (61 cases) according to the difference of treatment. The control group was given Tirofiban Hydrochloride Sodium Chloride Injection, and the initial dosage was 0.4 μg/(kg·min). After 30 min, the infusion was continued at the rate of 0.1 μg/(kg·min). Patients in the treatment group were po administered with Tongmai Yangxin Pills on the basis of the control group, 40 pills/time, twice daily. Patients in two groups were treated for 10 d. The clinical efficacy of the two groups was observed, and the changes of cardiac function, serology and coagulation indexes before and after treatment were compared between the two groups. Results After treatment, the total effective rate of the treatment group was 98.36%, much higher than that of the control group (81.97%, P<0.05). After treatment, CO, SV and EF were significantly increased in both groups (P<0.05). After treatment, cardiac function indexes of patients in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, two groups of patients with serum Gal-3, ICTP, sST2, sICAM-1, PTX-3, levels were significantly decreased (P<0.05); After treatment, serological indexes of the treatment group were lower than those of the control group (P<0.05). After treatment, the levels of FIB and D-D in both groups were significantly decreased (P<0.05). After treatment, FIB and D-D in the treatment group were lower than those in the control group (P<0.05). Conclusion Tongmai Yangxin Pills combined with tirofiban can effectively improve the clinical efficacy in treatment of unstable angina pectoris, and can improve cardiac function and serological indexes, and is beneficial to regulate blood coagulation indexes, which has certain clinical application value.

R972

河北省医学科学研究项目[冀工办科教（2017）3号]