目的 探讨冠脉通片联合硫酸氢氯吡格雷片治疗冠心病心绞痛的临床疗效。方法 选取2019年5月-2020年5月在天津市南开区中医医院治疗的冠心病心绞痛患者94例，根据就诊顺序分为对照组（47例）和治疗组（47例）。对照组口服硫酸氢氯吡格雷片，75 mg/次，1次/d；治疗组在对照组的基础上口服冠脉通片，1.8 g/次，3次/d。两组患者均经4周治疗。观察两组患者心绞痛和心电图疗效，同时比较治疗前后两组患者心绞痛发作次数和持续时间，及血清血小板颗粒膜蛋白-140（GMP-140）、可溶性细胞间黏附分子-1（sICAM-1）、纤溶酶原激活剂抑制物-1（PAI-1）、白细胞三烯E4（LTB4）、髓过氧化物酶（MPO）、脂联素（APN）、血小板黏附率（PAR）、血浆黏度（PV）、纤维蛋白原（FIB）、全血黏度（WBV）、磷酸肌酸激酶（CK）、磷酸肌酸酶同工酶（CK-MB）、乳酸肌氢酶（LDH）和羟丁酸脱氢酶（HBDH）水平。结果 治疗后，对照组心绞痛和心电图有效率分别为80.65%和82.98%，均分别显著低于治疗组的95.74%和97.87%，两组比较差异有统计学意义（P<0.05）。治疗后，两组心绞痛发作次数和持续时间均显著下降（P<0.05），且治疗组下降更明显（P<0.05）。治疗后，两组血清GMP-140、sICAM-1、PAI-1、LTB4、MPO、PV、WBV、PAR、FIB、CK、CK-MB、LDH、HBDH水平均显著下降（P<0.05），而APN显著升高（P<0.05），且治疗组这些血清学指标改善更明显（P<0.05）。结论 冠心病心绞痛患者给予氯吡格雷治疗的同时口服冠脉通片可促进心绞痛症状改善，有利于心肌酶谱及血清GMP-140、sICAM-1、PAI-1、LTB4、MPO、APN水平改善，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Guangmaitong Tablets combined with clopidogrel tablets in treatment of angina pectoris of coronary heart disease. Methods Patients (94 cases) with angina pectoris of coronary heart disease in Tianjin Nankai District Hospital of TCM from May 2019 to May 2020 were divided into control (47 cases) and treatment (47 cases) groups based on visiting sequence. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 75 mg/time, once daily. Patients in the treatment group were po administered with Guangmaitong Tablets on the basis of the control group, 1.8 g/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the angina pectoris and electrocardiogram efficacy were evaluated, and the frequency and duration of angina pectoris, the serum levels of GMP-140, sICAM-1, PAI-1, LTB4, MPO, APN, PV, WBV, PAR, FIB, CK, CK-MB, LDH and HBDH in two groups before and after treatment were compared. Results After treatment, the angina pectoris and electrocardiogram efficacy in the control group were 80.65% and 82.98%, which were significantly lower than 95.74% and 97.87% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly lower than that in the control group (P<0.05). After treatment, the serum levels of GMP-140, sICAM-1, PAI-1, LTB4, MPO, PV, WBV, PAR, FIB, CK, CK-MB, LDH and HBDH in two groups were significantly decreased (P<0.05), but the APN levels were significantly increased (P<0.05), and these serological indicators in the treatment group were significantly better than those in the control group (P<0.05). Conclusion Oral administration with Guanmaitong Tablets can improve the symptoms of angina pectoris in patients with angina pectoris of coronary heart disease treated with clopidogrel, and is conducive to the improvement of myocardial enzyme spectrum and the serum GMP-140, sICAM-1, PAI-1, LTB4, MPO, APN levels, which has a certain clinical application value.

R972