目的 探讨冠心苏合丸联合替格瑞洛治疗冠心病心绞痛的临床研究。方法 选取2018年3月—2020年3月在南阳市第二人民院心血管科治疗的112例冠心病心绞痛患者，根据随机数字法分为对照组（56例）和治疗组（56例）。对照组口服替格瑞洛片，起始剂量2片/次，维持剂量1片/次，2次/d。治疗组在对照组的基础上咀嚼冠心苏合丸，1丸/次，2次/d。两组连续治疗12个月。观察两组患者临床疗效，比较治疗前后两组患者心绞痛发作频率、发作持续时间、心功能指标左心室射血分数（LVEF）、心脏每搏输出量（SV）和心输出量（CO），血清因子白细胞介素6（IL-6）、超敏C反应蛋白（hs-CRP）、血管内皮生长因子（VEGF）、内皮素-1（ET-1）水平及不良反应。结果 治疗后，治疗组总有效率为96.43%显著高于对照组的76.78%（P<0.05）。治疗后，两组心绞痛发作频率、发作持续时间指标均明显低于治疗前（P<0.05）；治疗后，治疗组心绞痛发作情况改善优于对照组（P<0.05）。治疗后，治疗组患者心功能LVEF、SV、CO指标明显高于对照组（P<0.05）；治疗后，治疗组患者IL-6、hs-CRP、ET-1均明显低于对照组，而VEGF指标明显高于对照组（P<0.05）；治疗组患者不良反应发生率明显低于对照组（P<0.05）。结论 冠心苏合丸联合替格瑞洛治疗冠心病心绞痛疗效明显，能有效改善临床症状，降低炎性因子，心功能改善显著，且安全有效。

Objective To investigate the clinical effect of Guanxin Suhe Pills combined with ticagrelor in treatment of angina pectoris of coronary heart disease. Methods Patients (112 cases) with angina pectoris of coronary heart disease in Nanyang Second General Hospital from March 2018 to March 2020 were randomly divided into control (56 cases) and treatment (56 cases) groups. Patients in the control group were po administered with Ticagrelor Tablets, the initial dose was 2 tablets/time, and the maintenance dose was 1 tablets/time, twice daily. Patients in the treatment group chewed Guanxin Suhe Pills on the basis of the control group, 1 pill/time, twice daily. Patients in two groups were treated for 12 months. After treatment, the clinical efficacy was evaluated, and the attack frequency and duration of angina pectoris, cardiac function index of LVEF, SV and CO, serum factors of IL-6, hs-CRP, ET-1 and VEGF levels, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 96.43%, which was significantly higher than that of the control group (76.78%, P<0.05). After treatment, the attack frequency and duration of angina pectoris in both groups were significantly lower than those before treatment (P<0.05). After treatment, the improvement of angina attack in the treatment group was better than that in the control group (P<0.05). After treatment, the indexes of LVEF, SV, and CO of cardiac function in the treatment group were significantly higher than those in the control group (P<0.05). After treatment, the indexes of IL-6, hs-CRP, and ET-1 in the treatment group were significantly lower than those in the controlgroup, while the index of VEGF in the treatment group was significantly higher than that in the control group (P<0.05). The incidence of adverse reactions in the treatment group was significantly lower than that in the control group (P<0.05). Conclusion Guanxin Suhe Pills combined with Ticagrelor Tablets is effective in treatment of angina pectoris of coronary heart disease, which can effectively improve clinical symptoms, reduce inflammatory factors, improve cardiac function significantly, and which is safe and effective.

R972

河南省医学科技攻关项目（2018020986）