目的 探讨葛兰心宁软胶囊联合双嘧达莫片治疗冠心病心绞痛的临床疗效。方法 选择2019年6月—2021年6月在南阳南石医院治疗的84例冠心病心绞痛患者，根据用药的差别分成对照组（42例）和治疗组（42例）。对照组口服双嘧达莫片，50 mg/次，3次/d；治疗组在对照组基础上口服葛兰心宁软胶囊，1.16 g/次，2次/d。两组均经4周治疗。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次数和持续时间，GQOLI-74、SF-36、SAQ和临床症状积分，及血清C反应蛋白（CRP）、可溶性CD40配体（sCD40L）、白细胞介素-18（IL-18）、髓过氧化酶（MPO）、人可溶性细胞黏附分子（sICAM-1）和妊娠相关血浆蛋白-A（PAPP-A）水平。结果 经治疗，对照组总有效率为80.95%，显著低于治疗组的97.62%（P<0.05）。经治疗，两组心绞痛发作次数、持续时间均显著减少（P<0.05），但以治疗组减少最明显（P<0.05）。经治疗，两组GQOLI-74、SF-36和SAQ积分明显升高，临床症状积分明显降低（P<0.05），但治疗组积分明显好于对照组（P<0.05）。治疗后，两组患者血清CRP、sCD40L、IL-18、MPO、sICAM-1和PAPP-A水平明显降低（P<0.05），且治疗组降低更明显（P<0.05）。结论 双嘧达莫片联合葛兰心宁软胶囊治疗冠心病心绞痛不仅促进症状改善，还能够促进机体细胞因子及生活质量的改善，具有一定临床推广应用价值。

Objective To investigate the clinical efficacy of Gelan Xinning Soft Capsules combined with dipyridamole in treatment of angina pectoris of coronary heart disease. Methods Patients (84 cases) with angina pectoris of coronary heart disease in Nanshai Hospital of Nanyang from June 2019 to June 2021 were divided into control (42 cases) and treatment (42 cases) group according to different treatments. Patients in the control group were po administered with Dipyridamole Tablets, 50 mg/time, three times daily. Patients in the treatment group were po administered with Gelan Xinning Soft Capsules on the basis of the control group, 1.16 g/time, twice daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical evaluation was evaluated, the frequency and duration of angina pectoris, the scores of related GQOLI-74, SF-36, SAQ and clinical symptom, and the levels of serological indexes CRP, sCD40L, IL-18, MPO, sICAM-1 and PAPP-A in two groups before and after treatment were compared.Results After treatment, the clinical effective rate in the control group was 80.95%, which was significantly lower than 97.62% in the treatment group (P < 0.05). After treatment, the attack frequencies and duration of angina pectoris were significantly decreased in two groups (P < 0.05), but the treatment group decreased most obviously (P< 0.05). After treatment, the scores of GQOLI-74, SF-36 and SAQ in two groups were significantly increased, while the scores of clinical symptoms were significantly decreased (P < 0.05), and the score of the treatment group was significantly better than that of the control group (P < 0.05). After treatment, the serum levels of CRP, sCD40L, IL-18, MPO, sICAM-1 and PAPP-An in two groups were significantly decreased (P < 0.05), especially in the treatment group (P < 0.05).Conclusion Gelan Xinning Soft Capsules combined with dipyridamole in treatment of angina pectoris of coronary heart disease can not only promote the improvement of symptoms, but also the cytokines and quality of life, which has a certain clinical application value.

R972

河南省医学科技攻关计划项目（201701029）