目的 探讨脑心清胶囊联合美托洛尔治疗稳定型心绞痛的临床疗效。方法 选择2021年6月—2023年6月在南通市海门区人民医院治疗的110例稳定型心绞痛患者为研究对象，随机分为对照组和治疗组，每组各55例。对照组口服琥珀酸美托洛尔缓释片，23.75 mg/d。治疗组在对照组基础上口服脑心清胶囊，0.9 g/次，3次/d。两组患者均持续治疗2个月。观察两组临床疗效，比较治疗前后两组临床症状改善情况、心功能、血液流变学指标、血脂指标。结果 治疗后，治疗组总有效率为94.55%，相较对照组（72.73%）明显上升（P＜0.05）。治疗后，两组心绞痛持续时间、发作次数和心肌缺血总负荷均显著降低（P＜0.05），且治疗组明显低于对照组（P＜0.05）。治疗后，两组左心室舒张末期内径（LVEDD）明显降低，而左室射血分数（LVEF）、每搏量（SV）和6 min步行距离均升高（P＜0.05），且治疗组患者这些心功能指标明显好于对照组（P＜0.05）。治疗后，两组血浆黏度、全血高切黏度、全血低切黏度及纤维蛋白原水平明显降低（P＜0.05），且治疗后治疗组比对照组降低更显著（P＜0.05）。治疗后，两组三酰甘油（TG）、总胆固醇（TC）和低密度脂蛋白胆固醇（LDL-C）水平均显著降低，而高密度脂蛋白胆固醇（HDL-C）水平显著升高（P＜0.05），且治疗组明显好于对照组（P＜0.05）。结论 脑心清胶囊联合美托洛尔治疗稳定型心绞痛疗效显著，可有效改善临床症状、增强患者心功能，且安全可靠。

Objective To investigate the clinical efficacy of Naoxinqing Capsules combined with metoprolol in treatment of effort angina pectoris. Methods Patients (110 cases) with effort angina pectoris in Nantong Haimen People’s Hospital from June 2021 to June 2023 were randomly divided into control and treatment group, and each group had 55 cases. Patients in the control group were po administered with Metoprolol Succinate Sustained-release Tablets, 23.75 mg/d. Patients in the treatment group were po administered with Naoxinqing Capsules on the basis of the control group, 0.9 g/time, three time daily. Patients in two groups were treated for 2 month. After treatment, the clinical evaluations were evaluated, improvement of clinical symptoms, cardiac function status, blood rheology indexes, and blood lipid indexes in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 94.55%, significantly higher than 72.73% in the control group (P < 0.05). After treatment, the duration and frequency of angina pectoris and total myocardial ischemic load in 2 groups were significantly decreased (P < 0.05). And the duration and frequency of angina pectoris and total myocardial ischemic load were lower than those in control group (P < 0.05). After treatment, the LVEDD was significantly decreased in both groups (P < 0.05), while LVEF, SV, and 6 min walking distance was significantly increased in both groups (P < 0.05). And LVEDD, LVEF, SV, and 6 min walking distance in treatment group were better than those in control group (P < 0.05). After treatment, the plasma viscosity, whole blood high shear viscosity, whole blood low shear viscosity, and fibrinogen in the treatment group were lower than those in the control group (P < 0.05). After treatment, the reduction was more significant in the treatment group than in the control group (P < 0.05). After treatment, the levels of triglyceride (TG), total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) in both groups were significantly decreased, but the levels of high density lipoprotein cholesterol (HDL-C) were significantly increased (P < 0.05), and the treatment group was significantly better than the control group (P < 0.05). Conclusion Naoxinqing Capsules combined with metoprolol has good efficacy in treatment of effort angina pectoris, can effectively improve patients’ clinical symptoms and enhance their cardiac function with good efficacy and safety.

R972

江苏省卫生健康委科研课题(ZD2020038)