目的 观察心可宁胶囊联合氯吡格雷治疗不稳定型心绞痛的临床疗效。方法 选取2020年9月—2023年9月北京中医药大学孙思邈医院收治的100例不稳定型心绞痛患者，按照随机数字表法分为对照组和治疗组，每组各50例。对照组口服硫酸氢氯吡格雷片，2片/次，1次/d。治疗组在对照组基础上口服心可宁胶囊，2粒/次，3次/d。两组均连续治疗6周。观察两组的临床疗效，比较两组治疗前后心绞痛发作的持续时间、次数，在花生四烯酸（AA）、二磷酸腺苷（ADP）诱导下血小板聚集率，血清超敏C反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、同型半胱氨酸（Hcy）、血管内皮生长因子（VEGF）、内皮缩血管肽-1（ET-1）水平。结果 治疗后，治疗组总有效率是94.0%，显著高于对照组的78.0%（P＜0.05）。治疗后，两组心绞痛发作的持续时间、次数均显著降低（P＜0.05）；治疗后治疗组心绞痛持续时间、次数低于对照组（P＜0.05）。治疗后，两组AA、ADP诱导下的血小板聚集率均较治疗前显著降低（P＜0.05）；治疗后，治疗组血小板聚集率低于对照组（P＜0.05）。治疗后，两组hs-CRP、IL-6、Hcy、ET-1水平均较治疗前降低，而VEGF水平升高（P＜0.05）；治疗后，治疗组血清因子指标改善优于对照组（P＜0.05）。结论 心可宁胶囊联合氯吡格雷对不稳定型心绞痛的治疗效果较好，能够缓解临床症状，抑制血小板聚集，降低炎性因子水平，改善血管内皮功能，且安全性较好。

Objective To investigate the clinical efficacy of Xinkening Capsules combined with clopidogrel in treatment of unstable angina pectoris. Methods A total of 100 patients with unstable angina pectoris treated in Sun Simiao Hospital of Beijing University of Chinese Medicine from September 2020 to September 2023 were selected and divided into control group and treatment group according to random number table method, with 50 cases in each group. Patients in the control group were po administered with Clopidogrel Bisulfate Tablets, 2 tablets/time, once daily. Patients in the treatment group were po administered with Xinkening Capsules on the basis of the control group, 2 grains/time, three times daily. Both groups were treated continuously for 6 weeks. The clinical efficacy of the two groups were observed, and the duration and frequency of angina pectoris attacks before and after treatment, and the platelet aggregation rate induced by arachidonic acid (AA) and adenosine diphosphate (ADP) between the two groups, serum levels of hypersensitive C-reactive protein (hs-CRP), interleukin-6 (IL-6), homocysteine (Hcy), vascular endothelial growth factor (VEGF), and endothelial vasoconstricting peptide-1 (ET-1) in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 94.0%, which was significantly higher than that of the control group (78.0%, P < 0.05). After treatment, the duration and frequency of angina pectoris attacks in both groups were significantly decreased (P < 0.05). After treatment, the duration and frequency of angina pectoris in the treatment group were lower than those in the control group (P < 0.05). After treatment, the platelet aggregation rate induced by AA and ADP was significantly decreased in both groups compared with that before treatment (P < 0.05). After treatment, the platelet aggregation rate in treatment group was lower than that in control group (P < 0.05). After treatment, the levels of hs-CRP, IL-6, Hcy and ET-1 in both groups were decreased compared with before treatment, but the levels of VEGF were increased (P < 0.05). After treatment, the improvement of serum factor index in treatment group was better than that in control group (P < 0.05). Conclusion Xinkening Capsules combined with clopidogrel has good effect in treatment of unstable angina pectoris, and can alleviate clinical symptoms, inhibit platelet aggregation, reduce inflammatory factors, which can improve vascular endothelial function with good safety.

R972

陕西省中医药科研项目(JCPT054)