目的 探讨理气活血滴丸联合替格瑞洛治疗冠状动脉旁路移植术（CABG）后再发心绞痛的临床疗效。方法 纳入2021年10月—2025年9月秦皇岛市第一医院收治的96例CABG术后再发心绞痛患者的病例资料进行回顾性分析。按治疗方案不同分为对照组和治疗组，每组各48例。对照组口服替格瑞洛片，90 mg/次，2次/d。治疗组在对照组基础上餐后口服理气活血滴丸，10丸/次，3次/d。两组患者疗程4周。统计两组临床疗效，对比治疗前后心绞痛表现、中医症状评分、医院焦虑抑郁量表（HADS）和心绞痛生活质量问卷（APQLQ）评分，以及血小板指标P-选择素、血小板平均体积（MPV）、血小板–白细胞聚集体（PLA），中性粒细胞与淋巴细胞比值（NLR）、血栓前体蛋白（TPP）、C反应蛋白（CRP）水平。结果 治疗后，治疗组总有效率明显高于对照组（91.67% vs 77.08%，P＜0.05）。治疗后，两组疼痛VAS评分、发作次数均降低，持续时间均缩短（P＜0.05）；且治疗组均低于/短于对照组（P＜0.05）。比较硝酸甘油停减率，治疗组高于对照组（85.42% vs 66.67%，P＜0.05）。治疗后，两组中医症状评分、HADS评分和APQLQ评分，P-选择素、MPV、PLA、NLR、TPP和CRP水平均比治疗前显著降低（P＜0.05），且治疗组指标明显低于对照组（P＜0.05）。结论 理气活血滴丸联合替格瑞洛治疗CABG术后再发心绞痛，可显著改善患者心绞痛症状、情绪状态及生活质量，有效下调血小板活化、炎症及血栓相关指标，阻断炎症与血栓恶性循环，安全可靠。

Objective To explore the clinical efficacy of Liqi Huoxue Dripping Pills combined with ticagrelor in the treatment of recurrent angina pectoris after coronary artery bypass grafting (CABG). Methods A retrospective analysis was conducted on the clinical data of 96 patients with recurrent angina pectoris after CABG admitted to the First Hospital of Qinhuangdao from October 2021 to September 2025. The patients were divided into control group and treatment group according to different treatment methods, with 48 cases in each group. The control group received oral Ticagrelor Tablets at 90 mg, twice daily. On the basis of the above regimen, the treatment group was additionally given oral Liqi Huoxue Dripping Pills after meals, 10 pills each time, three times daily. The treatment course lasted 4 weeks for both groups. The clinical efficacy was evaluated. Angina symptoms, traditional Chinese medicine (TCM) symptom scores, Hospital Anxiety and Depression Scale (HADS) scores and Angina Pectoris Quality of Life Questionnaire (APQLQ) scores were compared before and after treatment. Platelet-related indicators including P-selectin, mean platelet volume (MPV) and platelet-leukocyte aggregates (PLA), as well as neutrophil-to-lymphocyte ratio (NLR), thrombus precursor protein (TPP) and C-reactive protein (CRP) were also detected. Results After treatment, the total effective rate of the treatment group was significantly higher than that of the control group (91.67% vs 77.08%, P < 0.05). In both groups, the visual analogue scale (VAS) score for pain, attack frequency and duration of angina were decreased after treatment (P < 0.05), and the treatment group showed better results in these indicators (P < 0.05). The nitroglycerin discontinuation and reduction rate was higher in the treatment group (85.42% vs 66.67%, P < 0.05). Additionally, TCM symptom scores, HADS scores, APQLQ scores, and levels of P-selectin, MPV, PLA, NLR, TPP and CRP were all markedly reduced in both groups (P < 0.05), with significantly lower values observed in the treatment group (P < 0.05). Conclusion For patients with recurrent angina pectoris after CABG, the combined therapy of Liqi Huoxue Dripping Pills and ticagrelor can remarkably relieve angina symptoms, improve emotional status and quality of life. It effectively downregulates indicators associated with platelet activation, inflammation and thrombosis, and interrupts the vicious cycle of inflammation and thrombosis. This therapeutic regimen is safe and reliable.

R972

秦皇岛市科学技术研究与发展计划项目（202004A096）