目的 探讨参松养心胶囊联合氨氯地平治疗冠心病心绞痛的临床疗效。方法 纳入2021年1月—2024年8月广州市荔湾中心医院收治的208例冠心病心绞痛患者，按照随机数字表法分为对照组和治疗组，每组各104例。对照组口服苯磺酸氨氯地平片，10 mg/次，1次/d。治疗组在对照组基础上口服参松养心胶囊，3粒/次，3次/d。两组疗程8周。比较两组临床疗效和病情控制情况[发作次数、持续时间、心绞痛视觉模拟量表（VAS）评分、硝酸甘油用量]，以及治疗前后中医症状、西雅图心绞痛量表（SAQ）、华西心晴指数量表（HEI）评分和血清内皮素-1（ET-1）、趋化因子C-X3-C基元配体1（CX3CL1）、基质金属蛋白酶-29（MMP-29）、可溶性细胞间黏附分子-1（sICAM-1）水平。结果 治疗后，治疗组的总有效率是94.23%，高于对照组的79.81%（P＜0.05）。治疗后，两组发作次数、持续时间、心绞痛VAS评分和硝酸甘油用量均降低（P＜0.05），治疗组都低于对照组（P＜0.05）。两组治疗后相关评分：中医症状评分与HEI评分均降低，SAQ评分都升高（P＜0.05）；治疗组中医症状评分与HEI评分低于对照组，SAQ评分高于对照组（P＜0.05）。两组治疗后血清ET-1、CX3CL1、MMP-29和sICAM-1水平均降低（P＜0.05）；治疗组都低于对照组（P＜0.05）。结论 冠心病心绞痛联合应用参松养心胶囊与氨氯地平，能有效抑制机体血管内皮功能障碍及炎症反应，促进动脉斑块稳定及心绞痛症状缓解和病情控制，促进患者生活质量和情绪改善。

Objective To explore the clinical efficacy of Shensong Yangxin Capsules combined with amlodipine in treatment of angina pectoris in coronary heart disease. Methods A total of 208 patients with angina pectoris due to coronary heart disease admitted to Liwan Central Hospital of Guangzhou from January 2021 to August 2024 were included and divided into control groups and treatment group according to the random number table method, with 104 cases in each group. Patients in control group were po administered with Amlodipine Besilate Tablets, 10 mg/time, once daily. Patients in the treatment group were po administered with Shensong Yangxin Capsules on the basis of the control group, 3 grains/time, three times daily. The treatment course for both groups was 8 weeks. The clinical efficacy and disease control conditions [frequency of attacks, duration, Visual Analogue Scale (VAS) score for angina pectoris, dosage of nitroglycerin] of the two groups were compared. The traditional Chinese medicine symptoms, Seattle Angina Questionnaire (SAQ) score, Huaxi Heart Clearing Index (HEI) score, serum endothelin-1 (ET-1), chemokine C-X3-C ligand 1 (CX3CL1), matrix metalloproteinase-29 (MMP-29), and soluble intercellular adhesion molecule-1 (sICAM-1) levels in two groups before and after treatment were compared. Results After treatment, the total effective rate of the treatment group was 94.23%, which was higher than that of the control group (79.81%, P < 0.05). After treatment, the frequency of attacks, duration, VAS score of angina pectoris and dosage of nitroglycerin in both groups decreased (P < 0.05), and the treatment group was lower than the control group (P < 0.05). The relevant scores after treatment in both groups, the TCM symptom score and HEI score decreased, but the SAQ score increased (P < 0.05). The TCM symptom score and HEI score of the treatment group were lower than those of the control group, but the SAQ score was higher than that of the control group (P < 0.05). After treatment in both groups, the levels of serum ET-1, CX3CL1, MMP-29, and sICAM-1 all decreased (P < 0.05). The treatment group was lower than those in the control group (P < 0.05). Conclusion The combined application of Shensong Yangxin Capsules and amlodipine for angina pectoris due to coronary heart disease can effectively inhibit vascular endothelial dysfunction and inflammatory response in the body, promote the stability of arterial plaques, relieve angina pectoris symptoms and control the condition, and improve the life quality and mood of patients.

R972

广州市荔湾区科技计划项目（荔科工信【2023】73号）