目的 研究心通颗粒联合地尔硫卓治疗冠心病心绞痛的临床疗效。方法 选取2023年1月—2024年6月山西省中医院收治的120例冠心病心绞痛患者，以信封抽签法将患者分为对照组和治疗组，每组各60例。对照组以盐酸地尔硫卓片口服，每次60 mg，每日2次。治疗组采取心通颗粒联合地尔硫卓治疗，以心通颗粒5.3 g加入适量温开水溶解后口服，每日3次。两组均治疗4周后评估效果。评估两组患者临床疗效、心绞痛改善指标、心功能指标、血清炎症因子。结果 治疗后，治疗组总有效率是91.67%，显著高于对照组的76.67%（P＜0.05）。治疗后，两组心绞痛发作次数、每周硝酸甘油用量显著减少，且每次发作的持续时间缩短（P＜0.05）；治疗后，治疗组心绞痛发作次数、每周硝酸甘油用量、每次发作的持续时间均小于对照组（P＜0.05）。治疗后，两组左室射血分数（LVEF）、心输出量（CO）较前升高，而左心室舒张末期容积（LVEDV）、左心室舒张末期内径（LVEDD）显著降低（P＜0.05）；治疗后，治疗组LVEF、CO高于对照组，LVEDV、LVEDD低于对照组（P＜0.05）。治疗后，两组血清白细胞介素-18（IL-18）、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）水平均较前显著降低（P＜0.05）；且治疗后，治疗组血清IL-18、CRP、TNF-α水平显著低于对照组（P＜0.05）。结论 心通颗粒联合地尔硫卓治疗冠心病心绞痛的疗效显著，可显著缓解患者的心绞痛发作，提升心功能水平，抑制炎症因子表达。

Objective To investigate the therapeutic effect of Xintong Granules combined with diltiazem in treatment of angina pectoris of coronary heart disease. Methods A total of 120 patients with angina pectoris of coronary heart disease admitted to Shanxi Provincial Hospital of Traditional Chinese Medicine from January 2023 to June 2024 were selected. The patients were divided into control group and treatment group by envelope lottery, with 60 cases in each group. Patients in control group were po administered with Diltiazem Hydrochloride Tablets, 60 mg each time, twice daily. Patients in treatment group were treated with Xintong Granules combined with diltiazepam, 5.3 g of Xintong Granules were dissolved in an appropriate amount of warm water and taken orally, three times daily. The effects of both groups were evaluated after 4 weeks of treatment. The clinical efficacy, improvement indicators of angina pectoris, cardiac function indicators and serum inflammatory factors of two groups of patients were evaluated. Results After treatment, the total effective rate of the treatment group was 91.67%, significantly higher than 76.67% of the control group (P < 0.05). After treatment, the frequency of angina pectoris attacks and the weekly dosage of nitroglycerin in both groups were significantly reduced, and the duration of each attack was shortened (P < 0.05). After treatment, the frequency of angina pectoris attacks, the weekly dosage of nitroglycerin, and the duration of each attack in the treatment group were all less than those in the control group (P < 0.05). After treatment, LVEF and CO in both groups increased compared with before, but LVEDV and LVEDD significantly decreased (P < 0.05). After treatment, the LVEF and CO in treatment group were higher than those in control group, but the LVEDV and LVEDD were lower than those in control group (P < 0.05). After treatment, the levels of serum IL-18, CRP, and TNF-α in both groups were significantly lower than before (P < 0.05). Moreover, after the treatment, the levels of serum IL-18, CRP, and TNF-α in treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Xintong Granules combined with diltiazem has a remarkable therapeutic effect on angina pectoris of coronary heart disease, can significantly alleviate the angina pectoris attacks of patients, improve the level of cardiac function, and inhibit the expression of inflammatory factors.

R972

山西省卫生健康委科研课题项目（2023019）