目的 观察益心通脉颗粒联合尼可地尔片治疗稳定型心绞痛的临床疗效。方法 将2023年5月—2024年10月在西安市第九医院治疗的138例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69例。对照组口服尼可地尔片，5～10 mg/次，3次/d。治疗组在对照组基础上口服益心通脉颗粒，1袋/次，3次/d，两组患者连续用药4周。比较两组患者总有效率、心绞痛改善情况（心绞痛发作频率、持续时间）、心功能指标心脏指数（CI）、心输出量（CO）、每搏输出量（SV）、左心室射血分数（LVEF）、血清炎症因子白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）和氧化应激指标丙二醛（MDA）、超氧化物歧化酶（SOD）、总抗氧化力（TAC）的差异。结果 治疗后，治疗组和对照组的总有效率分别为94.20%（65/69）和81.16%（56/69），两组比较差异有统计学意义（P＜0.05）。治疗后，两组在每周心绞痛发作次数及持续时间均显著降低（P＜0.05），且治疗组均低于对照组（P＜0.05）。两组CI、CO、SV及LVEF均较治疗前显著升高（P＜0.05）。治疗组患者的CI、CO、SV及LVEF水平较对照组更高（P＜0.05）。治疗后，两组患者血清IL-6、TNF-α和CRP水平较治疗前显著降低（P＜0.05），且治疗组较对照组的下降更显著（P＜0.05）。治疗后，两组患者MDA水平明显降低，而SOD和TAC明显升高（P＜0.05），且治疗组血清MDA明显低于对照组，SOD和TAC高于对照组（P＜0.05）。结论 益心通脉颗粒联合尼可地尔片治疗稳定型心绞痛具有良好的疗效，能够调节心绞痛发作频率，减少持续时间，降低血清炎症因子并改善氧化应激反应，具有较好的安全性。

Objective To observe the clinical efficacy of Yixin Tongmai Granules combined with Nicorandil Tablets in treatment of stable angina pectoris. Methods A total of 138 patients with stable angina pectoris treated in Xi'an No.9 Hospital from May 2023 to October 2024 were divided into the control group and the treatment group according to the random number table method, with 69 patients in each group. The control group was administered Nicorandil Tablets orally at a dose of 5 — 10 mg per time, 3 times a day. On the basis of the control group, the treatment group was additionally administered Yixin Tongmai Granules orally, 1 bag per time, 3 times a day. Both groups received continuous medication for 4 weeks. The differences in total effective rate, improvement of angina pectoris (frequency and duration of angina pectoris attacks), cardiac function indexes [cardiac index (CI), cardiac output (CO), stroke volume (SV), left ventricular ejection fraction (LVEF)], serum inflammatory factors [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP)] and oxidative stress indexes [malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant capacity (TAC)] were compared between the two groups. Results After treatment, the total effective rates of the treatment group and the control group were 94.20% (65/69) and 81.16% (56/69), respectively, with a statistically significant difference between the two groups (P < 0.05). After treatment, the weekly frequency and duration of angina pectoris attacks were significantly decreased in two groups (P < 0.05), and which in the treatment group were significantly lower than those in the control group (P < 0.05). Compared with the pre-treatment levels, the cardiac index (CI), cardiac output (CO), stroke volume (SV), and left ventricular ejection fraction (LVEF) were significantly increased in both groups (P < 0.05), and the levels of these indicators in the treatment group were significantly higher than those in the control group (P < 0.05). In addition, serum levels of interleukin‑6 (IL‑6), tumor necrosis factor‑α (TNF‑α), and C‑reactive protein (CRP) in two groups were significantly reduced after treatment compared with pre-treatment (P < 0.05), and the reduction amplitude in the treatment group was significantly greater than that in the control group (P < 0.05). Similarly, after treatment, the serum malondialdehyde (MDA) level was significantly decreased, while the superoxide dismutase (SOD) and total antioxidant capacity (TAC) levels were significantly increased in two groups (P < 0.05), compared with the control group, the treatment group had significantly lower serum MDA level and significantly higher SOD and TAC levels (P < 0.05). Conclusion Yixin Tongmai Granules combined with Nicorandil Tablets exerts a good curative effect in the treatment of stable angina pectoris. It can reduce the frequency and duration of angina pectoris attacks, decrease the levels of serum inflammatory factors, improve the oxidative stress response, and has good safety.

R972

陕西省自然科学基础研究计划项目（2023-JC-QN-0891）