目的 探讨冠心舒通胶囊联合辛伐他汀片治疗不稳定型心绞痛的临床疗效。方法 选取2016年5月-2017年8月开封市祥符区第一人民医院收治的不稳定型心绞痛患者104例为研究对象，根据入院编号将患者分为对照组和治疗组，每组各52例。对照组晚上口服辛伐他汀片20 mg/d。治疗组在对照组治疗的基础上口服冠心舒通胶囊，3粒/次，3次/d。两组患者均连续治疗4周。观察两组临床有效率和心电图有效率，比较治疗前后两组患者的临床症状指标、血脂水平、血液流变学指标、血清细胞因子和不良反应情况。结果 治疗后，对照组和治疗组临床疗效分别为82.7%、96.2%，心电图疗效分别为76.9%、92.3%，两组比较差异具有统计学意义（P<0.05）。治疗后，两组心绞痛发作次数、心绞痛持续时间、硝酸甘油日耗量显著下降，同组治疗前后比较差异有统计学意义（P<0.05）。治疗后，治疗组临床症状指标均显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）水平均显著降低，高密度脂蛋白胆固醇（HDL-C）水平显著升高，同组治疗前后比较差异有统计学意义（P<0.05）。治疗后，治疗组血脂水平显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组纤维蛋白原、血浆黏度、血细胞比容、血小板聚集率均显著降低，同组治疗前后比较差异有统计学意义（P<0.05）。治疗后，治疗组血液流变学指标显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后两组血清脂联素（APN）显著升高、正五聚体蛋白-3（PTX-3）显著降低，同组治疗前后比较差异有统计学意义（P<0.05）。治疗后，治疗组血清APN显著高于对照组，PTX-3显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗期间，治疗组不良反应发生率为7.7%，显著低于对照组的17.3%，两组比较差异有统计学意义（P<0.05）。结论 冠心舒胶囊通联合辛伐他汀片治疗不稳定性心绞痛的效果确切，可有效降低血脂，改善血液流变学指标，具有一定临床推广使用价值。

Objective To investigate the clinical efficacy of Guanxin Shutong Capsules combined with Simvastatin Tablets in treatment of unstable angina pectoris. Methods Patients (104 cases) with unstable angina pectoris in the First People's Hospital of Kaifeng Xiangfu District from May 2016 to August 2017 were randomly divided into control and treatment groups according to admission number, and each group had 52 cases. Patients in the control group were po administered with Simvastatin Tablets in the evening, 20 mg/d. Patients in the treatment group were po administered with Guanxin Shutong Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy and electrocardiogram efficacy were evaluated, and the clinical symptom indexes, blood lipid levels, hemorheological indexes, serum cytokine, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment groups were 82.7% and 96.2%, and electrocardiogram efficacy in two groups were 76.9% and 92.3%, respectively, and there were differences between two groups (P < 0.05). After treatment, the frequency of angina pectoris, duration of angina pectoris, and daily consumption of nitroglycerin in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the clinical symptom indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of TC, TG, and LDL-C in two groups were significantly decreased, but the levels of HDL-C in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the blood lipid levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, fibrinogen, plasma viscosity, hematocrit, and platelet aggregation rate in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the hemorheological indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the serum APN levels in two groups were significantly increased, but PTX-3 levels were obviously decreased, and the difference was statistically significant in the same group (P < 0.05). After treatment, the serum APN levels in the treatment group were higher than those in the control group, but PTX-3 levels were lower than those in the control group, with significant difference between two groups (P < 0.05). During the treatment, the adverse reactions rate in the treatment group was 7.7%, which was significantly lower than 17.3% in the control group, with significant difference between two groups (P < 0.05). Conclusion Guanxin Shutong Capsules combined with Simvastatin Tablets has obvious curative effect in treatment of unstable angina pectoris, can effectively reduce blood lipid, improve the hemorheological indexes, which has a certain clinical application value.