目的 探讨麝香心脑乐胶囊联合美托洛尔治疗冠心病心绞痛的临床疗效。方法 选取2017年3月-2018年2月在恩施自治州中心医院治疗的冠心病心绞痛患者88例，根据用药差别分为对照组（44例）和治疗组（44例）。对照组口服酒石酸美托洛尔片，25 mg/次，2次/d；治疗组在对照组基础上口服麝香心脑乐胶囊，1.6 g/次，3次/d。两组患者均治疗12周。观察两组患者心绞痛和心电图疗效，同时比较治疗前后两组患者心绞痛发作次数和持续时间及血清学指标和血液流变学指标。结果 治疗后，对照组心绞痛和心电图临床有效率分别为81.82%和72.73%，均分别显著低于治疗组的95.45%和88.64%，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和持续时间均显著减少（P<0.05），且治疗组心绞痛发作次数和持续时间明显少于对照组（P<0.05）。治疗后，两组IL-18、可溶性细胞间黏附分子-1（sICAM-1）、髓过氧化物酶（MPO）、肿瘤坏死因子-α（TNF-α）、妊娠相关血浆蛋白-A（PAPP-A）、全血黏度（WBV）、血浆黏度（PV）、纤维蛋白原（FIB）和血小板黏附率（PAR）水平均显著降低（P<0.05），且治疗组上述血清学指标和血液流变学指标水平明显低于对照组（P<0.05）。结论 麝香心脑乐胶囊联合酒石酸美托洛尔片治疗冠心病心绞痛可有效改善临床症状，降低血清炎症因子水平，促进血液流变学指标改善。

Objective To investigate the clinical efficacy of Shexiang Xinlaole Capsules combined with metoprolol in treatment of angina pectoris of coronary heart disease.Methods Patients (88 cases) with angina pectoris of coronary heart disease in the Central Hospital of Enshi Autonomous Prefecture from March 2017 to February 2018 were divided into control (44 cases) and treatment (44 cases) groups according to different treatments. Patients in the control group were po administered with Metoprolol Tartrate Tablets, 25 mg/time, twice daily. Patients in the treatment group were po administered with Shexiang Xinlaole Capsules on the basis of the control group, 1.6 g/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the angina pectoris and electrocardiogram efficacy was evaluated, and the frequency and duration of angina pectoris, the serological and hemorheological indexes in two groups before and after treatment were compared.Results After treatment, the angina pectoris and electrocardiogram efficacy in the control group were 81.82% and 72.73%, which were significantly lower than 95.45% and 88.64% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the frequency and duration of angina pectoris in two groups was significantly decreased (P<0.05), and which in the treatment group was significantly less than that in the control group (P<0.05). After treatment, the IL-18, sICAM-1, MPO, TNF-α, PAPP-A, WBV, PV, FIB, and PAR levels in two groups were significantly decreased (P<0.05), and the serological and hemorheological indexes levels in the treatment group were significantly lower than those in the control group (P<0.05).Conclusion Shexiang Xinlaole Capsules combined with metoprolol in treatment of angina pectoris of coronary heart disease can effectively improve clinical symptoms, reduce the serum inflammatory factors levels and improve the hemorheological index.