目的 探讨通心络胶囊联合曲美他嗪对老年心肌缺血的疗效及安全性的影响。方法 选取2015年9月-2018年9月东南大学附属中大医院江北院区82例心肌缺血患者作为研究对象。根据随机数字表法将患者分为对照组和观察组，每组各41例。对照组口服盐酸曲美他嗪缓释片，20 mg/次，3次/d。观察组患者在对照组的基础上口服通心络胶囊，1.04 g/次，3次/d。两组均连续治疗2个月。观察两组患者的临床疗效和不良反应发生情况，同时比较两组治疗前后的ST段缺血情况和心肌酶谱各指标水平。结果 治疗后，观察组患者总有效率为92.68%，对照组总有效率为73.17%，两组比较存在统计学差异（P<0.05）。治疗后，两组患者ST段缺血次数和持续时间均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。治疗后，两组患者血清心肌酶谱各指标均显著降低（P<0.05），且观察组显著低于对照组（P<0.05）。治疗期间，观察组患者药物所致不良反应发生率均显著低于对照组（P<0.05）。结论 通心络胶囊联合曲美他嗪可有效改善心肌缺血患者ST段缺血情况及心肌酶谱指标，疗效安全显著，对促进心肌缺血患者病情康复具有积极意义。

Objective To investigate the efficacy and safety of Tongxinluo Capsules combined with trimotaziaine on myocardial ischemia in elderly. Methods A total of 82 patients with myocardial ischemia in the Jiangbei District, Zhongda Hospital Southeast University from September 2015 to September 2018 were selected as study subjects. According to the random number table method, the patients were divided into control group and observation group, 41 cases in each group. Patients in the control group were po administered with Trimetazidine Dihydrochloride Modified Release Tablets, 20 mg/time, three times daily. Patients in the observation group were po administered with Tongxinluo Capsules on the basis of the control group, 1.04 g/time, three times daily. Both groups were treated continuously for 2 months. The clinical efficacy and adverse reactions of two groups were observed, and ST segment ischemia and myocardial enzyme spectrum before and after treatment were compared between two groups. Results After treatment, the total effective rate was 92.68% in the observation group and 73.17% in the control group, showing statistical difference between the two groups (P<0.05). After treatment, the number and duration of ST segment ischemia in two groups were significantly reduced (P<0.05), and the observation group was significantly lower than the control group (P<0.05). After treatment, all indexes of serum myocardial enzyme spectrum in two groups were significantly decreased (P<0.05), and the observation group was significantly lower than those in the control group (P<0.05). During the treatment, the incidence of druginduced adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Tongxinluo Capsules combined with trimotaziaine can effectively improve the ST segment ischemia and myocardial enzyme index in patients with myocardial ischemia, with significant safety effect and positive significance for promoting the rehabilitation of patients with myocardial ischemia.

R972