目的 探討脈血康膠囊聯(lián)合二丁酰環(huán)磷腺苷治療不穩(wěn)定型心絞痛的臨床療效。方法 選取2015年7月—2016年7月在達(dá)州市達(dá)川區(qū)人民醫(yī)院進(jìn)行治療的不穩(wěn)定型心絞痛患者64例，根據(jù)治療方案的差別分為對(duì)照組（32例）和治療組（32例）。對(duì)照組患者靜脈滴注注射用二丁酰環(huán)磷腺苷鈣，40 mg加入5%葡萄糖注射液250 mL，1次/d。治療組在對(duì)照組的基礎(chǔ)上口服脈血康膠囊，4粒/次，3次/d。兩組患者均治療4周。評(píng)價(jià)兩組治療后患者臨床療效，同時(shí)比較治療前后兩組患者心絞痛改善情況、氧化應(yīng)激水平、血管內(nèi)皮功能和炎性因子水平變化。結(jié)果 治療后，對(duì)照組和治療組的總有效率分別為81.25%、93.75%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P < 0.05）。治療后，兩組患者心絞痛發(fā)作次數(shù)、發(fā)作持續(xù)時(shí)間、心電圖ST段壓低數(shù)和心電圖T波總倒置數(shù)均較同組治療前明顯降低（P < 0.05）；且治療組患者比對(duì)照組降低的更顯著（P < 0.05）。與治療前相比，治療后兩組血清丙二醛（MDA）水平顯著降低，超氧化物歧化酶（SOD）活性顯著升高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療組上述指標(biāo)改善的更顯著（P < 0.05）。治療后，兩組患者血清內(nèi)皮素-1（ET-1）水平明顯降低，NO水平明顯增高，同組比較差異具有統(tǒng)計(jì)學(xué)意義（P < 0.05）；且治療后治療組患者上述血管內(nèi)皮功能優(yōu)于對(duì)照組（P < 0.05）。治療后，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、白細(xì)胞介素-18（IL-18）、腫瘤壞死因子-α（TNF-α）水平均顯著降低（P < 0.05）；且治療后治療組患者炎性因子水平比對(duì)照組更低（P < 0.05）。結(jié)論 脈血康膠囊聯(lián)合二丁酰環(huán)磷腺苷治療不穩(wěn)定型心絞痛效果顯著，可顯著改善血管內(nèi)皮功能和降低氧化應(yīng)激反應(yīng)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Maixuekang Capsules combined with dibutyryladenosine cyclophosphate in treatment of unstable angina pectoris. Methods Patients (64 cases) with unstable angina pectoris in Dachuan District People's Hospital in Dazhou City from July 2015 to July 2016 were divided into control (32 cases) and treatment (32 cases) groups based on different treatments. Patients in the control group were iv administered with Calcium Dibutyryladenosine Cyclophosphate for injection, 40 mg added into 5% glucose injection 250 mL, once daily. Patients in the treatment group were po administered with Maixuekang Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for four weeks. After treatment, the clinical efficacy was evaluated, and the angina pectoris improvement, oxidative stress levels, vascular endothelial function, and inflammatory factors levels in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 81.25% and 93.75% respectively, and there was difference between two groups (P < 0.05). After treatment, the frequency and duration of angina pectoris, ECG ST segment reduction, and the total number of ECG T wave inversion in two groups were significantly decreased (P < 0.05). And these indicators levels in the treatment group were significantly lower than those in the control group (P < 0.05). Compared with those before treatment, the MDA level in two groups was significantly decreased after treatment, but the SOD level was significantly increased, and there was difference in the same groups (P < 0.05). And these indexes in the treatment group were significantly better than those in the control group (P < 0.05). After treatment, the ET-1 level in two groups was significantly decreased, the NO level was significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the vascular endothelial function in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the hs-CRP, IL-18, and TNF-α levels in two groups were significantly decreased (P < 0.05). And these inflammatory factors levels in the treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Maixuekang Capsules combined with dibutyryladenosine cyclophosphate has significant clinical effect in treatment of unstable angina pectoris, can improve endothelial function and reduce oxidative stress reaction, which has a certain clinical application value.