目的 探討心可舒片聯(lián)合阿托伐他汀鈣片治療不穩(wěn)定型心絞痛的臨床療效。方法 選取2018年3月-2019年7月在天津市寧河區(qū)醫(yī)院就診的84例不穩(wěn)定型心絞痛患者為研究對象，將全部患者根據(jù)隨機數(shù)字表法分為對照組和治療組，每組各有42例。對照組口服阿托伐他汀鈣片，20 mg/次，1次/d。治療組在對照組基礎(chǔ)上口服心可舒片，4片/次，3次/d。兩組患者連續(xù)治療6個月。觀察兩組的臨床療效，比較兩組的臨床癥狀改善、血脂、血液流變學(xué)、血清因子水平。結(jié)果 治療后，對照組和治療組的心絞痛療效總有效率分別為76.19%、92.86%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，對照組和治療組的心電圖療效總有效率分別為61.90%、69.05%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組心絞痛發(fā)作頻率、持續(xù)時間均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組的發(fā)作頻率、持續(xù)時間明顯低于對照組，兩組差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組的總膽固醇（TC）、三酰甘油（TG）、低密度脂蛋白膽固醇（LDL-C）水平均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組的LDL-C水平明顯低于對照組，兩組差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組的全血黏度、血漿黏度、纖維蛋白原（FIB）、D-二聚體水平均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組的全血黏度、血漿黏度、FIB、D-二聚體水平明顯低于對照組，兩組差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組的C-反應(yīng)蛋白（CRP）、內(nèi)皮素-1（ET-1）、同型半胱氨酸（Hcy）水平均明顯降低，一氧化氮（NO）水平明顯升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組的血清因子水平明顯優(yōu)于對照組，兩組差異有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 心可舒片聯(lián)合阿托伐他汀鈣片治療不穩(wěn)定型心絞痛具有較好的臨床療效，可減輕心絞痛癥狀，降低炎癥因子水平，提高血管內(nèi)皮功能，改善血液流變學(xué)和血脂水平，具有一定的臨床應(yīng)用價值。

Objective To investigate the clinical efficacy of Xinkeshu Tablets combined with Atorvastatin Calcium Tablets in treatment of unstable angina pectoris. Methods Patients (84 cases) with unstable angina pectoris in Tianjin Ninghe Hospital from March 2018 to July 2019 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in the control group were po administered with Atorvastatin Calcium Tablets, 20 mg/time, once daily. Patients in the treatment group were po administered with Xinkeshu Tablet on the basis of the control group, 4 tablets/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical efficacies were evaluated, and improvement of clinical symptoms, blood lipid levels, hemorheology, and serum factor levels in two groups were compared. Results After treatment, the curative effect of angina pectoris in the control and treatment groups were 76.19% and 92.86%, and the electrocardiogram effect in the control and treatment groups were 61.90% and 69.05%, respectively, and there was difference between two groups (P < 0.05). After treatment, the frequency and duration of angina pectoris in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the clinical symptoms 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 level of TG, TC, and LDL-C in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the levels of LDL-C in the treatment group were significantly lower than that in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of whole blood viscosity, plasma viscosity, FIB, and D-dimer in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the hemorheology 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 CRP, ET-1, and Hcy in two groups were significantly decreased, but the levels of NO in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the serum factor levels in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Xinkeshu Tablet combined with Atorvastatin Calcium Tablets has clinical curative effect in treatment of unstable angina pectoris, can alleviate the symptoms of angina pectoris, reduce the level of inflammatory factors, improve the function of vascular endothelium, and improve the level of Hemorheology and blood lipids, which has a certain clinical application value.

R972