目的 探討血府逐瘀聯(lián)合非洛地平治療老年冠心病心絞痛患者的安全性與有效性。方法 選取2018年6月—2019年12月在天津醫(yī)科大學(xué)第二醫(yī)院治療的老年冠心病心絞痛患者145例，隨機(jī)分成對照組（72例）和治療組（73例）。對照組患者口服非洛地平緩釋片，1片/次，1次/d；治療組患者在對照組基礎(chǔ)上口服血府逐瘀膠囊，6粒/次，2次/d。兩組患者均連續(xù)治療2個(gè)月。觀察兩組患者臨床療效和心電圖療效，同時(shí)比較治療前后兩組患者心絞痛發(fā)作次數(shù)、硝酸甘油用量、西雅圖心絞痛評分，心功能指標(biāo)左室射血分?jǐn)?shù)（LVEE）、左室收縮末期內(nèi)徑（LVESD）和左室收縮末期容積（LVESV），血清肌酸激酶同工酶（CK-MB）、N-端腦利鈉肽前體（NT-proBNP）和可溶性CD105（sCD105）水平及不良反應(yīng)情況。結(jié)果 治療后，對照組臨床總有效率和心電圖有效率分別為83.33%、81.94%，均明顯低于治療組的95.89%、97.26%（P<0.05）。治療后，兩組患者心絞痛發(fā)作次數(shù)和硝酸甘油用量顯著下降，而西雅圖心絞痛評分明顯升高（P<0.05）；且治療組各指標(biāo)相較于對照組改善更顯著（P<0.05）。治療后，兩組患者心功能指標(biāo)LVEE明顯升高（P<0.05），而LVESD和LVESV明顯降低（P<0.05），且治療組各指標(biāo)相較于對照組改善的更為顯著（P<0.05）。治療后，兩組患者血清CK-MB、NT-proBNP、sCD105水平顯著降低（P<0.05），且治療組比對照組降低更明顯（P<0.05）。治療期間，對照組不良反應(yīng)發(fā)生率為11.11%，明顯高于治療組的2.74%，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 血府逐瘀膠囊聯(lián)合非洛地平治療老年冠心病心絞痛療效顯著，能夠顯著改善患者的心絞痛癥狀，促進(jìn)血清生化指標(biāo)的平衡，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the safety and effectiveness of Xuefu Zhuyu Capsules combined with felodipine in treatment of senile coronary heart disease angina pectoris. Methods Patients (145 cases) with coronary heart disease angina pectoris in the Second Hospital of Tianjin Medical University from June 2018 to December 2019 were randomly divided into control (72 cases) and treatment (73 cases) groups. Patients in the control group were po administered with Felodipine Sustained Release Tablets, 1 tablet/time, once daily. Patients in the treatment group were po administered with Xuefu Zhuyu Capsules on the basis of the control group, 6 grains/time, twice daily. Patients in two groups were treated for 2 months. After treatment, the clinical efficacy and ECG efficacy were evaluated, and the frequency of angina pectoris episodes, the amount of nitroglycerin, and the angina pectoris scale scores, the cardiac function related indicators of LVEE, LVESD and LVESV, the serum biochemical indicators of CK-MB, NT-proBNP and sCD105, and the adverse reactions in two groups before and after treatment were compared. Results After treatment, the clinical efficacy and ECG efficacy in the control group were 83.33% and 81.94%, which were significantly lower than 95.89% and 97.26% in the treatment group, respectively, and there were differences between two groups (P<0.05). After treatment, the frequency of angina pectoris episodes and the amount of nitroglycerin in two groups were significantly decreased, but the angina pectoris scale scores were significantly increased (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 cardiac function related indicator of LVEE in two groups were significantly increased, but the LVESD and LVESV were significantly decreased (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 serum biochemical indicators of CK-MB, NT-proBNP and SCD105 in two groups were significantly decreased (P<0.05), and which in the treatment group were significantly lower than those in the control group (P<0.05). During the treatment, the adverse reactions rate in the control group was 11.11%, which was significantly higher than 2.74% in treatment the group, with significant difference between two groups (P<0.05). Conclusion Xuefu Zhuyu Capsules combined with felodipine has significant curative effect on senile coronary heart disease angina pectoris, can significantly improve the symptoms of angina pectoris and promote the balance of serum biochemical indicators, which has a certain clinical application value.

R972