目的 探討杏靈分散片聯(lián)合伊伐布雷定治療穩(wěn)定型心絞痛的臨床研究。方法 選取2018年9月—2019年10月在濮陽市安陽地區(qū)醫(yī)院治療的150例穩(wěn)定性心絞痛患者，隨機(jī)分成對照組（75例）和治療組（75例）。對照組患者口服鹽酸伊伐布雷定片，5 mg/次，2次/d；治療組患者在對照組基礎(chǔ)上口服杏靈分散片，1片/次，3次/d，兩組患者連續(xù)治療2周。觀察兩組患者臨床療效，比較治療前后兩組患者西雅圖心絞痛（SAQ）量表評分，血清生化指標(biāo)內(nèi)皮素-1（ET-1）、降鈣素基因相關(guān)肽（CGRP）和可溶性CD40配體（sCD40L），血清炎性因子白細(xì)胞介素6（IL-6）、C反應(yīng)蛋白（CRP）和腫瘤壞死因子α（TNF-α）及不良反應(yīng)情況。結(jié)果 治療后，治療組臨床總有效率97.33%，顯著高于對照組的86.67%（P<0.05）。治療后，兩組患者心絞痛穩(wěn)定狀態(tài)、軀體活動(dòng)受限度、治療滿意程度、心絞痛發(fā)作情況、疾病認(rèn)識(shí)程度評分均高于治療前水平（P<0.05）；治療組SAQ量表評分高于對照組（P<0.05）。治療后，兩組患者血清ET-1、sCD40L水平均顯著降低，但血清CGRP水平升高（P<0.05）；治療后，治療組血清生化指標(biāo)優(yōu)于對照組（P<0.05）。治療后，兩組患者血清IL-6、CRP、TNF-α水平均顯著降低（P<0.05）；治療后，治療組血清炎性因子水平低于對照組（P<0.05）。治療組不良反應(yīng)總發(fā)生率為6.67%，明顯低于對照組的13.33%（P<0.05）。結(jié)論 杏靈分散片聯(lián)合伊伐布雷定治療穩(wěn)定型心絞痛臨床療效顯著，可以有效改善患者心絞痛癥狀，有效較低血脂及炎性因子水平，不良反應(yīng)發(fā)生率低，患者的生活質(zhì)量得到顯著提高。

Objective To explore the clinical effect of Xingling Dispersible Tablets combined with ivabradine in treatment of stable angina pectoris. Methods Patients (150 cases) with stable angina pectoris in Anyang District Hospital of Puyang from September 2018 to October 2019 were randomly divided into control (75 cases) and treatment (75 cases) groups. Patients in the control group were po administered with Ivabradine Hydrochloride Tablets, 5 mg/time, twice daily. Patients in the treatment group were po administered with Xingling Dispersible Tablets on the basis of the control group, 1 tablet/time, three times daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the SAQ scale score, blood lipid indexes ET-1, sCD40L, and CGRP, serum inflammatory factor levelsIL-6, CRP, and TNF-α, and adverse reactions in two groups before and after treatment were compared. Results After treatment, the total clinical effective rate in the treatment group was 97.33%, which was significantly higher than 86.67% in the control group (P<0.05). After treatment, angina stable state, physical activity limit, treatment satisfaction, angina attack and disease awareness scores in two groups were all higher than those before treatment (P<0.05). The SAQ score in treatment group was higher than that in control group (P<0.05). After treatment, serum ET-1 and sCD40L levels in two groups were significantly decreased, but serum CGRP level was increased (P<0.05). After treatment, the serum biochemical indexes of treatment group were better than those of control group (P<0.05). After treatment, the levels of serum IL-6, CRP and TNF-α in two groups were significantly decreased (P<0.05). After treatment, the level of serum inflammatory factors in treatment group was lower than that in control group (P<0.05). The total incidence of adverse reactions in the treatment group was 6.67%, which was significantly lower than 13.33% in the control group (P<0.05). Conclusion Xingling Dispersible Tablets combined with ivabradine is effective in the treatment of stable angina pectoris, which can effectively improve the symptoms of angina pectoris, lower blood lipids and inflammatory factors, lower the incidence of adverse reactions, and significantly improve the quality of life of patients.

R972

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃項(xiàng)目（2018020855）