目的 研究心通顆粒聯(lián)合地爾硫卓治療冠心病心絞痛的臨床療效。方法 選取2023年1月—2024年6月山西省中醫(yī)院收治的120例冠心病心絞痛患者，以信封抽簽法將患者分為對(duì)照組和治療組，每組各60例。對(duì)照組以鹽酸地爾硫卓片口服，每次60 mg，每日2次。治療組采取心通顆粒聯(lián)合地爾硫卓治療，以心通顆粒5.3 g加入適量溫開(kāi)水溶解后口服，每日3次。兩組均治療4周后評(píng)估效果。評(píng)估兩組患者臨床療效、心絞痛改善指標(biāo)、心功能指標(biāo)、血清炎癥因子。結(jié)果 治療后，治療組總有效率是91.67%，顯著高于對(duì)照組的76.67%（P＜0.05）。治療后，兩組心絞痛發(fā)作次數(shù)、每周硝酸甘油用量顯著減少，且每次發(fā)作的持續(xù)時(shí)間縮短（P＜0.05）；治療后，治療組心絞痛發(fā)作次數(shù)、每周硝酸甘油用量、每次發(fā)作的持續(xù)時(shí)間均小于對(duì)照組（P＜0.05）。治療后，兩組左室射血分?jǐn)?shù)（LVEF）、心輸出量（CO）較前升高，而左心室舒張末期容積（LVEDV）、左心室舒張末期內(nèi)徑（LVEDD）顯著降低（P＜0.05）；治療后，治療組LVEF、CO高于對(duì)照組，LVEDV、LVEDD低于對(duì)照組（P＜0.05）。治療后，兩組血清白細(xì)胞介素-18（IL-18）、C反應(yīng)蛋白（CRP）、腫瘤壞死因子-α（TNF-α）水平均較前顯著降低（P＜0.05）；且治療后，治療組血清IL-18、CRP、TNF-α水平顯著低于對(duì)照組（P＜0.05）。結(jié)論 心通顆粒聯(lián)合地爾硫卓治療冠心病心絞痛的療效顯著，可顯著緩解患者的心絞痛發(fā)作，提升心功能水平，抑制炎癥因子表達(dá)。

Objective To investigate the therapeutic effect of Xintong Granules combined with diltiazem in treatment of angina pectoris of coronary heart disease. Methods A total of 120 patients with angina pectoris of coronary heart disease admitted to Shanxi Provincial Hospital of Traditional Chinese Medicine from January 2023 to June 2024 were selected. The patients were divided into control group and treatment group by envelope lottery, with 60 cases in each group. Patients in control group were po administered with Diltiazem Hydrochloride Tablets, 60 mg each time, twice daily. Patients in treatment group were treated with Xintong Granules combined with diltiazepam, 5.3 g of Xintong Granules were dissolved in an appropriate amount of warm water and taken orally, three times daily. The effects of both groups were evaluated after 4 weeks of treatment. The clinical efficacy, improvement indicators of angina pectoris, cardiac function indicators and serum inflammatory factors of two groups of patients were evaluated. Results After treatment, the total effective rate of the treatment group was 91.67%, significantly higher than 76.67% of the control group (P < 0.05). After treatment, the frequency of angina pectoris attacks and the weekly dosage of nitroglycerin in both groups were significantly reduced, and the duration of each attack was shortened (P < 0.05). After treatment, the frequency of angina pectoris attacks, the weekly dosage of nitroglycerin, and the duration of each attack in the treatment group were all less than those in the control group (P < 0.05). After treatment, LVEF and CO in both groups increased compared with before, but LVEDV and LVEDD significantly decreased (P < 0.05). After treatment, the LVEF and CO in treatment group were higher than those in control group, but the LVEDV and LVEDD were lower than those in control group (P < 0.05). After treatment, the levels of serum IL-18, CRP, and TNF-α in both groups were significantly lower than before (P < 0.05). Moreover, after the treatment, the levels of serum IL-18, CRP, and TNF-α in treatment group were significantly lower than those in the control group (P < 0.05). Conclusion Xintong Granules combined with diltiazem has a remarkable therapeutic effect on angina pectoris of coronary heart disease, can significantly alleviate the angina pectoris attacks of patients, improve the level of cardiac function, and inhibit the expression of inflammatory factors.

R972

山西省衛(wèi)生健康委科研課題項(xiàng)目（2023019）