目的 探討麝香保心丸對冠心病患者胰島素抵抗（IR）影響及機(jī)制。方法 2016年1月—2017年3月選擇在南陽市第二人民醫(yī)院診治的冠心病患者82例作為研究對象，根據(jù)隨機(jī)信封抽簽原則分為觀察組與對照組各41例，對照組給予常規(guī)治療，觀察組在對照組治療的基礎(chǔ)上給予麝香保心丸治療，2丸/次，3次/d，兩組治療觀察周期為3個(gè)月。比較兩組的臨床療效、IR指數(shù)及C反應(yīng)蛋白（CRP）水平，同時(shí)采用超聲進(jìn)行冠狀動脈重構(gòu)指數(shù)（RI）的測定。結(jié)果 觀察組與對照組的總有效率分別為97.6%和82.9%，觀察組好于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組與對照組治療后的IR指數(shù)分別為（1.79±0.45）和（2.44±0.51），都明顯低于治療前的（4.01±0.44）和（4.00±0.56），同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且觀察組治療后的IR指數(shù)明顯低于對照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。觀察組與對照組治療后的血清CRP水平都明顯低于治療前，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；同時(shí)治療后觀察組的血清CRP水平也明顯低于對照組，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后觀察組的冠狀動脈正性重構(gòu)、無重構(gòu)與負(fù)性重構(gòu)分別為4例、25例與12例，而對照組分別為15例、10例和16例，組間對比差異都有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 麝香保心丸治療冠心病患者能提高治療療效，改善IR狀況，其作用機(jī)制可能與抑制炎癥因子表達(dá)、改善冠狀動脈重構(gòu)有關(guān)。

Objective To investigate the effects and mechanism of Shexiang Baoxin Pills on insulin resistance (IR) in patients with coronary heart disease.Methods From January 2016 to March 2017, 82 patients with coronary heart disease in The Second People’s Hospital of Nanyang were selected as the research object. All the patients were divided into observation group and control group with 41 cases in each group according to the principle of random envelope drawing. The control group was given conventional treatment, and the observation group was treated with Shexiang Baoxin Pills on the basis of the treatment of the control group. The observation periods of the two groups were 3 months.Results The total effective rates of the observation group and control group were 97.6% and 82.9%, respectively, and the observation group was better than that of the control group (P<0.05). The IR indexes of the observation group and control group after treatment were (1.79 ±0.45) and (2.44 ±0.51), respectively, which were significantly lower than before treatment of (4.01 ±0.44) and (4.00 ±0.56) (P<0.05), and the IR index in the observation group after treatment was significantly higher than that in the control group (P<0.05). The serum CRP levels of the observation group and control group were significantly lower than those before treatment (P<0.05), and the level of serum CRP in the observation group after treatment was also significantly lower than that in the control group (P<0.05). After treatment, the coronary artery remodeling, no reconstruction and negative reconstruction in the observation group were 4 cases, 25 cases and 13 cases, while the control group were 15 cases, 10 cases and 16 cases, the difference between the two groups was statistically significant (P<0.05).Conclusion Shexiang Baoxin Pill can improve the therapeutic effect and improve the IR status in patients with coronary heart disease, and its mechanism may be related to inhibiting the expression of inflammatory factors and improving coronary artery remodeling.