目的 探討通心絡膠囊聯(lián)合曲美他嗪對老年心肌缺血的療效及安全性的影響。方法 選取2015年9月-2018年9月東南大學附屬中大醫(yī)院江北院區(qū)82例心肌缺血患者作為研究對象。根據(jù)隨機數(shù)字表法將患者分為對照組和觀察組，每組各41例。對照組口服鹽酸曲美他嗪緩釋片，20 mg/次，3次/d。觀察組患者在對照組的基礎上口服通心絡膠囊，1.04 g/次，3次/d。兩組均連續(xù)治療2個月。觀察兩組患者的臨床療效和不良反應發(fā)生情況，同時比較兩組治療前后的ST段缺血情況和心肌酶譜各指標水平。結果 治療后，觀察組患者總有效率為92.68%，對照組總有效率為73.17%，兩組比較存在統(tǒng)計學差異（P<0.05）。治療后，兩組患者ST段缺血次數(shù)和持續(xù)時間均顯著降低（P<0.05），且觀察組顯著低于對照組（P<0.05）。治療后，兩組患者血清心肌酶譜各指標均顯著降低（P<0.05），且觀察組顯著低于對照組（P<0.05）。治療期間，觀察組患者藥物所致不良反應發(fā)生率均顯著低于對照組（P<0.05）。結論 通心絡膠囊聯(lián)合曲美他嗪可有效改善心肌缺血患者ST段缺血情況及心肌酶譜指標，療效安全顯著，對促進心肌缺血患者病情康復具有積極意義。

Objective To investigate the efficacy and safety of Tongxinluo Capsules combined with trimotaziaine on myocardial ischemia in elderly. Methods A total of 82 patients with myocardial ischemia in the Jiangbei District, Zhongda Hospital Southeast University from September 2015 to September 2018 were selected as study subjects. According to the random number table method, the patients were divided into control group and observation group, 41 cases in each group. Patients in the control group were po administered with Trimetazidine Dihydrochloride Modified Release Tablets, 20 mg/time, three times daily. Patients in the observation group were po administered with Tongxinluo Capsules on the basis of the control group, 1.04 g/time, three times daily. Both groups were treated continuously for 2 months. The clinical efficacy and adverse reactions of two groups were observed, and ST segment ischemia and myocardial enzyme spectrum before and after treatment were compared between two groups. Results After treatment, the total effective rate was 92.68% in the observation group and 73.17% in the control group, showing statistical difference between the two groups (P<0.05). After treatment, the number and duration of ST segment ischemia in two groups were significantly reduced (P<0.05), and the observation group was significantly lower than the control group (P<0.05). After treatment, all indexes of serum myocardial enzyme spectrum in two groups were significantly decreased (P<0.05), and the observation group was significantly lower than those in the control group (P<0.05). During the treatment, the incidence of druginduced adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Tongxinluo Capsules combined with trimotaziaine can effectively improve the ST segment ischemia and myocardial enzyme index in patients with myocardial ischemia, with significant safety effect and positive significance for promoting the rehabilitation of patients with myocardial ischemia.

R972