曹敏 黄斐 余亚鹏

【摘要】 目的：探索琥珀酸美托洛尔缓释片与复心合剂联合治疗冠状动脉心肌桥心绞痛的价值。方法：选取2020年2月—2022年10月南昌市洪都中医院收治的70例冠状动脉心肌桥心绞痛患者为研究对象，按随机数字表法分组，各35例。对照组选择琥珀酸美托洛尔缓释片治疗，观察组选择琥珀酸美托洛尔缓释片结合复心合剂治疗。比较两组临床效果、不良反应发生情况等。结果：两组不良反应发生率对比，差异无统计学意义（P>0.05）。观察组临床总有效率高于对照组，差异有统计学意义（P<0.05）。治疗前，两组心功能、血管内皮功能、心绞痛发作情况对比，差异均无统计学意义（P>0.05）；治疗后，观察组一氧化氮（nitricoxide，NO）、反应性充血指数（reactive hyperemia index，RHI）、左心室射血分数（LVEF）、左心室短轴缩短率（FS）、二尖瓣前向血流E峰与A峰的比值均高于对照组，6分钟步行距离（6 minutes walking distance，6MWD）远于对照组，内皮缩血管肽（endothelin，ET）-1、神经肽Y（neuropeptide Y，NPY）均低于对照组，心绞痛发作次数少于对照组，持续时间短于对照组，差异均有统计学意义（P<0.05）。结论：琥珀酸美托洛尔缓释片与复心合剂联合治疗冠状动脉心肌桥心绞痛具有理想疗效。

【关键词】 冠状动脉心肌桥 心绞痛 琥珀酸美托洛尔缓释片 复心合剂 血管内皮功能

The Effect of Metoprolol Succinate Sustained-release Tablets Combined with Fuxin Mixture in the Treatment of Coronary Artery Myocardial Bridging Angina and Its Impact on Vascular Endothelial Function/CAO Min， HUANG Fei， YU Yapeng. //Medical Innovation of China， 2024， 21（14）： 0-052

[Abstract] Objective： To explore the value of the combination of Metoprolol Succinate Sustained-release Tablets and Fuxin Mixture in the treatment of coronary artery myocardial bridging angina. Method： A total of 70 coronary artery myocardial bridging angina patients from February 2020 to October 2022 in Nanchang Hongdu Hospilal of TCM were selected as the study subjects， they were divided into two groups by random number table method， with 35 cases in each group. The control group was treated with Metoprolol Succinate Sustained-release Tablets， while the observation group was treated with Metoprolol Succinate Sustained-release Tablets combined with Fuxin Mixture. The clinical efficacy and incidence of adverse reactions between two groups were compared. Result： There was no statistically significant difference in the incidence of adverse reactions between the two groups （P>0.05）. The clinical total effective rate of the observation group was higher than that of the control group， the difference was statistically significant （P<0.05）. Before treatment， there were no significant differences in the comparison of heart function， vascular endothelial function， and incidence of angina between the two groups （P>0.05）; after treatment， levels of nitric oxide （NO）， reactive hyperemia index （RHI）， left ventricular ejection fraction （LVEF）， left ventricular fraction shortening （FS）， ratio of peak E to peak A of mitral valve anterior blood flow in the observation group were higher compared to those the control group， 6 minutes walking distance （6MWD） was longer than that in the control group; endothelin-1 （ET-1）， neuropeptide Y （NPY） in the observation group were lower than those in the control group， frequency of angina attack was lower than that in the control group， duration of angina attack was shorter than that in the control group， the differences were statistically significant （P<0.05）. Conclusion： The combination of Metoprolol Succinate Sustained-release Tablets and Fuxin Mixture has an ideal therapeutic effect on coronary artery myocardial bridging angina.

[Key words] Coronary artery muscle bridging Angina Metoprolol Succinate Sustained-release Tablets Fuxin Mixture Vascular endothelial function

First-author's address： Comprehensive Internal Medicine Department， Nanchang Hongdu Hospital of TCM， Nanchang 330008， China

doi：10.3969/j.issn.1674-4985.2024.14.012

冠状动脉心肌桥作为一种先天性的血管发育异常，在肌肉舒张时出现，而在肌肉收缩时则完全消失，在心肌运行过程中，当心肌组织收缩时可对血管造成挤压，导致出现狭窄和心肌缺血的情况，继而引起心绞痛症状，若未及时干预可威胁患者生命。研究发现，心肌桥多位于左冠脉前降支中段，其中角分支占比18%、边缘分支占比40%，药物为目前治疗冠状动脉心肌桥心绞痛的主要方法，但西药单一治疗获得的临床效果有限[1-3]，近年随着研究的深入，发现中西医结合可降低心肌收缩力，增加冠脉血流量，为深入分析该方案的应用价值，本文选取70例冠状动脉心肌桥心绞痛患者研究，现报道如下。