观察针刺联合冠心宁片治疗心脉瘀阻型胸痹的临床疗效。【方法】将80例心脉瘀阻型胸痹患者随机分为观察组 和对照组，每组各40例，对照组给予常规西药治疗，观察组在对照组治疗的基础上，给予针刺联合冠心宁片治疗，2组患者 均持续治疗30 d。治疗1个月后，评价2组临床疗效。观察2组患者治疗前后中医证候积分包括胸闷心悸、胸部刺痛、面色 晦暗等的变化情况，以及心绞痛的发作频次与持续时间。比较2组患者治疗前后血清单核细胞趋化因子1（MPC-1）、超敏 C-反应蛋白（hs-CRP）、肿瘤坏死因子α（TNF-α）、丝裂原活化蛋白激酶（MAPK）、Toll样受体4（TLR4）水平的变化情况。 【结果】（1）观察组总有效率为95.00%（38/40），对照组为75.00%（30/40）。观察组疗效优于对照组，差异有统计学意义（P＜ 0.05）。（2）治疗后，2组患者中医证候积分包括胸闷心悸、胸部刺痛、面色晦暗均明显改善，且观察组在改善胸闷心悸、胸部 刺痛、面色晦暗中医证候积分方面明显优于对照组，差异均有统计学意义（P＜0.05）。（3）治疗后，2组患者的心绞痛发作频 次及持续时间明显改善，且观察组在改善心绞痛发作频次及持续时间方面明显优于对照组，差异有统计学意义（P＜0.05）。 （4）治疗后，2组患者的血清hs-CRP、MPC-1、TNF-α水平均明显改善（P＜0.05），且观察组在改善血清hs-CRP、MPC-1、 TNF-α水平方面明显优于对照组，差异均有统计学意义（P＜0.05）。（5）治疗后，2组患者的血清MAPK、TLR4水平明显改善 （P＜0.05），且观察组在改善血清MAPK、TLR4水平方面明显优于对照组，差异有统计学意义（P＜0.05）。【结论】针刺联合冠 心宁片治疗心脉瘀阻型胸痹，能明显改善患者的临床症状，有效缓解机体炎症反应，降低血清MAPK、TLR4水平，临床疗 效显著。

To observe the clinical efficacy of acupuncture combined with Guanxinning Tablets in the treatment of heart vessel obstruction type of chest obstruction syndrome. Methods Eighty patients with heart vessel obstruction type of chest obstruction syndrome were randomly divided into the observation group and the control group，with 40 cases in each group，the control group was given conventional western medicine treatment，the observation group was given acupuncture combined with Guanxinning Tablets on the basis of the treatment in the control group，and the patients in the two groups were treated continuously for 30 days. The clinical efficacy of the two groups was evaluated after 1 month of treatment. After 1 month of treatment，the clinical efficacy of the two groups was evaluated. The changes in the traditional Chinese medicine（TCM）scores，including chest tightness， palpitations，stabbing pains in the chest，and dark complexion，as well as the frequency and duration of angina pectoris were observed before and after the treatment in the two groups. The changes of serum monocyte chemotactic factor 1（MPC-1），hs-CRP，tumor necrosis factor α（TNF-α），mitogen-activated protein kinase（MAPK）， and Toll-like receptor 4（TLR4）were observed before and after treatment in the two groups. Results（1）The total effective rate was 95.00%（38/40）in the observation group and 75.00%（30/40）in the control group. The efficacy of the observation group was superior to that of the control group，and the difference was statistically significant （P＜0.05）.（2） After treatment， the TCM syndrome scores of patients in the two groups， including chest tightness and palpitations， chest tingling， and dark complexion， were significantly improved， and the observation group was significantly superior to the control group in improving the TCM syndrome scores of chest tightness and palpitations，chest tingling，and dark complexion，and the difference was statistically significant （P＜0.05）.（3）After treatment，the frequency and duration of angina attacks in the two groups were significantly improved，and the observation group was significantly superior to the control group in improving the frequency and duration of angina attacks， and the difference was statistically significant（P＜0.05）.（4）After treatment， the serum hs-CRP， MPC-1， and TNF-α levels of patients in the two groups were significantly improved（P＜ 0.05），and the observation group was significantly superior to the control group in improving the serum hs-CRP， MPC-1 and TNF-α levels，and the difference was statistically significant（P＜0.05）.（5）After treatment，the serum MAPK and TLR4 levels of patients in the two groups were significantly improved（P＜0.05）， and the observation group was significantly superior to the control group in improving serum MAPK and TLR4 levels，and the difference was statistically significant （P＜0.05）. Conclusion Acupuncture combined with Guanxinning Tablets for the treatment of heart vessel obstruction type of chest obstruction syndrome can significantly improve the clinical symptoms of the patients， effectively alleviate the body’s inflammatory response， reduce the level of serum MAPK and TLR4，and the clinical efficacy is remarkable.

R246.9

新疆维吾尔自治区自然科学基金资助项目（编号：2021D01C123）