【目的】 探讨谷红注射液治疗冠状动脉微血管功能障碍（CMD）气滞血瘀证患者的临床疗效。【方法】 将 2021 年 6 月至 2022年8月广东省中医院收治的60例CMD气滞血瘀证患者按随机数字表法随机分为对照组和试验组，每组各30例。对照组 给予西医常规治疗，试验组在对照组的基础上联合谷红注射液治疗，疗程为10 d。观察2组患者治疗前后中医证候积分、血 脂指标及血清炎症因子、内皮因子水平的变化情况，并评价2组患者的临床疗效。【结果】（1）脱落情况方面，研究过程中， 对照组脱落 3 例，试验组脱落 2 例，最终共有 55 例患者纳入疗效统计分析（其中对照组 27 例，试验组28例）。（2）疗效方面， 治疗10 d后，试验组的总有效率为89.29%（25/28），对照组为40.74%（11/27），组间比较（χ2检验），试验组的疗效明显优于对 照组（P < 0.01）。（3）中医证候积分方面，治疗后，2组患者的中医证候积分均较治疗前下降（P < 0.05），且试验组对中医证候 积分的下降幅度明显优于对照组（P < 0.01）。（4）血脂指标方面，治疗后，2组患者的甘油三酯（TG）、总胆固醇（TC）、低密度 脂蛋白胆固醇（LDL-C）水平均较治疗前下降（P < 0.05），高密度脂蛋白胆固醇（HDL-C）水平均较治疗前升高（P < 0.05），且试 验组对 TG、TC、LDL-C水平的下降幅度及对 HDL-C水平的升高幅度均明显优于对照组（P < 0.05或 P < 0.01）。（5）炎症因子 方面，治疗后，2组患者的血清超敏 C反应蛋白（hs-CRP）、白细胞介素 6（IL-6）、肿瘤坏死因子 α（TNF-α）水平均较治疗前 下降（P < 0.05），且试验组对血清 hs-CRP、IL-6、TNF-α水平的下降幅度均明显优于对照组（P < 0.01）。（6）内皮因子方面， 治疗后，2组患者的血清一氧化氮（NO）水平均较治疗前升高（P < 0.05），血清内皮素1（ET-1）水平均较治疗前下降（P < 0.05）， 且试验组对血清NO水平的升高幅度及对血清ET-1水平的下降幅度均明显优于对照组（P < 0.05或P < 0.01）。【结论】 在西医 常规治疗基础上联合谷红注射液治疗CMD气滞血瘀证患者疗效显著，能有效缓解症状，调节血脂水平，减轻炎症反应，改 善内皮功能。

Objective To investigate the clinical efficacy of Guhong Injection for the treatment of patients with coronary microvascular dysfunction（CMD）of qi stagnation and blood stasis syndrome. Methods Sixty cases of patients with CMD of qi stagnation and blood stasis syndrome who were admitted to Guangdong Provincial Hospital of Chinese Medicine from June 2021 to August 2022 were randomly divided into the control group and the trial group according to the random number table method，with 30 cases in each group. The control group was treated with conventional western medicine，and the trial group was treated with Guhong Injection on the basis of treatment for the control group. The course of treatment for the two groups covered 10 days. The changes in traditional Chinese medicine（TCM）syndrome scores， and levels of lipid indicators， serum inflammatory factors and endothelial factors in the two groups were observed before and after treatment. After treatment，the clinical efficacy of the two groups was evaluated. Results（1）During the trial，three cases in the control group and two cases in the trial group fell off and a total of 55 cases were finally included in the statistical analysis of efficacy，including 27 cases in the control group and 28 cases in the trial group.（2）After 10 days of treatment，the total effective rate of the trial group was 89.29%（25/28），and that of the control group was 40.74%（11/27），and the intergroup comparison （tested by chi-square test）showed that the therapeutic efficacy of the trial group was significantly superior to that of the control group（P < 0.01）.（3）After treatment，the TCM syndrome scores of patients in both groups were decreased compared with those before treatment（P < 0.05），and the decrease in the trial group was significantly superior to that in the control group（P < 0.01）.（4）After treatment，the levels of lipid indicators triglyceride （TG），total cholesterol（TC），and low-density lipoprotein cholesterol（LDL-C）in the two groups of patients were decreased compared with those before treatment（P < 0.05）， and the level of high-density lipoprotein cholesterol（HDL-C）was increased compared with that before treatment（P < 0.05）. The intergroup comparison showed that the decrease of TG，TC，and LDL-C levels as well as the increase of HDL-C level in the trial group was significantly superior to that in the control group（P < 0.05 or P < 0.01）.（5）After treatment， the serum levels of inflammatory factors high-sensitivity C-reactive protein（hs-CRP），interleukin 6（IL-6）and tumor necrosis factor α（TNF-α）in the two groups of patients were decreased compared with those before treatment（P < 0.05），and the decrease in the trial group was significantly superior to that in the control group（P < 0.01）.（6）After treatment， the serum level of endothelial factor nitric oxide（NO）in the two groups of patients was increased（P < 0.05）and the serum endothelin 1（ET-1）level was decreased compared with that before treatment（P < 0.05），and the increase of serum NO level， as well as the decrease of serum ET-1 level in the trial group was significantly superior to that in the control group（P < 0.05 or P < 0.01）. Conclusion Based on the conventional treatment in western medicine，the application of Guhong Injection in the treatment of patients with CMD of qi stagnation and blood stasis syndrome exerts remarkable efficacy， which can effectively alleviate the symptoms， regulate the levels of blood lipids，reduce the inflammatory response，and improve the endothelial function.

R259.414

国家自然科学基金面上项目（编号：82074342）；广州市科技计划项目（编号：202201020352）