【目的】 探讨宽胸气雾剂改善冠状动脉临界病变（ICS）伴心绞痛患者的即时疗效及其对静息全周期比（RFR）、冠脉造影 校正TIMI血流帧数值（CTFC）、冠脉血清炎症因子的影响。【方法】 将2023年3月至2024年3月广东省中医院大德路总院心血 管科收治的60例ICS伴心绞痛患者随机分为宽胸气雾剂组（试验组）和空白对照组（对照组），每组各30例。试验组给予连续 舌下喷服宽胸气雾剂 4喷，对照组不予任何干预，观察 10 min。比较 2组患者干预前后冠脉 RFR值、CTFC值、胸痛视觉模 拟量表（VAS）评分以及冠脉血清C反应蛋白（CRP）、白细胞介素6（IL-6）、脂蛋白相关磷脂酶A2（Lp-PLA2）水平的变化情况， 分析2组患者干预期间不良反应发生情况。【结果】（1）干预后，试验组的冠脉RFR值较干预前有显著性升高（P < 0.01），而对 照组的冠脉RFR值较干预前无显著性升高（P > 0.05）；组间比较，试验组对冠脉RFR值的升高作用优于对照组（P < 0.05）。（2）干 预后，试验组的 CTFC值较干预前有显著性降低（P < 0.01），而对照组的 CTFC值较干预前无显著性降低（P > 0.05）；组间比 较，试验组对 CTFC值的降低作用有优于对照组趋势，但差异无统计学意义（P > 0.05）。（3）干预后，试验组的胸痛 VAS评分 较干预前有显著性降低（P < 0.01），而对照组的胸痛 VAS评分较干预前无显著性降低（P > 0.05）；组间比较，试验组对胸痛 VAS评分的降低作用明显优于对照组（P < 0.01）。其中，在缓解胸痛的即时疗效方面，试验组舌下喷服宽胸气雾剂10 min后 缓解胸痛的有效率为96.67%（29/30），明显优于对照组的10.00%（3/30），组间比较，差异有统计学意义（P < 0.001）。（4）干预 后，试验组的Lp-LPA2值较干预前降低（P < 0.05），而试验组的CRP、IL-6值和对照组的CRP、IL-6、Lp-LPA2值均较干预 前无显著性降低（P > 0.05）；组间比较，试验组对Lp-LPA2值的降低作用明显优于对照组（P < 0.05）。（5）2组患者干预前后的 一般生命体征均无明显变化，且均未发生与用药相关的不良反应。【结论】 宽胸气雾剂可以即时改善ICS伴心绞痛患者的冠脉 生理学功能指标，提高患者的冠脉血流速度，减轻冠脉内部分炎症反应，从而减轻ICS患者心绞痛症状。

Objective To investigate the immediate therapeutic efficacy of Kuanxiong Aerosol on improving the angina pectoris in the patients complicated with intermediate coronary stenosis（ICS），and to observe its effect on resting full-cycle ratio（RFR），corrected TIMI（thrombolysis in myocardial infarction）frame count（CTFC）in angiography，and coronary serum inflammatory factors. Methods Sixty angina pectoris patients with ICS admitted to the Cardiovascular Department of Dade Road Hospital, Guangdong Provincial Hospital of Traditional Chinese Medicine from March 2023 to March 2024 were randomly divided into the trial group and the control group，with 30 patients in each group. The trial group was given four consecutive sprays of Kuanxiong Aerosol by sublingual spray，and the control group had no intervention but just was given the monitoring for 10 minutes. Before and after the intervention，the changes of coronary RFR，CTFC，Visual Analogue Scale（VAS）score of chest pain，and the serum levels of C-reactive protein（CRP），interleukin 6（IL-6）and lipoprotein-associated phospholipase A2（LpPLA2）in the two groups were observed. Moreover，the incidence of adverse reactions during the intervention in the two groups of patients was compared. Results（1）After the intervention，the coronary RFR value of the trial group was increased significantly compared with that before intervention（P < 0.01），while the coronary RFR value of the control group was not increased significantly compared with that before intervention（P > 0.05）；the comparison between the two groups showed that the effect on increasing the coronary RFR value in the trial group was superior to that in the control group（P < 0.05）.（2）After intervention，the CTFC value of the trial group was significantly decreased compared with that before intervention（P < 0.01），while the CTFC value of the control group was not significantly decreased compared with that before intervention（P > 0.05）；the intergroup comparison showed that the trial group tended to have a better effect on the decrease of CTFC value than the control group， but the difference being not statistically significant（P > 0.05）.（3）After the intervention，the chest pain VAS score of the trial group was significantly reduced compared with that before intervention（P < 0.01），while the pre- and posttreatment changes of the score in the control group was not significant（P > 0.05）； the intergroup comparison showed that the decrease of the chest pain VAS score in the trial group was superior to that in the control group （P < 0.01）. In particular for immediate therapeutic efficacy， Kuanxiong Aerosol achieved the effective rate of 96.67%（29/30）for relieving chest pain 10 minutes after sublingual spraying，which was significantly superior to that of the control group [10.00%（3/30）]，and the comparison between the two groups showed that the difference was statistically significant（P < 0.001）.（4）After the intervention，the Lp-LPA2 value of the trial group was decreased compared with that before intervention（P < 0.05），while the CRP and IL-6 values of the trial group as well as the CRP，IL-6，and Lp-LPA2 values of the control group were all not significantly decreased compared with those before intervention（P > 0.05）. The intergroup comparison showed that the trial group 􀆳s effect on the decrease of Lp-LPA2 value was significantly superior to that of the control group（P < 0.05）.（5）Before and after the intervention，no obvious changes of the general vital signs in the two groups were shown，no drug-related adverse occurred， either. Conclusion Kuanxiong Aerosol can immediately improve the coronary physiological function indicators of angina pectoris patients with ICS，increase the coronary flow rate，and inhibit inflammatory response of the coronary artery to some degree， thus to alleviate the symptoms of angina pectoris in patients with ICS.

R259.414

广东省基础与应用基础研究基金项目（编号：2021A1515220035，2023A1515220029）；广东省中医药局面上项目（编号：20221192）； 广州市科技局市院联合资助项目 （编号：20221020318）