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目的:观察枳实薤白桂枝汤合桂枝茯苓丸治疗冠心病的效果及对内皮损伤、炎症反应及血小板活化的影响.方法:以我院2013年2月～2015年10月收治的70例冠心病患者为对象,随机数字表法均分为西药组及联合组各35例,西药组实施常规西药治疗,联合组另给予枳实薤白桂枝汤和桂枝茯苓丸治疗,观察治疗后2组临床疗效、血管内皮功能[血浆内皮素(ET)、血栓素2 (TXB2)、一氧化氮(N0)]、炎症因子[白细胞介素-6(IL-6)、肿瘤坏死因子(TNF-α)]、血小板活化指标(血小板活化因子CD62 p、血小板活化因子CD63)及药物安全性.结果:治疗后联合组总有效率88.57％、不良反应发生率8.57％较西药组明显高、低(P＜0.05);治疗前2组ET、TXB2、NO、IL-6、TNF-α相较无明显差异(P＞0.05);与治疗前相较,治疗后2组ET、TXB2、IL-6、TNF-α明显降低,NO明显升高,CD62p、CD63明显减小,且治疗后联合组的改善幅度较西药组明显大,有统计学意义(P＜0.05).结论:枳实薤白桂枝汤合桂枝茯苓丸治疗冠心病可有效降低患者ET、TXB2、NO、IL-6、TNF-α,升高NO,减小CD62p、CD63,是一种疗效确切、安全可靠的药物方案.“,”Objective:To investigate the effects of Zhishi Xiebai Guizhi Decoction combined with Guizhi Fuling Pills in the treatment of coronary heart disease and the effect on endothelial injury,inflammation and platelet activation.Methods:From February 2013 to October 2015,70 patients with coronary heart disease in our hospital were randomly divided into the western medicine group and the combined group,35 cases in each group.The western medicine group was treated with routine western medicine while the combined group was additionally treated with Zhishi Xiebai Guizhi Decoction combined with Guizhi Fuling Pills.The clinical efficacy,vascular endothelial function [plasma endothelin (ET),thromboxane 2 (TXB2),nitric oxide (NO)],inflammatory factors [interleukin-6 (IL-6),tumor necrosis factor α (TNF-α)],platelet activation markers (platelet activating factor CD62p and platelet activating factor.CD63) and drug safety were observed.Results:After treatment,the total effective rate and the incidence rate of adverse reactions in the combined group were significantly higher than those in the western medicine group (P ＜ 0.05).Before treatment,ET,TXB2,NO,IL-6 and TNF-α showed no significant differences between the two groups (P ＞ 0.05).After treatment,ET,TXB2,IL-6and TNF-α,CD62p and CD63 decreased significantly while NO increased significantly,and the decrease and increase in the combined treatment group were more significant than those in the western medicine group (P ＜ 0.05).Conclusion:Zhishi Xiebai Guizhi Decoction combined with Guizhi Fuling Pills can effectively reduce the levels of ET,TXB2,NO,IL-6 and TNF-α,increase NO,and reduced CD62p and CD63 in patients with coronary heart disease.It is an effective,safe and reliable treatment plan.