目的 探讨复方苁蓉益智胶囊联合奥拉西坦注射液治疗轻中度血管性痴呆的临床效果。方法 选取2018年1月—2020年1月天津市西青医院收治的120例血管性痴呆患者，奇偶顺序法分为对照组和治疗组，每组各60例。对照组静脉滴注奥拉西坦注射液，4 g加入到500 mL生理盐水，1次/d。治疗组在对照组的基础上口服复方苁蓉益智胶囊，4粒/次，3次/d。两组患者均连续治疗4周。观察两组患者临床疗效，比较治疗前后两组患者美国国立卫生院卒中量表（NIHSS）、日常生活能力量表（ADL）、简易智力状态量表（MMSE）评分，及血清同型半胱氨酸（Hcy）、脑源性神经营养因子（BDNF）和胰岛素样生长因子-1（IGF-1）水平。结果 治疗后，治疗组的临床有效率高于对照组（91.67%vs 76.67%，P<0.05）。治疗后，两组MMSE评分显著升高，而ADL、NIHSS评分显著降低（P<0.05），且治疗组评分明显好于对照组（P<0.05）。治疗后，两组患者BDNF、IGF-1水平显著升高，而Hcy水平显著降低（P<0.05），且治疗组明显好于对照组（P<0.05）。结论 复方苁蓉益智胶囊联合奥拉西坦注射液治疗轻中度血管性痴呆，安全有效，可改善患者认知功能、生活自理能力，促进症状改善。

Objective To investigate the clinical effect of Compound Congrong Yizhi Capsules combined with oxiracetam in treatment of mild to moderate vascular dementia. Methods Patients (120 cases) with mild to moderate vascular dementia in Tianjin Xiqing Hospital from January 2018 to January 2020 were divided into control and treatment groups based on parity order, and each group had 30 cases. Patients in the control group were iv administered with Oxiracetam Injection, 4 g added into normal saline 500 mL, once daily. Patients in the treatment group were po administered with Compound Congrong Yizhi Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, the MMSE, ADL, and NIHSS scores, and the levels of serum BDNF, Hcy, and IGF-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was higher than that in the control group (91.67% vs 76.67%, P < 0.05). After treatment, the MMSE score in two groups were significantly increased, while the scores of ADL and NIHSS were significantly decreased (P < 0.05), and the scores of the treatment group were significantly better than that of the control group (P < 0.05). After treatment, BDNF and IGF-1 in two groups were significantly increased, while Hcy were significantly decreased (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Compound Congrong Yizhi Capsules combined with oxiracetam is safe and effective on treatment of mild to moderate vascular dementia, can improve patients' cognitive function, self-care ability, and promote the improvement of symptoms.

R971

国家科技重大专项（2011ZX09304-07）