目的 观察安脑丸联合石杉碱甲治疗脑梗死后血管性痴呆的临床效果。方法 选取2018年1月—2019年12月广州市荔湾中心医院接收的脑梗死后血管性痴呆患者100例，根据随机数字表法将所有患者分为对照组和治疗组，每组各50例。对照组口服石杉碱甲片，0.1～0.2 mg/次，2次/d，一日量最多不超过0.45 mg。治疗组在对照组基础上口服安脑丸，3～6 g/次，2次/d。两组疗程为2个月。观察两组的临床疗效，比较两组治疗前后相关量表评分、血清学指标的变化情况。结果 治疗后，治疗组总有效率是80.00%，较对照组的62.00%显著提高（P＜0.05）。治疗后，两组痴呆简易筛查量表（BSSD）评分、简易智力状态检查量表（MMSE）评分、日常生活能力量表（ADL）评分高于治疗前（P＜0.05），且治疗组改善优于对照组（P＜0.05）。治疗后，两组脑源性神经营养因子（BDNF）、血管内皮生长因子（VEGF）较治疗前显著升高，而同型半胱氨酸（Hcy）、内皮素-1（ET-1）、超敏C反应蛋白（hs-CRP）较治疗前显著下降（P＜0.05），且治疗组患者改善优于对照组（P＜0.05）。结论 石杉碱甲联合安脑丸治疗脑梗死后血管性痴呆的疗效较为显著，可有效改善患者的临床症状，可调节BDNF、Hcy、VEGF、ET-1、hs-CRP等实验室指标。

Objective To observe the clinical effect of Annao Pills combined with Huperzine A in treatment of vascular dementia after cerebral infarction.Methods A total of 100 patients with vascular dementia after cerebral infarction admitted to Guangzhou Liwan Central Hospital from January 2018 to December 2019 were selected.According to the random number table method,all patients were divided into control group and treatment group,with 50 cases in each group.Patients in the control group were po administered with Huperzine A Tablets,0.1-0.2 mg/time,twice daily,the daily dosage should not exceed 0.45 mg.Patients in the treatment group were po administered with Annao Pills on the basis of the control group,3-6 g/time,twice daily.The two groups were treated for 2 months.The clinical efficacy of the two groups was observed,and the changes of related scale scores and serological indexes before and after treatment were compared between the two groups.Results After treatment,the total effective rate of the treatment group was 80.00%,which was significantly higher than that of the control group (62.00%)(P<0.05).After treatment,the scores of Dementia Mini-Screening Scale (BSSD) and Mini-Mental State Examination (MMSE) in the two groups and the scores of Activities of daily Living Scale (ADL) were higher than those before treatment (P<0.05),and the improvement in the treatment group was better than that in the control group (P<0.05).After treatment,brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) in the two groups were significantly increased compared with those before treatment,but homocysteine (Hcy),endothelin-1(ET-1) and high-sensitivity C-reactive protein (hs-CRP) were significantly decreased compared with those before treatment (P<0.05).The improvement of the treatment group was better than that of the control group (P<0.05).Conclusion Annao Pills combined with Huperzine A has a remarkable effect in treatment of vascular dementia after cerebral infarction,and can effectively improve the clinical symptoms of patients and regulate laboratory indicators such as BDNF,Hcy,VEGF,ET-1 and hs-CRP.

R971

广东省医学科研基金项目(A2017147)