目的 探讨丁苯酞联合尼莫地平治疗血管性认知障碍的临床效果。方法 选取2011年6月-2015年5月陕西省第二人民医院收治的血管性认知障碍患者72例，随机分为对照组和治疗组，每组各36例。对照组口服尼莫地平片，30 mg/次，3次/d。治疗组在对照组基础上口服丁苯酞软胶囊，0.2 g/次，4次/d。两组均治疗8周。观察两组的临床疗效，比较治疗前后双侧大脑前动脉（ACA）、双侧大脑中动脉（MCA）、双侧大脑后动脉（PCA）、双侧椎动脉（VA）和基底动脉（BA）平均血流速度、蒙特利尔认知评估量表（MOCA）评分、简易智力状态检查量表（MMSE）评分、神经元特异性烯醇化酶（NSE）、血栓素B2（TXB2）的变化。结果 治疗后，对照组和治疗组的总有效率分别为72.22%、91.67%，两组比较差异有统计学意义（P<0.05）。治疗后，两组双侧ACA、双侧MCA、双侧PCA、双侧VA和BA平均血流速度均上升，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的上升程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组MMSE和MOCA评分均上升，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的上升程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组TXB2和NSE水平均降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些观察指标的下降程度明显优于对照组，两组比较差异具有统计学意义（P<0.05）。结论 丁苯酞联合尼莫地平治疗血管性认知障碍具有较好的临床疗效，可改善认知功能和脑血液循环，降低炎症因子水平，安全性较好，具有一定的临床推广应用价值。

Objective To explore the clinical effect of butylphthalide combined with nimodipine in treatment of vascular cognitive impairment. Methods Patients (72 cases) with vascular cognitive impairment in Shaanxi Second Province People's Hospital from June 2011 to May 2015 were randomly divided into control and treatment groups, and each group had 36 cases. Patients in the control group were po administered with Nimodipine Tablets, 30 mg/time, three times daily. Patients in the treatment group were po administered with Butylphthalide Soft Capsules on the basis of the control group, 0.2 g/time, four times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and average blood flow velocity of bilateral ACA, bilateral MCA, bilateral PCA, bilateral VA, and BA, MOCA score, MMSE score, NSE, and TXB2 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.22% and 91.67%, respectively, and there was difference between two groups (P<0.05). After treatment, the average blood flow velocity of bilateral ACA, bilateral MCA, bilateral PCA, bilateral VA, BA in two groups were increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, MOCA scores and MMSE scores in two groups were increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TXB2 and NSE in two groups were decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Butylphthalide combined with nimodipine has clinical curative effect in treatment of vascular cognitive impairment, and can improve cognitive function and cerebral blood circulation, decrease the level of inflammatory factors, with good safety, which has a certain clinical application value.