目的 探讨石杉碱甲片联合长春西汀治疗老年血管性痴呆的安全性和有效性。方法 选取铁岭市中心医院2014年7月-2016年7月收治的老年血管性痴呆患者176例，随机将患者分成对照组（88例）和治疗组（88例）。对照组患者静脉滴注注射用长春西汀，20 mg加入500 mL生理盐水中，1次/d；治疗组在对照组的基础上口服石杉碱甲片，0.1 mg/次，2次/d。两组患者均连续治疗21 d。比较两组患者治疗前后临床疗效、MMSE评分、BSSD评分、血液流变学指标以及不良反应发生情况。结果 治疗后，对照组和治疗组的总有效率分别为86.36%和96.59%，两组总有效率比较差异有统计学意义（P<0.05）。治疗后，两组简易精神状态评价量表（MMSE）评分和痴呆简易筛查量表（BSSD）评分均显著提高（P<0.05）；同时治疗组患者MMSE和BSSD评分的改善情况明显优于对照组患者（P<0.05）。治疗后，两组患者血红细胞压积、全血黏度以及纤维蛋白原均比治疗前显著降低（P<0.05）；同时治疗组患者治疗后上述观察指标均明显低于对照组患者（P<0.05）。对照组患者的不良反应发生率为13.64%，显著高于治疗组的5.68%，两组不良反应比较差异具有统计学意义（P<0.05）。结论 石杉碱甲联合长春西汀治疗老年血管性痴呆患者临床疗效好，安全性高，具有一定的临床推广应用价值。

Objective To investigate the clinical safety and efficacy of Huperzine A Tablets combined with vinpocetine in treatment of senile vascular dementia. Methods Patients (176 cases) with senile vascular dementia in Tieling Central Hospital from July 2014 to July 2016 were randomly divided into control (88 cases) and treatment (88 cases) groups. Patients in the control group were iv administered with Vinpocetine for injection, 20 mg added into 500 mL normal saline, once daily. Patients in the treatment group were po administered with Huperzine A Tablets on the basis of the control group, 0.1 mg/time, twice daily. Patients in two groups were treated for 21 d. After treatment, the clinical efficacy, MMSE score, BSSD score, hemorheological indexes, and adverse reactions in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 86.36% and 96.59%, respectively, and there was difference between two groups (P<0.05). After treatment, the MMSE and BSSD scores in two groups were significantly increased (P<0.05). And MMSE and BSSD scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the hematocrit, whole blood viscosity, and fibrinogen in two groups were significantly decreased (P<0.05). And these indicators in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the adverse reaction rate in the control group was 13.64%, which was significantly higher than 5.68% in the treatment group, with significant difference between two groups (P<0.05). Conclusion Huperzine A Tablets combined with vinpocetine has good clinical efficacy in treatment of senile vascular dementia with high safety, which has a certain clinical application value.