目的 考察银杏叶胶囊联合甲钴胺治疗脑小血管病性认知障碍的临床疗效和安全性。方法 随机选取南宁市第九人民医院2017年9月-2018年10月脑小血管病性认知功能障碍患者100例，随机分为对照组（50例）和治疗组（50例）。对照组口服甲钴胺片，0.5 mg/次，3次/d。治疗组患者在对照组基础上口服银杏叶胶囊，2粒/次，3次/d。两组患者均治疗4个月。观察两组患者临床疗效，同时比较治疗前后两组患者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、阿尔茨海默病评价量表（ADAS-cog）评分、血清同型半胱氨酸（Hcy）和超敏C-反应蛋白（hs-CRP）水平及全血高切黏度、全血低切黏度和血浆黏度。结果 治疗后，对照组临床有效率为76.0%，显著低于治疗组的90.0%，两组比较差异有统计学意义（P<0.05）。治疗后，两组MOCA、MMSE评分显著升高（P<0.05），ADAS-cog评分显著降低（P<0.05），且治疗组患者认知功能明显好于对照组（P<0.05）。治疗后，两组患者血清Hcy和hs-CRP水平均显著降低（P<0.05），且治疗组患者血清Hcy和hsCRP水平明显低于对照组（P<0.05）。治疗后，两组患者全血高切黏度、全血低切黏度和血浆黏度均显著降低（P<0.05），且治疗组患者全血高切黏度、全血低切黏度和血浆黏度明显低于对照组（P<0.05）。结论 银杏叶胶囊联合甲钴胺可显著改善脑小血管病患者认知功能和血液流变学，降低血清Hcy和hs-CRP水平。

Objective To investigate the clinical efficacy and safety of Yinxingye Capsules combined with mecobalamin in treatment of cerebrovascular cognitive impairment. Methods Patients (100 cases) with cerebrovascular cognitive impairment in Ninth People's Hospital of Nanning from September 2017 to October 2018 were randomly divided into control (50 cases) and treatment (50 cases) groups. Patients in the control group were po administered with Mecobalamin Tablets, 0.5 mg/time, three times daily. Patients in the treatment group were po administered with Yinxingye Capsules on the basis of the control group, 2 grains/time, three times daily. Patients in two groups were treated for 4 months. After treatment, the clinical efficacy was evaluated, and the MOCA scores, MMSE scores, ADAS-cog scores, serum levels of Hcy and hs-CRP, and whole blood high shear viscosity, whole blood low shear viscosity, and plasma viscosity in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 76.0%, which was significantly lower than 90.0% in the treatment group, and there were differences between two groups (P<0.05). After treatment, the MOCA and MMSE scores in two groups were significantly increased (P<0.05), but ADAS-cog scores were significantly decreased (P<0.05), and the cognitive function in the treatment group was significantly better than that in the control group (P<0.05). After treatment, the serum levels of Hcy and hs-CRP in two groups were significantly decreased (P<0.05), and the Hcy and hs-CRP levels in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the whole blood high shear viscosity, whole blood low shear viscosity, and plasma viscosity in two groups were significantly decreased (P<0.05), and these indexes in the treatment group were significantly lower than those in the control group (P<0.05). Conclusion Yinxingye Capsules combined with mecobalamin can significantly improve the cognitive function and hemorheology of patients with cerebrovascular cognitive impairment, and reduce serum Hcy and hs-CRP levels.

南宁市本级科学研究与技术开发计划项目（20183042-4）