目的 探讨血栓通注射液联合盐酸多奈哌齐片治疗血管性痴呆的临床疗效。方法 选取2018年3月-2019年12月在平煤神马医疗集团总医院就诊的112例血管性痴呆患者作为本研究的对象，按照随机数字表法将全部患者分为对照组和治疗组，每组各56例。对照组睡前口服盐酸多奈哌齐片，5 mg/次，1次/d。治疗组在对照组的基础上静脉滴注血栓通注射液，5 mL用10%葡萄糖注射液250 mL稀释后使用，1次/d。两组患者连续治疗2周。观察两组的临床疗效，比较两组的评分血流动力学、血清指标和简易精神检查量表（MMSE）。结果 治疗后，治疗组的总有效率为92.86%，对照组为78.57%，组间比较差异有统计学意义（P<0.05）。治疗后，两组的阻力指数（RI）、搏动指数（PI）明显降低，血流高速峰值（V_m）均明显升高（P<0.05）；且治疗后治疗组的RI、PI低于对照组，V_m高于对照组，差异有统计学意义（P<0.05）。治疗后，两组的内皮素-1（ET-1）、血管紧张素Ⅱ（Ang Ⅱ）、同型半胱氨酸（Hcy）水平均明显降低，差异有统计学意义（P<0.05）；且治疗后治疗组的ET-1、AngⅡ、Hcy水平低于对照组，差异有统计学意义（P<0.05）。治疗后，两组的MMSE评分均明显升高，差异有统计学意义（P<0.05），且治疗组MMSE评分升高的更明显，差异有统计学意义（P<0.05）。结论 血栓通注射液联合盐酸多奈哌齐片可提高血管性痴呆的疗效，改善患者的认知功能和血管内皮功能，调节血流动力学水平。

Objective To investigate the clinical efficacy of Xueshuantong injection combined with Donepezil Hydrochloride Tablets in the treatment of vascular dementia. Methods Patients (112 cases) with vascular dementia in Pingmei Shenma Medical Group General Hospital from March 2018 to December 2019 were randomly divided into control and treatment groups, and each group had 56 cases. Patients in the control group were po administered with Donepezil Hydrochloride Tablets, 5 mg/time, once daily. Patients in the treatment group were iv administered with Xueshuantong injection on the basis of the control group, 5 mL added into 10% glucose solutioin 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and hemodynamics, serum indexes and MMSE score in two groups were compared. Results After treatment, the total effective rates were 92.86% and 78.57% in the treatment group and control group, and the difference was statistically significant (P<0.05). After treatment, the RI and PI of two groups were significantly decreased, but the VM of two groups was significantly increased (P<0.05). And the RI and PI of the treatment group were lower than those of the control group, but the VM of the treatment group was higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of ET-1, Ang Ⅱ, and Hcy in two groups were significantly decreased, and the difference was statistically significant (P<0.05). After treatment, the levels of ET-1, Ang Ⅱ, and Hcy in the treatment group were lower than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the MMSE scores of two groups were significantly increased, and the difference was statistically significant (P<0.05). And the MMSE score of the treatment group increased more significantly, and the difference was statistically significant (P<0.05). Conclusion Xueshuantong Injection combined with Donepezil Hydrochloride Tablets can enhance the curative effect of vascular dementia, improve the cognitive function and vascular endothelial function of patients, and regulate the level of hemodynamics..

R971

国家自然科学基金资助项目（UI804174）