目的 观察复方苁蓉益智胶囊联合尼莫地平片治疗血管性痴呆的临床疗效。方法 选取2020年3月-2022年1月云南省第三人民医院收治的112例血管性痴呆患者，采用随机数字表法将所有患者分为对照组和治疗组，各56例。对照组口服尼莫地平片，30 mg/次，3次/d。治疗组在对照组的治疗基础上口服复方苁蓉益智胶囊，4粒/次，3次/d。两组持续用药3个月。观察两组的临床疗效，比较两组的两组简易智能精神状态检查量表（MMSE）、日常生活能力量表（ADL）评分和血清胆碱能神经递质、血管内皮功能指标、血清神经损伤因子水平。结果 治疗后，对照组总有效率为80.36%；治疗组总有效率为94.64%，治疗组的总有效率高于对照组（P<0.05）。治疗后，两组MMSE评分升高，ADL评分降低（P<0.05），且治疗组MMSE评分较对照组高，ADL评分较对照组低（P<0.05）。治疗后，两组血清神经元特异性烯醇化酶（NSE）、钙结合蛋白S100β（S100β）蛋白水平降低（P<0.05），且治疗组血清NSE、S100β蛋白水平较对照组更低（P<0.05）。治疗后，两组血清一氧化氮（NO）水平升高，血清内皮素-1（ET-1）水平降低（P<0.05），且治疗组血清NO水平高于对照组，血清ET-1水平低于对照组（P<0.05）。治疗后，两组血清乙酰胆碱酯酶（AchE）水平均降低，血清乙酰胆碱（Ach）、胆碱乙酰转移酶（ChAT）水平均升高（P<0.05），且治疗组患者血清AchE水平低于对照组，血清Ach、ChAT水平低于对照组（P<0.05）。结论 复方苁蓉益智胶囊联合尼莫地平片治疗血管性痴呆可改善患者认知功能，提高生活自理能力，调节血清胆碱能神经递质、神经损伤因子、血管内皮功能指标水平。

Objective To observe the clinical effect of Compound Congrong Yizhi Capsules combined with Nimodipine Tablets in treatment of vascular dementia. Methods Patients (112 cases) with vascular dementia in the Third People's Hospital of Yunnan Province from March 2020 to January 2022 were divided into control and treatment groups according to the random number table method, and each group had 56 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 Compound Congrong Yizhi Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and MMSE scores, ADL scores, the serum levels of cholinergic neurotransmitters, vascular endothelial function indicators, and serum nerve injury factors in two groups were compared. Results After treatment, the total effective rate of the control group was 80.36%, and the total effective rate of the treatment group was 94.64%, and the total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, MMSE scores in two groups were increased, but ADL scores in two groups were decreased (P < 0.05). And MMSE scores in the treatment group were higher than those in the control group, while ADL scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of NSE and S100β protein in the two groups were decreased (P < 0.05), and the serum levels of NSE and S100β protein in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of NO were increased, but the serum levels of ET-1 were decreased in two groups (P < 0.05). And the serum levels of NO in the treatment group were higher than those in the control group, but the serum levels of ET-1in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of AchE in two groups were decreased, while the serum levels of Ach and ChAT were increased (P < 0.05), and the serum levels of AchE in the treatment group were lower than those in the control group, but the serum levels of Ach and ChAT in the treatment group were higher than those in the control group (P < 0.05). Conclusion Compound Congrong Yizhi Capsules combined with Nimodipine Tablets in treatment of vascular dementia can improve patients' cognitive function, enhance their self-care ability, regulate the serum levels of cholinergic neurotransmitters, nerve injury factors, and vascular endothelial function indicators.

R971

国家卫生计生委医药卫生科技发展研究中心课题（W2018ZT866）