目的 探讨九味益脑颗粒联合尼麦角林片治疗血管性痴呆的临床疗效及安全性。方法 选择2022年5月—2024年5月安康市中医医院收治的血管性痴呆患者100例，使用随机数字表法将患者分为对照组（50例）和治疗组（50例）。对照组患者口服尼麦角林片，20 mg/d，2次/d。治疗组在对照组基础上口服九味益脑颗粒，5 g/次，3次/d。两组患者连续给药6个月。观察两组患者临床疗效，比较治疗前后两组患者简易精神状态检查表（MMSE）和日常生活自理能力量表（ADL）评分，血清神经递质乙酰胆碱（Ach）、多巴胺（DA）、去甲肾上腺素（NE）和5-羟色胺（5-HT）水平，及脑血流动力学指标收缩期峰值速度（V_max）、舒张期峰值速度（V_min）、搏动指数（PI）和阻力指数（RI）水平。结果 治疗后，治疗组总有效率为94.00%，明显高于对照组的80.00%（P＜0.05）。治疗后，两组患者MMSE评分明显高于治疗前，而ADL评分显著低于治疗前（P＜0.05），且治疗组评分改善情况明显优于对照组（P＜0.05）。治疗后，两组患者血清Ach、DA、NE和5-HT水平均明显高于治疗前（P＜0.05），且治疗组患者血清神经递质水平显著高于对照组（P＜0.05）。治疗后，治疗组V_max、V_min和PI明显升高，而RI显著降低（P＜0.05），且在治疗组中，V_max、V_min、PI和RI则显著好于对照组（P＜0.05）。结论 九味益脑颗粒配合尼麦角林片治疗血管性痴呆，可显著提升血管性痴呆患者的治疗效果，改善其认知水平，增强生活自理能力，调节神经递质及脑血流动力学参数，安全性高。

Objective To explore the clinical efficacy and safety of Jiuwei Yinao Granules combined with nicergoline in treatment of vascular dementia. Methods Patients (100 cases) with vascular dementia in Ankang Hospital of Traditional Chinese Medicine from May 2022 to May 2024 were divided into control (50 cases) and treatment (50 cases) group by random number table method. Patients in the control group were po administered with Nicergoline Tablets, 20 mg/d, twice daily. Patients in the treatment group were po administered with Jiuwei Yinao Granules on the basis of the control group after meals, 5 g/time, three times daily. Patients in two groups were treated for 6 months. After treatment, the clinical evaluations were evaluated, and the scores of MMSE and ADL, and the serum neurotransmitter Ach, DA, NE and 5-HT levels, and cerebral hemodynamic indicators V_max, V_min, PI and RI levels in two groups before and after treatment were compared. Results After treatment, the total effective rate in the treatment group was 94.00%, which was significantly higher than 80.00% in the control group (P < 0.05). After treatment, the MMSE scores of patients in two groups were significantly higher than those before treatment, while the ADL scores were significantly lower than those before treatment (P < 0.05), and the improvement of scores in the treatment group was significantly better than that in the control group (P < 0.05). After treatment, the serum levels of Ach, DA, NE and 5-HT in two groups were significantly higher than those before treatment (P < 0.05), and the serum neurotransmitter levels in the treatment group were significantly higher than those in the control group (P < 0.05). After treatment, V_max, V_min and PI in the treatment group were significantly increased, while RI was significantly decreased (P < 0.05). In the treatment group, V_max, V_min, PI and RI were significantly better than those in the control group (P < 0.05). Conclusion The combination of Jiuwei Yinao Granules and Nicergoline Tablets can significantly improve the clinical efficacy of vascular dementia patients, enhance their cognitive function, improve their self-care ability, regulate neurotransmitters and cerebral hemodynamic indicators, and has high safety.

R971

陕西省卫生健康委科研项目（2021D0081）