目的 探讨珍黄安宫片联合加兰他敏治疗轻度血管性认知功能障碍的临床疗效。方法 纳入2024年2月—2025年10月江阴市中医院收治的148例轻度血管性认知功能障碍患者，按照随机数字表法为对照组和治疗组，每组各74例。对照组im氢溴酸加兰他敏注射液，2.5 mg/次，1次/d。治疗组在此基础上联合口服珍黄安宫片，4片/次，3次/d，温水送服。两组疗程均为12周。观察两组临床疗效，比较治疗前后中医症状评分、简易精神状态检查（MMSE）、ADAS-Cog量表延迟词语回忆（ADAS-COG-DVR）、改良Barthel指数（MBI）评分、事件相关电位P300和血清白细胞介素-6（IL-6）、脂蛋白相关磷脂酶A2（Lp-PLA2）、神经元特异性烯醇化酶（NSE）、β淀粉样蛋白1-42（Aβ_1-42）水平。结果 治疗组和对照组的总有效率分别是93.24%、82.43%，两组比较差异显著（P＜0.05）。治疗后，两组中医症状评分与ADAS-COG-DVR评分都降低，MMSE评分与MBI评分都增加（P＜0.05）；治疗组中医症状评分与ADAS-COG-DVR评分低于对照组，MMSE评分与MBI评分高于对照组（P＜0.05）。治疗后，两组P300潜伏期都短于同组治疗前，P300波幅都高于同组治疗前（P＜0.05）；治疗后，相较于对照组，治疗组P300潜伏期更短，P300波幅更高（P＜0.05）。治疗后，两组血清IL-6、Lp-PLA2、NSE和Aβ1-42水平均显著下降（P＜0.05）；治疗后，治疗组IL-6、Lp-PLA2、NSE和Aβ_1-42水平均低于对照组（P＜0.05）。结论 轻度血管性认知功能障碍采用珍黄安宫片联合加兰他敏治疗安全性良好，能有效逆转患者脑认知电生理状态，减轻神经炎症反应及神经元损害，促进患者症状好转及认知功能和日常生活能力恢复。

Objective To explore the clinical efficacy of Zhenhuang Angong Tablets combined with galantamine in treatment of mild vascular cognitive impairment. Methods A total of 148 patients with mild vascular cognitive impairment who were admitted to Jiangyin Hospital of Traditional Chinese Medicine from February 2024 to October 2025 were included. They were divided into control group and treatment group according to random number table method, with 74 cases in each group. Patients in control group were given intramuscular injection of Galantamine Hydrobromide Injection, 2.5 mg/time, once daily. Patients in treatment group were additionally administered the oral medication Zhenhuang Angong Tablets, 4 tablets/time, 3 times daily, taken with warm water. Both groups had a treatment duration of 12 weeks. The clinical efficacy of two groups was observed, and traditional Chinese medicine symptoms, the Simple Mental State Examination (MMSE), the ADAS-Cog scale delayed word recall (ADAS-COG-DVR), the modified Barthel Index (MBI) score, event-related potential P300, and serum levels of interleukin-6 (IL-6), lipoprotein-associated phospholipase A2 (Lp-PLA2), neuron-specific enolase (NSE), and β-amyloid protein 1-42 (Aβ1-42) in two groups before and after treatment were compared. Results After treatment, the total effective rates of treatment group and control group were 93.24% and 82.43%, respectively, there was a significant difference between two groups (P < 0.05). After treatment, the scores of traditional Chinese medicine symptoms and ADAS-COG-DVR in both groups decreased, but the MMSE score and MBI score increased (P < 0.05), the scores of traditional Chinese medicine symptoms and ADAS-COG-DVR in treatment group were lower than those in control group, and the MMSE score and MBI score were higher than those in control group (P < 0.05). After treatment, the P300 latency in both groups was shorter than that before treatment in the same group, and the P300 amplitude was higher than that before treatment in the same group (P < 0.05). After treatment, compared with control group, the P300 latency in treatment group was shorter and the P300 amplitude was higher (P < 0.05). After treatment, the levels of serum IL-6, Lp-PLA2, NSE, and Aβ_1-42 in both groups significantly decreased (P < 0.05). After treatment, the levels of IL-6, Lp-PLA2, NSE, and Aβ_1-42 in treatment group were lower than those in control group (P < 0.05). Conclusion The treatment of mild vascular cognitive impairment with Zhenhuang Angong Tablets combined with galantamine has good safety, and can effectively reverse the brain cognitive electrophysiological state of patients, alleviate neuroinflammatory responses and neuronal damage, and promote the improvement of patients’ symptoms and the recovery of cognitive function and daily living ability.

R971

无锡市中医药管理项目（ZYYB31）