目的 观察丁苯酞软胶囊治疗血管性认知障碍的临床疗效。方法 选取2016年3月-2018年5月在天津中医药大学第一附属医院治疗的166例血管性认知障碍患者作为研究对象，患者按就诊顺序随机分为对照组和治疗组，每组各83例。对照组口服尼莫地平片，2片/次，3次/d。治疗组口服丁苯酞软胶囊，2粒/次，3次/d。所有患者均治疗3个月。观察两组患者的临床疗效，同时比较两组治疗前后的蒙特利尔认知量表（MoCA）、简易智力状态检查量表（MMSE）、日常生活能力量表（ADL）、血管弹性指标和血流动力学指标。结果 治疗后，对照组和治疗组的总有效率分别为60.2%、75.9%，两组比较差异具有统计学意义（P<0.01）。治疗后，两组视空间/执行能力、注意力、语言、抽象能力、定向力评分和总分均显著上升，同组治疗前后比较差异具有统计学意义（P<0.05、0.01）；治疗后，治疗组上述评分均明显高于对照组，两组比较差异具有统计学意义（P<0.05、0.01）。治疗后，两组MMSE评分均有所提高，而ADL评分显著降低，同组治疗前后比较差异具有统计学意义（P<0.05、0.01）；治疗后，治疗组ADL评分显著低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组患者的血管压力-应变弹性系数（Ep）、僵硬程度指数（β）和脉搏波传导速度（PWVβ）降低，而顺应性（AC）升高，同组治疗前后比较差异具有统计学意义（P<0.05）；治疗后，治疗组血管弹性指标显著优于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组患者大脑中动脉、前动脉和椎动脉的血流搏动指数（PI）显著下降，收缩期峰值血流速度（Vs）和舒张期血流速度（Vd）显著升高，同组治疗前后比较差异具有统计学意义（P<0.05、0.01）；治疗后，治疗组血流动力学指标明显优于对照组，两组比较差异具有统计学意义（P<0.05、0.01）。结论 丁苯酞软胶囊治疗血管性认知障碍能显著提高患者的认知功能和生活自理能力，改善血管弹性、顺应性和脑部血流灌注，具有一定的临床推广应用价值。

Objective To observe the clinical efficacy of Butylphthalide Soft Capsules in treatment of vascular cognitive impairment.Methods Patients (166 cases) with vascular cognitive impairment in First Teaching Hospital of Tianjin University of Traditional Chinese Medicine from March 2016 to May 2018 were divided into control and treatment groups according to the order of visit, and each group had 83 cases. Patients in the control group were po administered with Nimodipine Tablets, 2 tablets/time, three times daily. Patients in the treatment group were po administered with Butylphthalide Soft Capsules, 2 grains/time, three times daily. Patients in two groups were treated for 3 month. After treatment, the clinical efficacy was evaluated, and the MoCA, MMSE, ADL, vascular elasticity indexes, and the hemodynamic parameters in two groups before and after treatment were compared.Results After treatment, the clinical efficacy in the control and treatment groups was 60.2% and 75.9%, respectively, and there were differences between two groups (P<0.01). After treatment, the visual spatial/executive ability, attention, language, abstract ability, orientation scores and total score in two groups were significantly increased, and the difference was statistically significant in the same group (P<0.05, 0.01). After treatment, the scores in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05, 0.01). After treatment, MMSE scores in two groups were increased, but ADL scores in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05, 0.01). After treatment, ADL scores in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, Ep, β, and PWVβ were significantly decreased in the treatment groups, but AC were increased, and the difference was statistically significant in the same group (P<0.05). After treatment, vascular elasticity indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, PI of middle cerebral artery, anterior artery, and vertebral artery in two groups were significantly decreased, but the Vs and Vd were increased, and the difference was statistically significant in the same group (P<0.05, 0.01). After treatment, the hemodynamic parameters in the treatment group was better than those in the control group, with significant difference between two groups (P<0.05, 0.01).Conclusion Butylphthalide Soft Capsules can improve the cognitive function and self-care ability of patients with vascular cognitive impairment, and improve the vascular elasticity, compliance, and cerebral blood flow perfusion, which has a certain clinical application value.

国家自然科学基金资助项目（81574049）；天津市自然科学基金重点课题资助项目（16JCZDJC36200）