目的 探討丁苯酞聯(lián)合尼莫地平治療血管性認(rèn)知障礙的臨床效果。方法 選取2011年6月-2015年5月陜西省第二人民醫(yī)院收治的血管性認(rèn)知障礙患者72例，隨機(jī)分為對照組和治療組，每組各36例。對照組口服尼莫地平片，30 mg/次，3次/d。治療組在對照組基礎(chǔ)上口服丁苯酞軟膠囊，0.2 g/次，4次/d。兩組均治療8周。觀察兩組的臨床療效，比較治療前后雙側(cè)大腦前動脈（ACA）、雙側(cè)大腦中動脈（MCA）、雙側(cè)大腦后動脈（PCA）、雙側(cè)椎動脈（VA）和基底動脈（BA）平均血流速度、蒙特利爾認(rèn)知評估量表（MOCA）評分、簡易智力狀態(tài)檢查量表（MMSE）評分、神經(jīng)元特異性烯醇化酶（NSE）、血栓素B2（TXB2）的變化。結(jié)果 治療后，對照組和治療組的總有效率分別為72.22%、91.67%，兩組比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組雙側(cè)ACA、雙側(cè)MCA、雙側(cè)PCA、雙側(cè)VA和BA平均血流速度均上升，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的上升程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組MMSE和MOCA評分均上升，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的上升程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組TXB2和NSE水平均降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且治療組這些觀察指標(biāo)的下降程度明顯優(yōu)于對照組，兩組比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 丁苯酞聯(lián)合尼莫地平治療血管性認(rèn)知障礙具有較好的臨床療效，可改善認(rèn)知功能和腦血液循環(huán)，降低炎癥因子水平，安全性較好，具有一定的臨床推廣應(yīng)用價值。

Objective To explore the clinical effect of butylphthalide combined with nimodipine in treatment of vascular cognitive impairment. Methods Patients (72 cases) with vascular cognitive impairment in Shaanxi Second Province People's Hospital from June 2011 to May 2015 were randomly divided into control and treatment groups, and each group had 36 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 Butylphthalide Soft Capsules on the basis of the control group, 0.2 g/time, four times daily. Patients in two groups were treated for 8 weeks. After treatment, the clinical efficacies were evaluated, and average blood flow velocity of bilateral ACA, bilateral MCA, bilateral PCA, bilateral VA, and BA, MOCA score, MMSE score, NSE, and TXB2 in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 72.22% and 91.67%, respectively, and there was difference between two groups (P<0.05). After treatment, the average blood flow velocity of bilateral ACA, bilateral MCA, bilateral PCA, bilateral VA, BA in two groups were increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, MOCA scores and MMSE scores in two groups were increased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P<0.05). After treatment, the levels of TXB2 and NSE in two groups were decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Conclusion Butylphthalide combined with nimodipine has clinical curative effect in treatment of vascular cognitive impairment, and can improve cognitive function and cerebral blood circulation, decrease the level of inflammatory factors, with good safety, which has a certain clinical application value.