目的 探討石杉堿甲片聯(lián)合長春西汀治療老年血管性癡呆的安全性和有效性。方法 選取鐵嶺市中心醫(yī)院2014年7月-2016年7月收治的老年血管性癡呆患者176例，隨機(jī)將患者分成對照組（88例）和治療組（88例）。對照組患者靜脈滴注注射用長春西汀，20 mg加入500 mL生理鹽水中，1次/d；治療組在對照組的基礎(chǔ)上口服石杉堿甲片，0.1 mg/次，2次/d。兩組患者均連續(xù)治療21 d。比較兩組患者治療前后臨床療效、MMSE評分、BSSD評分、血液流變學(xué)指標(biāo)以及不良反應(yīng)發(fā)生情況。結(jié)果 治療后，對照組和治療組的總有效率分別為86.36%和96.59%，兩組總有效率比較差異有統(tǒng)計學(xué)意義（P<0.05）。治療后，兩組簡易精神狀態(tài)評價量表（MMSE）評分和癡呆簡易篩查量表（BSSD）評分均顯著提高（P<0.05）；同時治療組患者M(jìn)MSE和BSSD評分的改善情況明顯優(yōu)于對照組患者（P<0.05）。治療后，兩組患者血紅細(xì)胞壓積、全血黏度以及纖維蛋白原均比治療前顯著降低（P<0.05）；同時治療組患者治療后上述觀察指標(biāo)均明顯低于對照組患者（P<0.05）。對照組患者的不良反應(yīng)發(fā)生率為13.64%，顯著高于治療組的5.68%，兩組不良反應(yīng)比較差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 石杉堿甲聯(lián)合長春西汀治療老年血管性癡呆患者臨床療效好，安全性高，具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical safety and efficacy of Huperzine A Tablets combined with vinpocetine in treatment of senile vascular dementia. Methods Patients (176 cases) with senile vascular dementia in Tieling Central Hospital from July 2014 to July 2016 were randomly divided into control (88 cases) and treatment (88 cases) groups. Patients in the control group were iv administered with Vinpocetine for injection, 20 mg added into 500 mL normal saline, once daily. Patients in the treatment group were po administered with Huperzine A Tablets on the basis of the control group, 0.1 mg/time, twice daily. Patients in two groups were treated for 21 d. After treatment, the clinical efficacy, MMSE score, BSSD score, hemorheological indexes, and adverse reactions in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 86.36% and 96.59%, respectively, and there was difference between two groups (P<0.05). After treatment, the MMSE and BSSD scores in two groups were significantly increased (P<0.05). And MMSE and BSSD scores in the treatment group were significantly better than those in the control group (P<0.05). After treatment, the hematocrit, whole blood viscosity, and fibrinogen in two groups were significantly decreased (P<0.05). And these indicators in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the adverse reaction rate in the control group was 13.64%, which was significantly higher than 5.68% in the treatment group, with significant difference between two groups (P<0.05). Conclusion Huperzine A Tablets combined with vinpocetine has good clinical efficacy in treatment of senile vascular dementia with high safety, which has a certain clinical application value.