目的 探討清開靈注射液聯(lián)合奧拉西坦治療血管性癡呆的臨床效果。方法 選取2015年6月-2017年12月亳州市人民醫(yī)院收治的126例血管性癡呆患者，隨機分為對照組和治療組，每組各63例。對照組靜脈滴注奧拉西坦注射液，4 g加入250 mL生理鹽水中均勻混合后給藥，1次/d。治療組在對照組治療基礎上靜脈滴注清開靈注射液，40 mL用250 mL生理鹽水充分稀釋后給藥，1次/d。兩組均連續(xù)治療14 d。觀察兩組的臨床療效，比較兩組治療前后簡易精神狀態(tài)檢查（MMSE）評分、神經(jīng)精神癥狀問卷（NPI）評分、日常生活能力量表（ADL）評分、頸內(nèi)動脈與椎動脈收縮期最大峰值流速（V_max）、平均血流量（Q_m）、白介素（IL）-1β、超敏C反應蛋白（hs-CRP）、丙二醛（MDA）、血管內(nèi)皮生長因子（VEGF）、tau蛋白的變化情況。結(jié)果 治療后，對照組和治療組的總有效率分別為79.4%、92.1%，兩組比較差異有統(tǒng)計學意義（P<0.05）。治療后，兩組患者MMSE評分、頸內(nèi)動脈和椎動脈的V_max、Q_m顯著增高，但NPI、ADL評分均顯著減低，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；治療后，治療組MMSE評分、頸內(nèi)動脈和椎動脈的V_max、Q_m顯著高于對照組，NPI、ADL評分均顯著低于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。治療后，兩組血清IL-1β、hs-CRP、MDA、tau蛋白水平均顯著降低，血清VEGF水平均顯著上升，同組治療前后比較差異具有統(tǒng)計學意義（P<0.05）；治療后，治療組IL-1β、hs-CRP、MDA、tau蛋白顯著低于對照組，血清VEGF水平顯著高于對照組，兩組比較差異具有統(tǒng)計學意義（P<0.05）。結(jié)論 清開靈注射液聯(lián)合奧拉西坦治療血管性癡呆具有較好的臨床療效，能明顯改善患者認知功能，增加腦血流灌注，減輕炎性及氧化應激損傷，具有一定的臨床推廣應用價值。

Objective To explore the clinical effect of Qingkailing Injection combined with oxiracetam in treatment of vascular dementia. Methods Patients (126 cases) with vascular dementia in Bozhou People's Hospital from June 2015 to December 2017 were randomly divided into control (63 cases) and treatment (63 cases) groups. Patients in the control group were iv administered with Oxiracetam Injection, 4 g was added to 250 mL normal saline, once daily. Patients in the treatment group were iv administered with Qingkailing Injection on the basis of the control group, 40 mL was added to 250 mL normal saline, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the changes of MMSE score, NPI score, ADL score, internal carotid and vertebral arteries V_max and Q_m, IL-1β, hs-CRP, MDA, VEGF, tau proteins in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group were 79.4% and 92.1%, and there were differences between two groups (P<0.05). After treatment, and there were differences in the same group (P<0.05). After treatment, MMSE score, internal carotid and vertebral arteries V_max and Q_m in two groups were significantly increased, but NPI score and ADL score were significantly decreased, and there were differences in the same group (P<0.05). After treatment, MMSE score, internal carotid and vertebral arteries V_max and Q_m in the treatment group were higher than those in the control group, but NPI score and ADL score were significantly lower than those in the control group, and there were differences between two groups (P<0.05). After treatment,IL-1β, hs-CRP, MDA, and tau protein in two groups were significantly decreased, but VEGF was significantly increased, and there were differences in the same group (P<0.05). After treatment, IL-1β, hs-CRP, MDA, and tau protein in the treatment group were significantly lower than those in the control group, but VEGF was higher than those in the control group, and there were differences between two groups (P<0.05). Conclusion Qingkailing Injection combined with oxiracetam has significant clinical effect in treatment of vascular dementia, and can significantly improve cognitive function, also can increase cerebral blood flow perfusion, and reduce the injury of inflammatory and oxidative stress, which has a certain clinical application value.