目的 探討血栓通注射液聯(lián)合鹽酸多奈哌齊片治療血管性癡呆的臨床療效。方法 選取2018年3月-2019年12月在平煤神馬醫(yī)療集團(tuán)總醫(yī)院就診的112例血管性癡呆患者作為本研究的對(duì)象，按照隨機(jī)數(shù)字表法將全部患者分為對(duì)照組和治療組，每組各56例。對(duì)照組睡前口服鹽酸多奈哌齊片，5 mg/次，1次/d。治療組在對(duì)照組的基礎(chǔ)上靜脈滴注血栓通注射液，5 mL用10%葡萄糖注射液250 mL稀釋后使用，1次/d。兩組患者連續(xù)治療2周。觀察兩組的臨床療效，比較兩組的評(píng)分血流動(dòng)力學(xué)、血清指標(biāo)和簡(jiǎn)易精神檢查量表（MMSE）。結(jié)果 治療后，治療組的總有效率為92.86%，對(duì)照組為78.57%，組間比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的阻力指數(shù)（RI）、搏動(dòng)指數(shù)（PI）明顯降低，血流高速峰值（V_m）均明顯升高（P<0.05）；且治療后治療組的RI、PI低于對(duì)照組，V_m高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的內(nèi)皮素-1（ET-1）、血管緊張素Ⅱ（Ang Ⅱ）、同型半胱氨酸（Hcy）水平均明顯降低，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組的ET-1、AngⅡ、Hcy水平低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組的MMSE評(píng)分均明顯升高，差異有統(tǒng)計(jì)學(xué)意義（P<0.05），且治療組MMSE評(píng)分升高的更明顯，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 血栓通注射液聯(lián)合鹽酸多奈哌齊片可提高血管性癡呆的療效，改善患者的認(rèn)知功能和血管內(nèi)皮功能，調(diào)節(jié)血流動(dòng)力學(xué)水平。

Objective To investigate the clinical efficacy of Xueshuantong injection combined with Donepezil Hydrochloride Tablets in the treatment of vascular dementia. Methods Patients (112 cases) with vascular dementia in Pingmei Shenma Medical Group General Hospital from March 2018 to December 2019 were randomly divided into control and treatment groups, and each group had 56 cases. Patients in the control group were po administered with Donepezil Hydrochloride Tablets, 5 mg/time, once daily. Patients in the treatment group were iv administered with Xueshuantong injection on the basis of the control group, 5 mL added into 10% glucose solutioin 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and hemodynamics, serum indexes and MMSE score in two groups were compared. Results After treatment, the total effective rates were 92.86% and 78.57% in the treatment group and control group, and the difference was statistically significant (P<0.05). After treatment, the RI and PI of two groups were significantly decreased, but the VM of two groups was significantly increased (P<0.05). And the RI and PI of the treatment group were lower than those of the control group, but the VM of the treatment group was higher than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the levels of ET-1, Ang Ⅱ, and Hcy in two groups were significantly decreased, and the difference was statistically significant (P<0.05). After treatment, the levels of ET-1, Ang Ⅱ, and Hcy in the treatment group were lower than those in the control group, and the difference was statistically significant (P<0.05). After treatment, the MMSE scores of two groups were significantly increased, and the difference was statistically significant (P<0.05). And the MMSE score of the treatment group increased more significantly, and the difference was statistically significant (P<0.05). Conclusion Xueshuantong Injection combined with Donepezil Hydrochloride Tablets can enhance the curative effect of vascular dementia, improve the cognitive function and vascular endothelial function of patients, and regulate the level of hemodynamics..

R971

國(guó)家自然科學(xué)基金資助項(xiàng)目（UI804174）