目的 探討復(fù)方蓯蓉益智膠囊聯(lián)合奧拉西坦注射液治療輕中度血管性癡呆的臨床效果。方法 選取2018年1月—2020年1月天津市西青醫(yī)院收治的120例血管性癡呆患者，奇偶順序法分為對照組和治療組，每組各60例。對照組靜脈滴注奧拉西坦注射液，4 g加入到500 mL生理鹽水，1次/d。治療組在對照組的基礎(chǔ)上口服復(fù)方蓯蓉益智膠囊，4粒/次，3次/d。兩組患者均連續(xù)治療4周。觀察兩組患者臨床療效，比較治療前后兩組患者美國國立衛(wèi)生院卒中量表（NIHSS）、日常生活能力量表（ADL）、簡易智力狀態(tài)量表（MMSE）評分，及血清同型半胱氨酸（Hcy）、腦源性神經(jīng)營養(yǎng)因子（BDNF）和胰島素樣生長因子-1（IGF-1）水平。結(jié)果 治療后，治療組的臨床有效率高于對照組（91.67%vs 76.67%，P<0.05）。治療后，兩組MMSE評分顯著升高，而ADL、NIHSS評分顯著降低（P<0.05），且治療組評分明顯好于對照組（P<0.05）。治療后，兩組患者BDNF、IGF-1水平顯著升高，而Hcy水平顯著降低（P<0.05），且治療組明顯好于對照組（P<0.05）。結(jié)論 復(fù)方蓯蓉益智膠囊聯(lián)合奧拉西坦注射液治療輕中度血管性癡呆，安全有效，可改善患者認(rèn)知功能、生活自理能力，促進(jìn)癥狀改善。

Objective To investigate the clinical effect of Compound Congrong Yizhi Capsules combined with oxiracetam in treatment of mild to moderate vascular dementia. Methods Patients (120 cases) with mild to moderate vascular dementia in Tianjin Xiqing Hospital from January 2018 to January 2020 were divided into control and treatment groups based on parity order, and each group had 30 cases. Patients in the control group were iv administered with Oxiracetam Injection, 4 g added into normal saline 500 mL, once daily. Patients in the treatment group were po administered with Compound Congrong Yizhi Capsules, 4 grains/time, three times daily. Patients in two groups were treated for 4 weeks. After treatment, the clinical efficacy was evaluated, the MMSE, ADL, and NIHSS scores, and the levels of serum BDNF, Hcy, and IGF-1 in two groups before and after treatment were compared. Results After treatment, the clinical effective rate in the treatment group was higher than that in the control group (91.67% vs 76.67%, P < 0.05). After treatment, the MMSE score in two groups were significantly increased, while the scores of ADL and NIHSS were significantly decreased (P < 0.05), and the scores of the treatment group were significantly better than that of the control group (P < 0.05). After treatment, BDNF and IGF-1 in two groups were significantly increased, while Hcy were significantly decreased (P < 0.05), and which in the treatment group were significantly better than those in the control group (P < 0.05). Conclusion Compound Congrong Yizhi Capsules combined with oxiracetam is safe and effective on treatment of mild to moderate vascular dementia, can improve patients' cognitive function, self-care ability, and promote the improvement of symptoms.

R971

國家科技重大專項（2011ZX09304-07）