目的 觀察安腦丸聯(lián)合石杉堿甲治療腦梗死后血管性癡呆的臨床效果。方法 選取2018年1月—2019年12月廣州市荔灣中心醫(yī)院接收的腦梗死后血管性癡呆患者100例，根據(jù)隨機數(shù)字表法將所有患者分為對照組和治療組，每組各50例。對照組口服石杉堿甲片，0.1～0.2 mg/次，2次/d，一日量最多不超過0.45 mg。治療組在對照組基礎(chǔ)上口服安腦丸，3～6 g/次，2次/d。兩組療程為2個月。觀察兩組的臨床療效，比較兩組治療前后相關(guān)量表評分、血清學(xué)指標(biāo)的變化情況。結(jié)果 治療后，治療組總有效率是80.00%，較對照組的62.00%顯著提高（P＜0.05）。治療后，兩組癡呆簡易篩查量表（BSSD）評分、簡易智力狀態(tài)檢查量表（MMSE）評分、日常生活能力量表（ADL）評分高于治療前（P＜0.05），且治療組改善優(yōu)于對照組（P＜0.05）。治療后，兩組腦源性神經(jīng)營養(yǎng)因子（BDNF）、血管內(nèi)皮生長因子（VEGF）較治療前顯著升高，而同型半胱氨酸（Hcy）、內(nèi)皮素-1（ET-1）、超敏C反應(yīng)蛋白（hs-CRP）較治療前顯著下降（P＜0.05），且治療組患者改善優(yōu)于對照組（P＜0.05）。結(jié)論 石杉堿甲聯(lián)合安腦丸治療腦梗死后血管性癡呆的療效較為顯著，可有效改善患者的臨床癥狀，可調(diào)節(jié)BDNF、Hcy、VEGF、ET-1、hs-CRP等實驗室指標(biāo)。

Objective To observe the clinical effect of Annao Pills combined with Huperzine A in treatment of vascular dementia after cerebral infarction.Methods A total of 100 patients with vascular dementia after cerebral infarction admitted to Guangzhou Liwan Central Hospital from January 2018 to December 2019 were selected.According to the random number table method,all patients were divided into control group and treatment group,with 50 cases in each group.Patients in the control group were po administered with Huperzine A Tablets,0.1-0.2 mg/time,twice daily,the daily dosage should not exceed 0.45 mg.Patients in the treatment group were po administered with Annao Pills on the basis of the control group,3-6 g/time,twice daily.The two groups were treated for 2 months.The clinical efficacy of the two groups was observed,and the changes of related scale scores and serological indexes before and after treatment were compared between the two groups.Results After treatment,the total effective rate of the treatment group was 80.00%,which was significantly higher than that of the control group (62.00%)(P<0.05).After treatment,the scores of Dementia Mini-Screening Scale (BSSD) and Mini-Mental State Examination (MMSE) in the two groups and the scores of Activities of daily Living Scale (ADL) were higher than those before treatment (P<0.05),and the improvement in the treatment group was better than that in the control group (P<0.05).After treatment,brain-derived neurotrophic factor (BDNF) and vascular endothelial growth factor (VEGF) in the two groups were significantly increased compared with those before treatment,but homocysteine (Hcy),endothelin-1(ET-1) and high-sensitivity C-reactive protein (hs-CRP) were significantly decreased compared with those before treatment (P<0.05).The improvement of the treatment group was better than that of the control group (P<0.05).Conclusion Annao Pills combined with Huperzine A has a remarkable effect in treatment of vascular dementia after cerebral infarction,and can effectively improve the clinical symptoms of patients and regulate laboratory indicators such as BDNF,Hcy,VEGF,ET-1 and hs-CRP.

R971

廣東省醫(yī)學(xué)科研基金項目(A2017147)