目的 探討培元通腦膠囊聯(lián)合奧拉西坦膠囊治療卒中后血管性癡呆的臨床療效。方法 選取2017年4月—2019年5月天津市寧河區(qū)醫(yī)院收治的84例卒中后血管性癡呆患者，根據(jù)隨機(jī)數(shù)字表法將患者分為對(duì)照組和治療組，每組各42例。對(duì)照組口服奧拉西坦膠囊，0.8 g/次，3次/d。治療組在對(duì)照組的基礎(chǔ)上口服培元通腦膠囊，3粒/次，3次/d。兩組療程均為12周。觀察兩組患者療效，比較簡(jiǎn)易精神狀態(tài)量表（MMSE）評(píng)分、日常生活活動(dòng)能力（ADL）評(píng)分、美國(guó)國(guó)立衛(wèi)生院卒中量表（NIHSS）評(píng)分、長(zhǎng)谷川癡呆量表（HDS）評(píng)分、血清同型半胱氨酸（Hcy）、脂蛋白磷脂酶A2（Lp-PLA2）、腦源性神經(jīng)營(yíng)養(yǎng)因子（BDNF）以及胰島素樣生長(zhǎng)因子-1（IGF-1）水平。結(jié)果 治療后，治療組的臨床總有效率為92.86%，明顯高于對(duì)照組的73.81%（P<0.05）。治療后，兩組MMSE、HDS評(píng)分升高，ADL、NIHSS評(píng)分下降（P<0.05）；且治療后治療組MMSE、HDS評(píng)分高于對(duì)照組，ADL、NIHSS評(píng)分低于對(duì)照組（P<0.05）。治療后，兩組BDNF水平升高，Hcy、Lp-PLA2、IGF-1水平均下降（P<0.05）；治療后治療組BDNF水平高于對(duì)照組，Hcy、Lp-PLA2、IGF-1水平則低于對(duì)照組（P<0.05）。結(jié)論 培元通腦膠囊聯(lián)合奧拉西坦膠囊治療卒中后血管性癡呆的療效顯著，可有效改善患者癥狀、生活質(zhì)量，調(diào)節(jié)Hcy、Lp-PLA2、IGF-1、BDNF水平，具有一定臨床推廣價(jià)值。

Objective To investigate the clinical effect of Peiyuan Tongnao Capsules combined with Oxiracetam Capsules in treatment of vascular dementia after stroke. Methods Patients (84 cases) with vascular dementia after stroke in Tianjin Ninghe Hospital from April 2017 to May 2019 were randomly divided into control and treatment groups, and each group had 42 cases. Patients in the control group were po administered with Oxiracetam Capsules, 0.8 g/time, three times daily. Patients in the treatment group were po administered with Peiyuan Tongnao Capsules on the basis of the control group, 3 grains/time, three times daily. Patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated, and Mini Mental State Scale (MMSE) scores, Activity of Daily Living (ADL) scores, National Institutes of Health Stroke Scale (NIHSS) scores, Hasegawa Dementia Scale (HDS) scores, and the levels of serum homocysteine (Hcy), lipoprotein phospholipase A2 (Lp-PLA2), brain derived neurotrophic factor (BDNF), and insulin like growth factor-1 (IGF-1) in two groups were compared. Results After treatment, the total clinical effective rate of the treatment group was 92.86%, which was higher than 73.81% of the control group (P<0.05). After treatment, MMSE scores and HDS scores in two groups were increased, but ADL scores and NIHSS scores in two groups were decreased (P<0.05). And MMSE scores and HDS scores in the treatment group were higher than those in the control group, but ADL scores and NIHSS scores in the treatment group were lower than those in the control group (P<0.05). After treatment, the levels of BDNF in two groups were increased, but the levels of Hcy, Lp-PLA2, and IGF-1 in two groups were decreased (P<0.05). And the levels of BDNF in the treatment group was higher than that in the control group, the levels of Hcy, Lp-PLA2, and IGF-1 in the treatment group were lower than that in the control group (P<0.05). Conclusion Peiyuan Tongnao Capsules combined with Oxiracetam Capsules has clinical curative effect in treatment of vascular dementia after stroke, can effectively improve the symptoms and quality of life of patients, and regulate the levels of Hcy,Lp-PLA2, IGF-1 and BDNF.

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