目的 觀察復(fù)方蓯蓉益智膠囊聯(lián)合尼莫地平片治療血管性癡呆的臨床療效。方法 選取2020年3月-2022年1月云南省第三人民醫(yī)院收治的112例血管性癡呆患者，采用隨機數(shù)字表法將所有患者分為對照組和治療組，各56例。對照組口服尼莫地平片，30 mg/次，3次/d。治療組在對照組的治療基礎(chǔ)上口服復(fù)方蓯蓉益智膠囊，4粒/次，3次/d。兩組持續(xù)用藥3個月。觀察兩組的臨床療效，比較兩組的兩組簡易智能精神狀態(tài)檢查量表（MMSE）、日常生活能力量表（ADL）評分和血清膽堿能神經(jīng)遞質(zhì)、血管內(nèi)皮功能指標(biāo)、血清神經(jīng)損傷因子水平。結(jié)果 治療后，對照組總有效率為80.36%；治療組總有效率為94.64%，治療組的總有效率高于對照組（P<0.05）。治療后，兩組MMSE評分升高，ADL評分降低（P<0.05），且治療組MMSE評分較對照組高，ADL評分較對照組低（P<0.05）。治療后，兩組血清神經(jīng)元特異性烯醇化酶（NSE）、鈣結(jié)合蛋白S100β（S100β）蛋白水平降低（P<0.05），且治療組血清NSE、S100β蛋白水平較對照組更低（P<0.05）。治療后，兩組血清一氧化氮（NO）水平升高，血清內(nèi)皮素-1（ET-1）水平降低（P<0.05），且治療組血清NO水平高于對照組，血清ET-1水平低于對照組（P<0.05）。治療后，兩組血清乙酰膽堿酯酶（AchE）水平均降低，血清乙酰膽堿（Ach）、膽堿乙酰轉(zhuǎn)移酶（ChAT）水平均升高（P<0.05），且治療組患者血清AchE水平低于對照組，血清Ach、ChAT水平低于對照組（P<0.05）。結(jié)論 復(fù)方蓯蓉益智膠囊聯(lián)合尼莫地平片治療血管性癡呆可改善患者認(rèn)知功能，提高生活自理能力，調(diào)節(jié)血清膽堿能神經(jīng)遞質(zhì)、神經(jīng)損傷因子、血管內(nèi)皮功能指標(biāo)水平。

Objective To observe the clinical effect of Compound Congrong Yizhi Capsules combined with Nimodipine Tablets in treatment of vascular dementia. Methods Patients (112 cases) with vascular dementia in the Third People's Hospital of Yunnan Province from March 2020 to January 2022 were divided into control and treatment groups according to the random number table method, and each group had 56 cases. Patients in the control group were po administered with Nimodipine Tablets, 30 mg/time, three times daily. Patients in the treatment group were po administered with Compound Congrong Yizhi Capsules on the basis of the control group, 4 grains/time, three times daily. Patients in two groups were treated for 3 months. After treatment, the clinical efficacies were evaluated, and MMSE scores, ADL scores, the serum levels of cholinergic neurotransmitters, vascular endothelial function indicators, and serum nerve injury factors in two groups were compared. Results After treatment, the total effective rate of the control group was 80.36%, and the total effective rate of the treatment group was 94.64%, and the total effective rate of the treatment group was higher than that of the control group (P < 0.05). After treatment, MMSE scores in two groups were increased, but ADL scores in two groups were decreased (P < 0.05). And MMSE scores in the treatment group were higher than those in the control group, while ADL scores in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of NSE and S100β protein in the two groups were decreased (P < 0.05), and the serum levels of NSE and S100β protein in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of NO were increased, but the serum levels of ET-1 were decreased in two groups (P < 0.05). And the serum levels of NO in the treatment group were higher than those in the control group, but the serum levels of ET-1in the treatment group were lower than those in the control group (P < 0.05). After treatment, the serum levels of AchE in two groups were decreased, while the serum levels of Ach and ChAT were increased (P < 0.05), and the serum levels of AchE in the treatment group were lower than those in the control group, but the serum levels of Ach and ChAT in the treatment group were higher than those in the control group (P < 0.05). Conclusion Compound Congrong Yizhi Capsules combined with Nimodipine Tablets in treatment of vascular dementia can improve patients' cognitive function, enhance their self-care ability, regulate the serum levels of cholinergic neurotransmitters, nerve injury factors, and vascular endothelial function indicators.

R971

國家衛(wèi)生計生委醫(yī)藥衛(wèi)生科技發(fā)展研究中心課題（W2018ZT866）