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目的:观察醒脑益髓汤配合针刺督脉四穴治疗脑梗死后血管性痴呆(Vascular dementia,VD)临床影响.方法:选取2012年12月～2017年12月间在本院接受治疗的肾虚血瘀型VD患者86例,随机数字表法将其分成两组,对照组(43例)行针刺治疗,观察组(43例)在对照组基础上行醒脑益髓汤;观察患者临床疗效,使用日常生活活动能力量表(ADL)、简易智能状态评价量表(MMSE)检测患者智力和日常生活能力改善状况,ELISA法检测血清γ-干扰素(IFN-γ)、白细胞介素-18(IL-18)、血管内皮生长因子(VEGF)及Livin含量.结果:治疗后观察组总的有效率为83.72％,对照组为60.47％,差异有统计学意义(P＜0.05);治疗后两组患者MMSE及ALD评分较治疗前显著升高,差异有统计学意义(P＜0.05),且观察组效果更优,治疗后观察组MMSE及ALD评分均高于对照组,差异有统计学意义(P＜0.05);治疗后观察组血清IFN-γ、IL-18含量较治疗前、对照组显著降低,Livin、VEGF含量较治疗前、对照组显著升高,差异有统计学意义(P＜0.05).结论:针刺督脉四穴结合醒脑益髓汤可提升患者日常生活能力和智力水平,降低血清炎性因子含量,改善其临床症状.“,”Objective:To analyze the clinical effect of Xingnao Yijie Decoction combined with acupuncture at four points of Du meridians in the treatment of vascular dementia (VD) after cerebral infarction.Methods:86 patients with kidney-deficiency and blood-stasis type VD who were treated in our hospital from December 2012 to December 2017 were randomly divided into two groups by means of random number table method.The controlled group (43 cases) was treated by acupuncture.The observation group (43 cases) was treated by Xingnao Yijie Decoction on the basis of the controlled group.Observation of clinical efficacy, use of the ADL, MMSE to detect the intelligence and improvement of daily living ability of the patients.Serum levels of interferon-γ (IFN-γ), interleukin-18 (IL-18), vascular endothelial growth factor (VEGF) and Livin were detected by ELISA.Results:The total effective rate was 83.72％ in the observation group and 60.47％ in the controlled group after treatment (P ＜ 0.05).After the treatment, the MMSE and ALD scores of the two groups were significantly higher than those before the treatment.The differences were statistically significant.Significance (P ＜ 0.05), and the observation group had better results.After treatment, the MMSE and ALD scores in the observation group were higher than those in the controlled group (P ＜ 0.05).Serum IFN-γ and IL-18 of the observation group was significantly lower than that before treatment and the controlled group.The levels of Livin and VEGF were significantly higher than those before treatment and the controlled group.The difference was statistically significant (P ＜ 0.05).Conclusion:Acupuncture at Dumai combined with Xingnao Yijie Decoction can improve the ability of daily living and intelligence, reduce the content of serum inflammatory factors, and improve the clinical symptoms.