Objective: To explore the clinical efficacy and mechanism of Tianzhi granules combined with donepezil for mild-to-moderate vascular dementia patients with liver-yang excessive syndromes by using the nuclear magnetic resonance (NMR) spectrum. Method: A total of 80 mild-to-moderate vascular dementia patients with liver-yang excessive syndrome were randomly divided into 2 groups according to random number table:treatment group and control group

with 40 patients in each group. Patients in control group were given with donepezil orally (5 mg/time

1 time/d);Patients in treatment group were also given with Tianzhi granules orally (3 times/d

5 g/time) based on the treatment of control group. Treatment course was 90 days in both groups. Mini-Mental State Examination Scale (MMSE)

Activity of Daily Living Scale (ADL) and Gan Yang Shang Kang Scale (GYSK) were evaluated before and after intervention. Multivoxel 1H-MRS examinations were performed with PRESS sequence and GE Signa EXCITE 3.0 T Magnetic Resonance Imaging system was used in the examination. The changes of N-acetyl-aspartic acid/creatine (NAA/Cr)

choline/creatine (Cho/Cr) ratios at left frontal lobe and hippocampus were observed as well. Result: Before treatment

no significant difference was observed in dementia degree

MMSE

ADL score and GYSK score between two groups. After 90 days of treatment

both groups had improvement in MMSE and ADL scores (P<0.05).GYSK score was decreased in control group

however the difference was not statistically significant .GYSK score was decreased significantly in treatment group

and it was lower than that of control group

with more significant difference (P<0.05). After 90 days of treatment

Cho/Cr ratio in the left frontal lobe and hippocampus was significantly decreased in both groups

while the NAA/Cr ratio was significantly increased in both groups (P<0.05). After 90 days of treatment

the NAA/Cr ratio of left frontal lobe and hippocampus in treatment group was higher than that of control group with statistical significance (P<0.05)

and the Cho/Cr ratio in treatment group was lower than that of control group without statistical significance. Conclusion: The efficacy of Tianzhi granules combined with donepezil therapy was superior than that of donepezil alone

and the mechanism may be associated with promotion of neuron repair

inhibition of gliocyte proliferation and regulatiojn of phospholipid metabolism of nerve cell membrane.