| Objective: To observe the clinical effect of Naoluo Xintong decoction,a prescription of Xin'an doctor's prescription with the effect of supplementing qi and activating blood circulation,on mild cognitive dysfunction in patients with small cerebral vascular disease with qi deficiency and blood stasis.And to observe the effect of Naoluo Xintong decoction on biochemical index and serology in patients,so as to explore the efficacy and safety of Naoluo Xintong decoction in treating mild cognitive dysfunction of small cerebral vascular disease with deficiency of qi and blood stasis,and to reveal its possible mechanism.Method:60 patients with CSVD-MCI were randomly divided into treatment group(n=30)and control group(n=30).During the treatment,the patients in both groups were given routine treatment such as controlling blood pressure,blood glucose,blood lipid,anti-platelet aggregation,and so on.However,other drugs with cognitive improvement were banned.The treatment group was treated with Naoluo Xintong decoction orally,while the control group was treated with nimodipine orally.The course of treatment in both groups was 8 weeks.The purpose was to observe the index changes and adverse reactions of clinical efficacy,Mo CA score,ADL score,TCM syndrome score,nitric oxide(NO),endothelin(ET-1),homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP)and hemorheological index before treatment,4 weeks and 8 weeks after treatment.Results:1.Evaluation of curative effect index(1)Analysis of clinical curative effect: After 8-week treatment,the total clinical efficacy rate of the treatment group was 48.1 and that of the control group was 46.1.There was no significant difference in curative effect between the two groups.(2)Mo CA score: After 4 weeks of treatment,the Mo CA scores of the two groups increased significantly,and the difference was statistically significant(P< 0.05);After 8weeks of treatment,the Mo CA scores in the two groups were significantly higher(P <0.01);After 8 weeks of treatment,the Mo CA score in both groups was significantly higher than that after 4 weeks treatment(P<0.05);There was no significant difference in Mo CA scores between the two groups after 4 weeks and 8 weeks of treatment(P>0.05).(3)ADL score: After 4 weeks of treatment,the ADL score of the two groups was lower than that before treatment,and the difference was statistically significant(P<0.05);After 8 weeks of treatment,the ADL score of the two groups was significantly lower than that before treatment,and the difference was statistically significant(P<0.01);After 8 weeks of treatment,the Mo CA score in both groups was significantly higher than that after 4 weeks treatment(P<0.05);There was no significant difference in Mo CA scores between the two groups after 4 weeks and 8 weeks of treatment(P>0.05).(4)TCM syndrome score: Compared with that before treatment,the scores of TCM syndromes in the treatment group decreased significantly after 4 weeks and 8 weeks of treatment,and the differences were statistically significant(P<0.01);In the control group,there was no significant difference in the score of TCM syndromes between 4weeks and 8 weeks after treatment(P>0.05);In the treatment group,the score of TCM syndrome after 8 weeks treatment was lower than that after 4 weeks treatment,and the difference was statistically significant(P<0.01);The scores of TCM syndromes in the treatment group after 4 weeks and 8 weeks were lower than those in the control group,and the difference was statistically significant(P<0.01).2.Evaluation of biochemical indicators(1)Nitric Oxide(NO)and Endothelin-1(ET-1)level: There was no significant difference in NO level and ET-1 level before treatment between the two groups(P >0.05);After 4 weeks of treatment,the level of NO in both groups was higher than that before treatment,and the difference was statistically significant(P<0.05);After 8 weeks of treatment,the level of NO in both groups was higher than that before treatment,and the difference was statistically significant(P<0.01);There was no significant difference in NO level between the two groups in the same period(P>0.05);The level of NO in the2 groups after 8 weeks was higher than that at 4 weeks.The difference was statistically significant(P<0.05);The level of ET-1 in the treatment group was significantly lower than that before treatment after 4 and 8 weeks treatment(P<0.01);The level of ET-1 in the control group decreased after 4 weeks and 8 weeks of treatment,but the difference was not statistically significant(P>0.05);The level of ET-1 in the treatment group was significantly lower than that after 4 weeks treatment(P<0.05);The level of ET-1 in the treatment group after 4 weeks and 8 weeks was significantly lower than that in the control group(P<0.01).(2)Homocysteine(HCY)level: The level of Hcy in the treatment group decreased after 4 weeks and 8 weeks,the difference was statistically significant(P<0.01);The Hcy level in the control group was also decreased after 4 weeks and 8 weeks of treatment,but the difference was not statistically significant(P>0.05);The level of Hcy in the treatment group was significantly lower than that in the control group after 8weeks of treatment(P<0.01);And the level of Hcy in the treatment group was lower than that in the control group after 4 weeks and 8 weeks of treatment(P<0.01).(3)Hypersensitive C-reactive protein(hs-CRP)level: After 4 and 8 weeks of treatment,the level of hs-CRP in the treatment group was lower than that before treatment,and the difference was statistically significant(P<0.01);In the control group,the level of hs-CRP decreased at 4 and 8 weeks,but there was no significant difference(P>0.05);The level of hs-CRP in the treatment group after 8 weeks was lower than that after 4 weeks treatment,and the difference was statistically significant(P<0.05);The level of hs-CRP in the treatment group after 4 weeks and 8 weeks was lower than that in the control group,and the difference was statistically significant(P<0.01).(4)Hemorheological determination: In the treatment group,every index was improved after 4 weeks treatment,the difference was statistically significant(P<0.05 or P<0.01);After 8 weeks of treatment,the indexes of the treatment group were significantly improved compared with those before treatment,and the difference was statistically significant(P<0.01);After 4 weeks and 8 weeks of treatment,the indexes of the control group were improved,but there was no statistical significance(P > 0.05);After 8 weeks of treatment and 4 weeks after treatment,the whole blood high shear viscosity index and plasma viscosity index in the treatment group were lower than those in the control group(P<0.01);After 4 weeks and 8 weeks of treatment,the hemorheology indexes of the treatment group were improved compared with the control group,and the difference was statistically significant(P<0.05 or P<0.01).3.Security indicators During the treatment period,no adverse reactions were found in the two groups.There was no significant change in blood routine,urine routine,stool routine,liver and kidney function,electrocardiogram and other safety indexes in the two groups compared with those before treatment(P>0.5).Conclusion:1.Naoluo Xintong decoction can improve the cognitive impairment of CSVD-MCI with qi deficiency and blood stasis,improve the patients' Mo CA score and self-care ability of daily life,It has a better clinical effect,and there is no significant difference compared with that of nimodipine.2.Naoluo Xintong decoction can improve the score of TCM syndromes of CSVD-MCI,improve the cognitive function of patients from the whole,and with the prolongation of the course of treatment,the effect is more obvious.It is better than nimodipine in improving TCM syndromes.3.Naoluo Xintong decoction can improve the clinical symptoms of CSVD-MCI by regulating the dynamic balance of no and ET-1,reducing the level of Hcy and hs-CRP,and improving the hemorheology indexes. 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