Abstract：Objective：To observe the effect of Xingnao Tongbi tang on cerebral oxygen metabolism and nerve injury in patients with vascular dementia(VD) after cerebral infarction. Methods：A total of 86 cases of patients with VD after cerebral infarction were selected and randomly divided into the western medicine group and the combination group. The western medicine group was given butylphthalide， and the combination group was given butylphthalide and Xingnao Tongbi tang. Clinical effects and incidence of adverse reactions were compared between the two groups. Before and after treatment，the cerebral oxygen metabolism indexes， cognitive function， motor function， language function， swallowing function， neurological deficit scores， neurotrophic factors and markers of nerve injury were compared between the two groups. Results：The total effective rate was 81.40% in the western medicine group，lower than that of 97.67% in the combination group(P＜0.05). After treatment，cerebral extraction of oxygen(CEO2)，myelin basic protein(MBP)，neuron specific enolase (NSE) and scores of National Institutes of Health Stroke Scale(NIHSS) in the two groups were decreased when compared with those before treatment in the same group(P＜0.05)； jugular venous oxygen saturation(SjvO2)， peripheral capillary oxygen saturation(SPO2)， cerebral oxygen extraction fraction(OEF)， brain- derived neurotrophic factor(BDNF)， basic fibroblast growth factor(bFGF)，as well as scores of Activity of Daily Living Scale(ADL)，Mini Mental State Examination(MMSE)，Fugl- Meyer Assessment(FMA) scale and Montreal Cognitive Assessment(MoCA) were increased(P＜0.05). After treatment， CEO2， MBP， NSE and NIHSS score in the combination group were lower than those in the western medicine group(P＜ 0.05)，and SjvO2，SPO2，OEF，BDNF，bFGF as well as scores of ADL，MMSE，FMA and MoCA were higher(P＜0.05). There was no significant difference being found in the comparison of incidence of adverse reactions between the two groups (P＞0.05). Conclusion： Xingnao Tongbi tang in the treatment of vascular dementia after cerebral infarction can improve cerebral oxygen metabolism， promote the recovery from nerve injury， and effectively enhance cognitive， language and other functions. It has positive significance for patients to obtain better curative effect.