目的：探讨不同剂量川芎嗪治疗非增殖期糖尿病视网膜病变(NPDR)的疗效。

方法：前瞻性研究。选取2016-03/2017-03我院治疗的NPDR患者90例，按照随机数字表法将患者分为对照组(DR常规治疗)、常规剂量组(DR常规治疗+川芎嗪120mg)、高剂量组(DR常规治疗+川芎嗪240mg)。比较三组患者血流动力学变化、治疗效果和不良反应发生情况。

结果：三组患者治疗后视网膜中央动脉、睫状后动脉和眼动脉收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)高于治疗前，阻力指数(RI)低于治疗前(P<0.05)； 常规剂量组和高剂量组患者治疗后视网膜中央动脉、睫状后动脉和眼动脉的PSV、EDV高于对照组，RI低于对照组(P<0.05)； 常规剂量组和高剂量组患者治疗后视网膜中央动脉、睫状后动脉和眼动脉PSV、EDV、RI比较无差异(P>0.05)。对照组、常规剂量组和高剂量组患者的治疗有效率分别为40%、70%、77%，两组间比较有差异(P<0.017)。对照组、常规剂量组和高剂量组患者不良反应发生率分别为17%、23%、27%(P>0.05)。

结论：治疗NPDR时，在常规治疗基础上联合川芎嗪可提高治疗效果，同时改善局部血液循环，并且增加川芎嗪使用量可提高治疗效果，不增加不良反应发生风险，因此，建议使用240mg川芎嗪治疗DR。

METHODS: From March 2016 to March 2017, 90 cases of patients with non-proliferative diabetic retinopathy were studied. According to the simple random method were divided into control group(routine treatment to diabetic retinopathy), routine dose group(conventional treatment to diabetic retinopathy + Ligustrazine 120mg), high dose group(conventional treatment to diabetic retinopathy+Ligustrazine 240mg). The changes of hemodynamics, therapeutic effect and adverse reaction were compared among the three groups.

RESULTS: The peak systolic blood flow velocity(PSV)and end diastolic blood flow velocity(EDV)of central retinal artery, posterior ciliary artery and ophthalmic artery in three groups after treatment were higher than those before treatment, and the resistance index(RI)was lower than that before treatment(P<0.05); the PSV and EDV of central retinal artery, posterior ciliary artery and ophthalmic artery in the conventional dose group and the high dose group after treatment were higher than those in the control group, and RI was lower. There was no significant difference in PSV, EDV and RI of central retinal artery, posterior ciliary artery and ophthalmic artery between routine dose group and high dose group(P>0.05). The effective rates of control group, routine dose group and high dose group were 40%, 70% and 77%, respectively. There was significant difference between the two groups(P<0.017). The incidence of adverse reactions in control group, conventional dose group and high dose group were 17%, 23% and 27%, respectively, with no significant difference(P>0.05).

CONCLUSION: In the treatment of non-proliferative DR, the combination of Ligustrazine on the basis of routine treatment can improve the therapeutic effect, improve local blood circulation, and increase the use of Ligustrazine can improve the therapeutic effect, without increasing the risk of adverse reactions. Therefore, 240mg Ligustrazine is recommended for the treatment of DR.