目的 研究牛痘疫苗致炎兔皮提取物注射液聯(lián)合維生素B1注射液和甲鈷胺注射液治療輕中度腕管綜合征的臨床療效和安全性。方法 選取常州市第二人民醫(yī)院2014年12月-2015年6月收治的138例輕中度腕管綜合癥患者，按照患者治療方案分為對照組（n=65）和治療組（n=73）。對照組患者肌肉注射維生素B1注射液100 mg，1次/d，同時(shí)肌肉注射甲鈷胺注射液0.5 mg，1次/d。治療組在對照組治療的基礎(chǔ)上靜脈滴注牛痘疫苗致炎兔皮提取物注射液7.2 U，1次/d。兩組患者均持續(xù)治療14 d。觀察兩組患者臨床療效，對比兩組患者治療前后神經(jīng)肌電圖指標(biāo)、VAS評分、癥狀緩解時(shí)間和Boston腕管問卷調(diào)查評分（BTCQ）評分。結(jié)果 治療后，對照組和治療組的有效率分別為70.8%、95.9%，兩組有效率比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.01）。治療后，兩組患者腕部正中神經(jīng)感覺神經(jīng)傳導(dǎo)速度（SCV）、感覺神經(jīng)動(dòng)作電位（SNAP）波幅均顯著增加，運(yùn)動(dòng)神經(jīng)復(fù)合肌動(dòng)作電位（CMAP）潛伏期顯著縮短，同組治療前后差異比較有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組SCV、SNAP波幅、CMAP潛伏期、CMAP波幅的改善程度均優(yōu)于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組患者的VAS評分、BTCQ評分均顯著降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組的降低更為明顯，與對照組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組疼痛緩解時(shí)間和麻木緩解時(shí)間均短于對照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 牛痘疫苗致炎兔皮提取物注射液聯(lián)合維生素B1注射液和甲鈷胺注射液治療輕中度腕管綜合征具有較好的臨床療效，能夠減輕疼痛，改善臨床癥狀，恢復(fù)生活質(zhì)量，安全性較高，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical efficacy and safety of extracts injection from rabbit skin inflamed by vaccinia virus combined with Vitamin B1 Injection and Mecobalamin Injection in treatment of moderate carpal tunnel syndrome. Methods Patients (138 cases) with moderate carpal tunnel syndrome in Changzhou Second People's Hospital from December 2014 to June 2015 were divided into control group (n=65) and study group (n=73). The patients in the control group were im administered with Vitamin B1 Injection, 100 mg/time, once daily. And in the same time, patients in the control group were im administered with Mecobalamin Injection, 0.5 mg/time, once daily. The patients in the treatment group were iv administered with rabbit skin inflamed by vaccinia virus injection on the basis of the control group, 7.2 U/time, once daily. The patients in two groups were treated for 14 d. After treatment, the efficacy was evaluated, and nerve EMG indexes, VAS scores, symptom relief time, and BTCQ scores in two groups were compared. Results After treatment, the effective rate of the control and treatment group were 70.8% and 95.9%, respectively, and there was difference between two groups (P<0.01). After treatment, SCV and SNAP amplitude in two groups were significantly increased, CMAP latency was significantly shortened,, and the difference was statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). After treatment, VAS score and BTCQ score were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05). Pain relief time and duration of pain relief time in the treatment group were shorter than those in the control group, and the difference was statistically significant (P<0.05). Conclusions Extracts injection from rabbit skin inflamed by vaccinia virus combined with Vitamin B1 Injection and Mecobalamin Injection has clinical curative effect in treatment of moderate carpal tunnel syndrome, and can reduce the pain, improve clinical symptoms, restore the quality of life with high safety, which has a certain clinical application value.