目的 探讨牛痘疫苗致炎兔皮提取物联合玻璃酸钠治疗创伤性踝关节炎的临床疗效。方法 将2015年11月—2020年12月长沙市第四医院收治的76例创伤性踝关节炎患者作为研究对象，将患者按照治疗方法分为对照组和观察组，每组各38例。对照组关节腔内注射玻璃酸钠注射液，1次/周，20 mg/次，连续治疗5周。观察组在对照组治疗的基础上关节腔内注射牛痘疫苗致炎兔皮提取物，3 mL/次，1次/周，连续治疗5周。观察两组患者的临床疗效，同时比较两组治疗前后的视觉模拟评分法（VAS）评分、美国矫形外科足踝协会评分标准（AOFAS）评分，白细胞介素（IL）-17、C反应蛋白（CRP）和IL-8水平，以及患肢的背伸活动度和跖屈活动度。结果 治疗后，观察组的总有效率为94.74%，明显高于对照组的78.95%，差异有统计学意义（P<0.05）。治疗后，两组的VAS评分显著降低，AOFAS评分显著升高（P<0.05）；治疗后，观察组的VAS评分比对照组低，AOFAS评分比对照组高，差异有统计学意义（P<0.05）。两组治疗后的IL-17、CRP、IL-8水平显著降低（P<0.05）；观察组的IL-17、CRP、IL-8水平显著低于对照组，差异有统计学意义（P<0.05）。两组治疗后的背伸活动度、跖屈活动度显著升高（P<0.05）；治疗后，观察组的背伸活动度、跖屈活动度比对照组高，差异有统计学意义（P<0.05）。结论 牛痘疫苗致炎兔皮提取物联合玻璃酸钠治疗创伤性踝关节炎的疗效确切，能减轻患者疼痛，控制病情发展，提高关节活动度，降低炎症因子的水平，具有良好临床运用价值。

Objective To investigate the clinical efficacy of extracts from rabbit skin inflamed by vaccinia virus combined with sodium hyaluronate in treatment of traumatic ankle arthritis. Methods A total of 76 patients with traumatic ankle arthritis admitted to the Fourth Hospital of Changsha from November 2015 to December 2020 were selected as the research subjects, and the patients were divided into control group and observation group according to treatment methods, with 38 patients in each group. Patient in the control group were injected with Sodium Hyaluronate Injection into the joint cavity once a week, 20 mg/time, for 5 consecutive weeks. Patient in the observation group were injected with Extracts from Rabbit Skin Inflamed by Vaccinia Virus for Injection on the basis of control group, 3 mL/time, once a week, for 5 consecutive weeks. Clinical efficacy of two groups were observed, and VAS score, AOFAS score, IL-17, CRP, and IL-8 levels, and dorsal-extension and plantar flexion activity of affected limbs before and after treatment were compared between two groups. Results After treatment, the total effective rate of the observation group was 94.74%, which was significantly higher than 78.95% of the control group, and the difference was statistically significant (P < 0.05). After treatment, VAS score in two groups was significantly decreased, while AOFAS score was significantly increased (P < 0.05). After treatment, the VAS score of the observation group was lower than that of the control group, and the AOFAS score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05). After treatment, the levels of IL-17, CRP, and IL-8 in two groups were significantly decreased (P < 0.05). The levels of IL-17, CRP, and IL-8 in the observation group were significantly lower than those in the control group, with statistical significance (P < 0.05). After treatment, the dorsal extension activity and plantarflexion activity of two groups were significantly increased (P < 0.05). After treatment, the dorsal extension activity and plantarflexion activity of the observation group were higher than those of the control group, and the difference was statistically significant (P < 0.05). Conclusion Rabbit skin inflamed by vaccinia virus combined with sodium hyaluronate has definite efficacy in treatment of traumatic ankle arthritis, which can alleviate the pain of patients, control the development of the disease, improve the range of motion of the joint, and reduce the level of inflammatory factors, and has good clinical application value.

R971