Objective Observation of the clinical efficacy of Qiangjing Tang in the dialectical treatment of mild to moderate spleen-kidney deficiency type carpal tunnel syndrome. Methods Sixty patients with primary carpal tunnel syndrome who visited the Brain Disease Department of Yunnan Provincial Hospital of Traditional Chinese Medicine from September 2022 to July 2024 were selected and divided into a study group of 30 cases and a control group of 30 cases. The study group received modified Qiangjing Tang orally, while the control group received oral methylcobalamin tablets combined with vitamin treatment. The improvement of patients‘ symptoms after medication was observed, and the results were reflected by BCTQ score and VAS score. Results The difference in BCTQ score and VAS score among patients after treatment was statistically significant(P<0.05). Conclusion The dialectical treatment of mild to moderate spleen kidney deficiency type carpal tunnel syndrome with modified Qiangjing Tang has good clinical efficacy. Reasonable use of modified Qiangjing Tang in the treatment of mild to moderate spleen kidney deficiency type carpal tunnel syndrome can relieve patients‘ symptoms as early as possible and avoid the pain of surgical treatment.