【目的】 观察通元针法联合调气活血解郁汤治疗中风恢复期气虚血瘀兼肝郁证的临床疗效。【方法】 将 2021 年 9 月至 2023年8月安徽省宿州市立医院收治的80例脑卒中恢复期患者按随机数表法随机分为观察组和对照组，每组各40例，对照 组给予常规西药和康复训练。观察组在对照组治疗的基础上，给予通元针法联合调气活血解郁汤治疗。连续治疗1个月。治 疗1个月后，评价2组临床疗效，观察2组患者治疗前后简易智力状态检查量表（MMSE）评分、肌力评分与美国国立卫生研究 院卒中量表（NIHSS）评分的变化情况，以及匹兹堡睡眠质量指数量表（PSQI）、日常生活自理能力量表（ADL）评分和中医证候 积分的情况。比较2组患者治疗前后降钙素原（PCT）、肿瘤坏死因子α（TNF-α）、白细胞介素6（IL-6）水平的变化情况。并评 价2组的安全性及不良反应的发生情况。【结果】（1）观察组总有效率为95.00%（38/40），对照组为77.50%（31/40）。观察组疗 效优于对照组，差异有统计学意义（P < 0.05）。（2）治疗后，2组患者的中医证候积分明显改善（P < 0.05），且观察组在改善中 医证候积分方面明显优于对照组，差异有统计学意义（P < 0.05）。（3）治疗后，2组患者的MMSE评分明显改善（P < 0.05），且 观察组在改善MMSE评分方面明显优于对照组，差异有统计学意义（P < 0.05）。（4）治疗后，2组患者的肌力评分与NIHSS评分 明显改善（P < 0.05），且观察组在改善肌力评分与 NIHSS评分方面明显优于对照组，差异有统计学意义（P < 0.05）。（5）治疗 后，2组患者的PSQI评分与ADL评分明显改善（P < 0.05），且观察组在改善PSQI评分与ADL评分方面明显优于对照组，差异 有统计学意义（P < 0.05）。（6）治疗后，2组患者的PCT、TNF-α、IL-6水平明显改善（P < 0.05），且观察组在改善PCT、TNF-α、 IL-6水平方面明显优于对照组，差异有统计学意义（P < 0.05）。（7）观察组不良反应发生率为10.00%，对照组为5.00%。观察 组与对照组的不良反应发生率比较，差异无统计学意义（P > 0.05）。【结论】 通元针法联合调气活血解郁汤治疗中风恢复期气 虚血瘀兼肝郁证，可明显改善患者的认知功能、神经功能与肢体肌力，提高患者的睡眠质量与生活能力，调整机体正常生 理状态，从而提高患者生活质量，疗效显著。

Objective To observe the clinical efficacy of Tongyuan acupuncture combined with Tiaoqi Huoxue Jieyu Decoction in treating stroke in recovery period of qi deficiency and blood stasis complicated by liver stagnation syndrome. Methods A total of 80 patients with stroke in recovery period were randomly divided into observation group and control group， 40 cases in each group. The control group was intervened by conventional western medicine and rehabilitation training，the observation group was treated by Tongyuan acupuncture combined with Tiaoqi Huoxue Jieyu Decoction on the basis of the treatment in the control group. The course of treatment covered one month continuously. After one month of treatment，the clinical efficacy of the two groups was evaluated，and the changes of scores in the patients of the two groups before and after treatment as follows were observed， including Mini-Mental State Examination（MMSE），muscle strength and National Institutes of Health Stroke Scale （NIHSS）， as well as Pittsburgh Sleep Quality Index（PSQI）， Activity of Daily Living Scale（ADL）， and traditional Chinese medicine（TCM）syndrome. The changes of procalcitonin（PCT）， tumor necrosis factor α （TNF-α），and interleukin 6（IL-6）levels before and after treatment were compared between the two groups. The safety and occurrence of adverse reactions in the two groups were also evaluated. Results（1）The total effective rate was 95.00%（38/40）in the observation group and 77.50%（31/40）in the control group. The efficacy of the observation group was superior to that of the control group，the difference being statistically significant（P < 0.05）. （2）After treatment，the TCM syndrome scores of patients in the two groups improved significantly（P < 0.05）， and the improvement in the observation group was significantly superior to that in the control group， with statistically significant differences（P < 0.05）.（3）After treatment，the MMSE scores of patients in the two groups improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，the difference being statistically significant（P < 0.05）.（4）After treatment，the muscle strength scores and NIHSS scores of patients in the two groups improved significantly（P < 0.05）， and the improvement in the observation group was significantly superior to that in the control group， with statistically significant difference（P < 0.05）.（5）After treatment，the PSQI scores and ADL scores of the patients in the two groups improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，with statistically significant difference（P < 0.05）.（6）After treatment，the PCT， TNF-α，and IL-6 levels of patients in the two groups improved significantly（P < 0.05），and the improvement in the observation group was significantly superior to that in the control group，with statistically significant difference （P < 0.05）.（7）The incidence rate of adverse reactions was 10.00% in the observation group and 5.00% in the control group. The intergroup comparison showed that the difference being not statistically significant（P > 0.05）. Conclusion Tongyuan acupuncture combined with Tiaoqi Huoxue Jieyu Decoction in treating stroke in recovery period of qi deficiency and blood stasis complicated by liver stagnation syndrome can significantly improve patients􀆳 cognitive function，neurological function and muscle strength of limbs，enhance patients􀆳 sleep quality and living ability，and adjust the normal physiological state of the body，thus improving patients􀆳 quality of life.

R246.9

广东省中医药管理局科研资助项目（编号：20182133）；安徽省卫生健康委科研项目（编号：AHWJ2021b039）；宿州市科技攻关 计划资助项目（编号：14SZSKJJZC014）