【目的】 观察温阳柔筋法针刺治疗脑卒中后上肢运动功能障碍的临床疗效及对凝血功能的影响。【方法】 选取2022年 1 月至 2023年 12月安徽省庐江县中医院病房及门诊收治的 90例明确诊断为脑卒中后上肢运动功能障碍的患者为研究对象。 按随机数字表将患者随机分为观察组和对照组，每组各 45例。对照组给予常规康复训练，观察组在对照组治疗的基础上， 给予温阳柔筋法针刺治疗，连续治疗 4周。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美国国立卫生院 神经功能缺损量表（NIHSS）评分和Fugl-Meyer运动功能量表（FMA）评分的变化情况，以及改良Ashworth量表（MAS）评分、Barthel 指数（MBI）评分和脑卒中专用生活质量量表（SS-QOL）评分的情况。比较2组患者治疗前后凝血活酶时间（APTT）、凝血酶原 时间（PT）、纤维蛋白原（Fib）的变化情况，以及肿瘤坏死因子 α（TNF-α）、白细胞介素 6（IL-6）和 C反应蛋白（CRP）的情况。 【结果】（1）观察组总有效率 93.33%（42/45），对照组总有效率 68.89%（31/45），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NIHSS评分与FMA评分均明显改善（P < 0.05），且观察组在改善NIHSS评分与FMA评分方 面明显优于对照组，差异均有统计学意义（P < 0.05）。（3）治疗后，2组患者MAS评分与MBI评分均明显改善（P < 0.05），且观 察组在改善MAS评分与MBI评分方面明显优于对照组，差异均有统计学意义（P < 0.05）。（4）治疗后，2组患者的APTT、PT、 Fib水平均明显改善（P < 0.05），且观察组在改善APTT、PT、Fib水平方面明显优于对照组，差异均有统计学意义（P < 0.05）。 （5）治疗后，2组患者的血清TNF-α、IL-6、CRP水平均明显改善（P < 0.05），且观察组在改善血清TNF-α、IL-6、CRP水平 方面明显优于对照组，差异均有统计学意义（P < 0.05）。（6）治疗后，2组患者的SS-QOL评分明显改善（P < 0.05），且观察组 在改善SS-QOL评分方面明显优于对照组，差异有统计学意义（P < 0.05）。【结论】 温阳柔筋法针刺治疗脑卒中后上肢运动功 能障碍，可有效改善患者的肢体运动功能和凝血功能，减轻神经功能受损程度及炎症反应，提高患者的自理能力，从而提 高患者生活质量，疗效显著。

Objective To observe the clinical efficacy of yang-warming and tendons-soothing acupuncture method in the treatment of post-stroke upper limb motor dysfunction， and to explore its effect on coagulation function. Methods Totally 90 patients with a definitive diagnosis of post-stroke upper limb motor dysfunction admitted to the wards and outpatient clinics of Lujiang County Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were selected for the study. The patients were randomly divided into the observation group and the control group according to the random number table method，with 45 cases in each group. The control group was given conventional rehabilitation training，and the observation group was treated with yang-warming and tendonssoothing acupuncture method on the basis of the treatment of the control group，the course of treatment covered four consecutive weeks. After one month of treatment，the clinical efficacy of the two groups was evaluated，and the changes of the National Institutes of Health Stroke Scale（NIHSS）and Fugl-Meyer Assessment Scale（FMA） scores，as well as the Modified Ashworth Spasticity Scale（MAS）score，the Barthel Index（MBI）score，and Stroke-Specific Quality of Life Scale（SS-QOL）score were observed in the patients of the two groups. Changes in the activated partial thromboplastin time（APTT），prothrombin time（PT），fibrinogen（Fib），and tumor necrosis factor α（TNF - α）， interleukin 6（IL-6）， and C-reactive protein（CRP）before and after treatment were compared between patients of the two groups. Results（1）The total effective rate of the observation group was 93.33%（42/45），and that of the control group was 68.89%（31/45），and 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 NIHSS scores and FMA scores of the patients in the two groups were significantly improved（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）.（3）After treatment，MAS scores and MBI scores of patients in the two groups were significantly improved（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 APTT，PT，and Fib levels of patients in the two groups were significantly improved（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）.（5）After treatment，the serum levels of TNF-α，IL-6，and CRP of patients in the two groups were significantly improved（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）.（6）After treatment， the SS-QOL scores of patients in the two groups were significantly improved（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）. Conclusion Yang-warming and tendons-soothing acupuncture method in the treatment of post-stroke upper limb motor dysfunction can effectively improve the patient􀆳s limb motor function and coagulation function， reduce the degree of neurological impairment and inflammatory response， improve the patient􀆳s activity of daily living，thereby improving the patient􀆳s quality of life.

R246.9

国家自然科学基金资助项目（编号：81974564）；安徽省自然科学类科学研究资助项目（编号：2022AH00439）