【目的】 观察靳三针疗法联合双侧高频重复经颅磁刺激治疗脑卒中后偏瘫的临床疗效。【方法】 选取2023年1月至2024年 6月延安市中医医院病房及门诊收治的116例明确诊断为脑卒中偏瘫患者为研究对象。按随机数字表将患者随机分为观察组 和对照组，每组各58例。对照组给予双侧高频重复经颅磁刺激治疗，观察组在对照组治疗的基础上，给予靳三针疗法治疗。 治疗30 d后，评价2组临床疗效。观察2组患者治疗前后中医证候积分、肢体运动评分量表（FMA）评分的变化情况，以及脑 卒中专用生活质量量表（SS-QOL）评分的情况。比较 2 组患者治疗前后神经元特异性烯醇化酶（NSE）、胶质纤维酸性蛋白 （GFAP）、中枢神经特异蛋白（S100-β）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91.38%（53/58），对照组为75.86%（44/58），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、肢体运动功能FMA评分均明显改善（P＜0.05），且观察组在改善中医证候积分、肢体运动功能FMA评分方面 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 NSE、GFAP、S100-β含量明显改善（P＜0.05），且 观察组在改善NSE、GFAP、S100-β含量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组患者的生活质 量 SS-QOL 评分明显改善（P＜0.05），且观察组在改善生活质量 SS-QOL 评分方面明显优于对照组，差异有统计学意义（P＜ 0.05）。（5）观察组不良反应发生率为12.07%（7/58）；对照组为8.62%（5/58）；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】 靳三针疗法联合双侧高频重复经颅磁刺激治疗脑卒中后偏瘫，可明显改善患者的临床症状， 提高患者肢体的运动功能，降低脑损伤标志物水平，提高患者的生活质量，安全性良好，疗效显著。

Objective To observe the clinical efficacy of Jin’s triple-needle therapy combined with bilateral highfrequency repetitive transcranial magnetic stimulation in the treatment of post-stroke hemiplegia. Methods A total of 116 patients diagnosed with post-stroke hemiplegia and admitted to the wards and outpatient clinics of Yan’an City Hospital of Traditional Chinese Medicine from January 2023 to June 2024 were selected as the study subjects. The patients were randomly divided into an observation group and a control group using a random number table， with 58 patients in each group. The control group received bilateral high-frequency repetitive transcranial magnetic stimulation，while the observation group received Jin’s triple-needle therapy in addition to the control group’s treatment. After 30-day treatment，the clinical efficacy of the two groups was evaluated. Changes in traditional Chinese medicine （TCM） syndrome scores，Fugl-Meyer Assessment （FMA） scores for limb motor function，and Stroke-Specific Quality of Life （SS-QOL） scores were observed before and after treatment. Changes in neuron-specific enolase （NSE）， glial fibrillary acidic protein （GFAP）， and central nervous system-specific protein （S100-β） levels were compared between the two groups before and after treatment. The safety and incidence of adverse reactions in both groups were also evaluated. Results （1） The total effective rate in the observation group was 91.38%（53/58），compared to 75.86%（44/58） in the control group. The observation group showed significantly better efficacy than the control group， with a statistically significant difference（P＜0.05）.（2）After treatment， both groups showed significant improvements in TCM syndrome scores and FMA scores for limb motor function（P＜ 0.05），and the observation group was significantly superior to the control group in improving TCM syndrome scores and FMA scores，with a statistically significant difference （P＜0.05）.（3） After treatment，both groups showed significant improvementss（P＜0.05） in NSE， GFAP， and S100- β level， and the observation group was significantly superior to the control group in improving NSE， GFAP， and S100- β levels， with a statistically significant difference （P＜0.05）.（4） After treatment，both groups showed significant improvements in SS-QOL scores for quality of life （P＜0.05），and the observation group was significantly superior to the control group in improving SS-QOL scores， with a statistically significant difference （P＜0.05）.（5） The incidence of adverse reactions in the observation group was 12.07%（7/58），compared to 8.62%（5/58） in the control group. There was no statistically significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion Jin’s triple-needle therapy combined with bilateral high-frequency repetitive transcranial magnetic stimulation can significantly improve clinical symptoms， enhance limb motor function， reduce levels of brain injury markers，and improve the quality of life in patients with post-stroke hemiplegia. The treatment is safe and shows significant efficacy.

R246.9

延安市科技计划资助项目（编号：2022SLSFGG-032）