目的 探讨“通督调神”针刺法联合手功能康复训练治疗脑梗死后患者手功能障碍的临床疗效。 方法 将104例患者随机分为两组，每组52例。观察组行“通督调神”针刺联合手功能康复训练）。对照组行手功能康复训练，治疗4周。观察患者治疗前后的改良Ashworth评分（MAS）、改良Lindmark评分（MLS）、Brunnstrom上肢运动功能评分（BMS）、Fugl-Meyer上肢运动功能评分（FMA）、改良Barthel指数（MBI）、握力值（GS）等观察指标变化，记录不良事件发生情况，统计各组有效率，进行疗效对比。 结果 在除掉剔除病例和脱落病例后有94例纳入最终统计，观察组有48例，对照组有46例。两组患者的MLS、MAS、BMS、FMA、MBI、GS等指标分值较治疗前均有明显变化（P < 0.05）；治疗后两组进行组间比较发现各项指标的分值差异均有统计学意义（P < 0.05）；观察组总有效率为91.7%，对照组为82.6%，两组的疗效等级差异有统计学意义（P < 0.05）。 结论 “通督调神”针刺法联合手功能训练在改善脑梗死后患者的手功能障碍情况，提高患肢的手部握力和精细动作能力，降低手部肌肉痉挛、关节僵硬程度，以及促进上肢运动功能恢复和改善患者日常生活能力等方面均要明显优于手功能康复训练的治疗。

Objective To evaluate the clinical efficacy of "Tongdu Tiaoshen" acupuncture combined with hand function rehabilitation training in patients with hand dysfunction following cerebral infarction. Methods A total of 104 patients were randomly assigned to either the observation group （receiving "Tongdu Tiaoshen" acupuncture combined with hand function rehabilitation training） or the control group （undergoing hand function rehabilitation training alone）， with 52 patients in each group. Both groups underwent a 4-week treatment regimen. The following outcome measures were assessed pre- and post-treatment： Modified Ashworth Scale （MAS）， Modified Lindmark Scale （MLS）， Brunnstrom Motor Function Score （BMS） for upper limbs， Fugl-Meyer Assessment （FMA） of upper limb motor function， Modified Barthel Index （MBI）， and grip strength （GS）. Adverse events were documented， and the clinical efficacy in each group was evaluated by calculating the effective rate. Results After excluding dropouts， a total of 94 cases were included in the final statistical analysis， with 48 cases assigned to the observation group and 46 to the control group. Both groups demonstrated significant improvements in MLS， MAS， BMS， FMA， MBI， and GS scores compared to pre-treatment levels， with all differences being statistically significant （P < 0.05）. Following treatment， intergroup comparisons also revealed statistically significant differences in all measured indicators （P < 0.05）. The total effective rate was higher in the observation group （91.7%） than in the control group （82.6%）， and the difference in efficacy grades between the two groups was statistically significant （P < 0.05）. Conclusions "Tongdu Tiaoshen" acupuncture， when combined with hand function training， demonstrates significantly greater efficacy than hand function rehabilitation training alone in improving post-cerebral infarction hand dysfunction. It enhances grip strength and fine motor coordination of the affected limb， alleviates hand muscle spasticity and joint stiffness， and promotes recovery of upper limb motor function， thereby improving patients' activities of daily living. This integrated therapeutic approach warrants further clinical validation and in-depth research for broader implementation.