目的 利用功能磁共振成像（fMRI）技术，基于双回归分析评价通督调神针法对急性缺血性脑卒中（AIS）患者认知网络的影响。 方法 取2023年6月至2024年8月在医院住院治疗的140例AIS患者为研究对象，采用中央随机系统进行随机分组，将患者分为观察组（n = 70）和对照组（n = 70）。1∶1匹配后，每组各70例患者。两组均接受基础药物与康复治疗，观察组在此基础上加用通督调神针法，对照组在此基础上采用假针刺。通过fMRI技术获取患者大脑结构和功能数据，采用双回归分析方法评估患者认知网络的变化。 结果 两组受试者临床资料比较，患者在年龄、性别、糖尿病史、体质量指数（BMI）及高血压病史等差异无统计学意义（P > 0.05），经匹配后，临床资料差异无统计学意义（P > 0.05），且匹配后直方图趋于一致，有效改善了基线特征均衡性。治疗后相对于对照组，观察组在运动功能量表评分FMA和MBI方面分值更高，mRs评分分值更低（P < 0.05）。对于两组受试者不同脑网络对比，试验后与对照组比较，观察组患者在中央前回、辅助运动区、额中回及中央后回的脑网络增强更为明显，但在额中回的脑网络影响较弱（P < 0.05，经Alphasim校正）。fALFF值异常脑区所功能连接分析结果表明，观察组右侧颞下回与左侧顶下回脑区之间的功能连接强度有所上升，然而，右侧额上回脑区之间的功能连接强度却有所下降。在探究两组受试者差异脑区与临床指标的相关性时，运用Pearson相关性分析方法，结果表明观察组不同脑区与NIHSS评分、FMA累加积分量表、巴塞尔（Barthel）指数以及简易精神状态检查表（MMSE）等临床指标之间存在显著差异（P < 0.05）。两组受试者差异脑区与临床指标的协方差分析显示，试验患者中央前回脑区功能连接增加，与MMSE、NIHSS评分、Barthel指数评分呈正相关（R = 0.254，P < 0.001；R = 0.309，P < 0.001；R = 0.314，P = 0.018）等。 结论 通过fMRI的双回归评价通督调神针法可显著增强患者中央前回、辅助运动区、额中回及中央后回等部分脑区的功能连接，有效改善NIHSS、MMSE认知相关评分，为其临床应用提供了影像学及多维度数据支持。

Objective The aim of this study is to use functional magnetic resonance imaging （fMRI） technology and double regression analysis method to explore the effect of Tongdu Tiaoshen acupuncture on cognitive network changes in patients with acute ischemic stroke （AIS）. Methods 140 AIS patients hospitalized in the hospital from June 2023 to August 2024 were selected as the research subjects. The patients were randomly divided into an experimental group （n = 70） and an observation group （n = 70） using a central randomization system. 1：1 After matching， there were 48 patients in each group. Both groups received basic medication and rehabilitation treatment. The experimental group was treated with Tongdu Tiaoshen acupuncture on this basis， while the observation group was treated with sham acupuncture on this basis. Obtain brain structure and function data of patients through fMRI technology， and evaluate changes in patients' cognitive networks using double regression analysis method. Results A comparison of clinical data between the two groups of subjects revealed no statistically significant differences in age， gender， history of diabetes， body mass index （BMI）， and history of hypertension （P > 0.05）. After matching， there was no significant difference in clinical data （P > 0.05）. After matching， the histograms tended to be consistent， effectively improving the balance of baseline characteristics. Compared to the observation group， the experimental group scored lower in cognitive function， memory function assessment， language assessment ability， and executive function assessment scales （P < 0.05）； Compared to the experimental group， the observation group scored lower in terms of mental assessment， daily living ability， and emotional state estimation （P < 0.05）. For the comparison of different brain networks between the two groups of subjects， after the experiment， compared with the observation group， the experimental group showed more significant brain network enhancement in the anterior central gyrus， auxiliary motor area， middle frontal gyrus， and posterior central gyrus， but weaker brain network influence in the middle frontal gyrus （P < 0.05， adjusted by Alphasim）. The functional connectivity analysis based on abnormal fALFF values in brain regions showed that the functional connectivity of the right inferior temporal gyrus and left inferior parietal gyrus in the experimental group was enhanced， while the functional connectivity of the right superior frontal gyrus was weakened. In the correlation analysis between different brain regions and clinical indicators in two groups of subjects， Pearson correlation analysis was used to determine that there were significant differences （P < 0.05） between different brain regions in the experimental group and clinical indicators such as the National Institutes of Health Stroke Scale （NIHSS）， Fugl Meyer （FMA） Cumulative Score Scale for Stroke， Barthel Index， and Mini Mental State Examination （MMSE）. The covariance analysis of the differences in brain regions and clinical indicators between the two groups of subjects showed that the functional connectivity of the central anterior gyrus in the trial patients increased， which was positively correlated with MMSE and NIHSS scores Barthel index scores （R = 0.254，P < 0.001；R = 0.309，P < 0.001 R = 0.314， P = 0.018）. Conclusions The dual regression evaluation of fMRI shows that the Tongdu Tiaoshen acupuncture method can significantly enhance the functional connectivity of some brain areas in patients， such as the anterior central gyrus， auxiliary motor area， middle frontal gyrus， and posterior central gyrus， effectively improving NIHSS and MMSE cognitive related scores， providing imaging and multidimensional data support for its clinical application.