目的 探讨时空针灸灵龟八法指导下艾灸干预对缺血性脑卒中睡眠障碍患者的临床疗效，分析其对血清5-羟色胺（5-HT）、褪黑素（MT）水平及神经功能、情绪状态的影响。 方法 前瞻性选取2024年6月至2025年6月于昆明市中医医院/云南中医药大学第三附属医院就诊的78例缺血性脑卒中合并睡眠障碍患者，采用随机数字表法分为对照组与观察组，每组39例。两组均实施常规护理和治疗，包括药物治疗、康复治疗。对照组采用普通艾灸治疗，观察组采用时空针灸灵龟八法艾灸治疗，两组均连续治疗3周。比较两组临床疗效、疲劳严重度量表（FSS）评分、匹兹堡睡眠质量指数（PSQI）、医院焦虑抑郁量表（HADS）评分、美国国立卫生研究院卒中量表（NIHSS）评分、血清5-HT与MT水平变化，并记录治疗期间不良反应发生情况。 结果 观察组治疗总有效率高于对照组（P < 0.05）。重复测量方差分析显示，两组FSS评分、PSQI总分、HADS总评分、NIHSS评分、血清5-HT水平、血清MT水平均存在显著的时间、组间及交互效应（P < 0.05）。进一步简单效应分析显示，治疗3周后观察组上述量表评分均显著低于对照组，血清5-HT、MT水平均显著高于对照组（P < 0.05）。两组不良反应发生率比较差异无统计学意义（P > 0.05）。 结论 在常规治疗基础上联合时空针灸灵龟八法指导的艾灸干预，可有效改善缺血性脑卒中睡眠障碍患者的睡眠质量，缓解疲劳与焦虑抑郁情绪，促进神经功能恢复，其作用机制可能与调控5-HT、MT等睡眠相关神经递质水平有关，安全性良好，适合临床推广应用。

Objective To investigate the clinical efficacy of acupuncture of time acupoint space based on Linggui Bafa in patients with sleep disorders secondary to ischemic stroke， and to evaluate its effects on serum 5-hydroxytryptamine （5-HT） and melatonin （MT） levels， neurological function， and emotional status. Methods A total of 78 patients with ischemic stroke and concurrent sleep disorders treated at our hospital between June 2024 and June 2025 were prospectively enrolled and randomly divided into a control group and a treatment group （n = 39 each）. The control group received conventional treatment and sleep management for ischemic stroke. The treatment group received the same conventional therapy plus Linggui Bafa-based spatiotemporal acupoint selection moxibustion. Both groups received continuous treatment for 3 weeks. The overall clinical efficacy， scores on the Fatigue Severity Scale （FSS）， Pittsburgh Sleep Quality Index （PSQI）， Hospital Anxiety and Depression Scale （HADS）， and National Institutes of Health Stroke Scale （NIHSS）， as well as serum 5-HT and MT levels， were compared between the two groups. Adverse events during the treatment period were also recorded. Results The overall effective rate in the treatment group was significantly higher than that in the control group （P < 0.05）. Repeated-measures analysis of variance （ANOVA） revealed significant main effects of time and group， as well as significant time × group interaction effects， on the FSS， PSQI， HADS， and NIHSS scores， and on serum 5-HT and MT levels （all P < 0.05）. Further simple main effect analysis demonstrated that after 3 weeks of treatment， the scores on all aforementioned scales in the treatment group were significantly lower than those in the control group， whereas serum 5-HT and MT levels were significantly higher （all P < 0.05）. No significant difference in the incidence of adverse events was observed between the two groups （P > 0.05）. Conclusions As an adjunct to conventional therapy， Linggui Bafa-based spatiotemporal moxibustion can effectively improve sleep quality， alleviate fatigue， anxiety， and depression， and promote neurological recovery in patients with sleep disorders following ischemic stroke. The underlying mechanism may be related to the regulation of sleep-associated neurotransmitters， such as 5-HT and MT. The intervention demonstrates a favorable safety profile and holds promise for clinical application.