Clinical Efficacy and Mechanism Exploration of Early Traditional Chinese Medicine Rehabilitation Interventional Therapy in Elderly Patients with Cerebral Infarction

目的：探讨早期中医康复介入治疗(针灸 + 中药 + 推拿 + 传统功法训练)在老年脑梗死患者神经功能、运动功能、中医证候评分及生活质量改善中的临床价值，为优化“时间窗–技术组合–个体化”治疗方案提供依据，并分析其潜在机制。方法：本研究是一项病例对照研究，回顾性地收集2023年1月~2023年12月在我院神经内科住院治疗的急性脑梗死患者相关资料，作为对照组：常规西医治疗 + 基础康复训练(物理治疗(关节活动度训练、步态训练)、作业治疗(ADL训练)，每日1次，每次30分钟，每周5天)；将2024年1月~2024年12月在我院神经内科住院治疗的急性脑梗死患者相关资料，作为观察组：常规西医治疗 + 早期中医康复介入(针灸 + 中药 + 推拿 + 传统功法训练)。采用SPSS 26.0软件统计分析，时间点：基线(T0)、干预1周(T1)、1个月(T2)。组间计量资料组间比较采用独立样本t检验，计数资料比较采用χ2检验，不同康复治疗方案的脑梗死患者各时间节点其NIHSS评分、生活自理能力评估量表Barthel评分、中医证候评分比较采用重复测量方差分析，以P P Objective: To explore the clinical value of early TCM rehabilitation interventional therapy (acupuncture + Chinese medicine + massage + traditional exercise training) in the improvement of neurological function, motor function, TCM syndrome score and quality of life in elderly patients with cerebral infarction, to provide a basis for optimizing the treatment plan of “time window-technology combination-individuation”, and to analyze its potential mechanism. Methods: This study was a case-control study. Data of patients with acute cerebral infarction who were hospitalized in the Department of Neurology of our hospital from January 2023 to December 2023 were retrospectively collected as control group: Conventional Western medicine treatment + basic rehabilitation training (physical therapy (joint motion training, gait training), occupational therapy (ADL training), once a day, 30 minutes each time, 5 days a week); The relevant data of patients with acute cerebral infarction hospitalized in the Department of Neurology of our hospital from January 2024 to December 2024 were selected as the observation group: conventional Western medicine treatment + early TCM rehabilitation intervention (acupuncture + traditional Chinese medicine + massage + traditional exercise training). SPSS 26.0 software was used for statistical analysis. Time points were baseline (T0), intervention for 1 week (T1), and intervention for 1 month (T2). Independent sample t test was used for inter-group comparison of measurement data, and χ2 test was used for comparison of counting data. The NIHSS score, self-care ability assessment scale Barthel score and TCM syndrome score of cerebral infarction patients with different rehabilitation treatment plans at each time node were compared by repeated measure ANOVA, with P P < 0.05), and there was no statistical difference between the two groups in stroke recurrence rate and adverse reactions within 1 month. Conclusion: According to the dynamic adjustment plan of different stages of cerebral infarction (super early stage, acute stage and convalescent stage), this study formed a multi-modal early TCM rehabilitation interventional treatment system by integrating traditional Chinese medicine, acupuncture, massage and traditional exercises (such as Baduanjin). Through multi-target regulation of inflammation, improvement of hemodynamics, and promotion of nerve remodeling, it can reduce the NIHSS score and TCM syndrome score of elderly patients with cerebral infarction, and improve the ADL score, providing a safe and effective comprehensive treatment plan for elderly patients with cerebral infarction.