Association of Fengchi (GB20) Warm-Needle Acupuncture Combined With Xiaoxuming Decoction With Short-Term Neurological Outcomes in Patients With Acute Ischemic Stroke and Wind–Phlegm Obstruction Syndrome

Objective This study aimed to investigate the associations between warm-needle acupuncture at Fengchi (GB20) combined with Xiaoxuming decoction and short-term neurological function, cerebral hemodynamics, and activity levels in patients with acute ischemic stroke and phlegm obstruction syndrome. Methods This retrospective study included 253 patients who completed 14 days of inpatient treatment at Huanggang Traditional Chinese Medicine Hospital from January 2023 to June 2024. According to medical records, 129 patients received the combined treatment, whereas 124 received routine care and neither study intervention. The National Institutes of Health Stroke Scale (NIHSS) scores at baseline, day 7, and day 14 were analyzed using a linear mixed-effects model; other day-14 outcomes were analyzed using multivariable linear regression. Results NIHSS scores in the combined group were 10.34 ± 3.99, 7.47 ± 3.34, and 5.35 ± 3.13 at baseline, day 7, and day 14, respectively, versus 11.48 ± 4.46, 9.81 ± 3.80, and 7.90 ± 3.46 in controls. Time and group-by-time interaction effects were significant (both p < .001). After adjustment, NIHSS scores were 2.38 and 2.59 points lower in the combined group on days 7 and 14, respectively (both Holm-adjusted p < .001). On day 14, the combined group showed higher mean blood flow velocity and Barthel Index and lower pulsatility index, resistance index, and traditional Chinese medicine syndrome scores (all p < .001), reflecting favorable changes in cerebral hemodynamic parameters, daily activity, and overall symptom severity. Adverse event rates did not differ significantly between groups (7.8% vs. 4.8%, p = .341). Conclusion Fengchi (GB20) warm-needle acupuncture combined with Xiaoxuming decoction was associated with better short-term neurological recovery, favorable cerebral hemodynamic changes, and greater functional activity. No statistically significant difference in the recorded adverse-event rate was observed between the groups during the 14-day treatment period.