Stroke is a common acute disease that affects mostly middle-aged and elderly people. It is characterized by sudden fainting, unconsciousness, paralysis, confusion, and lopsided mouth. In ancient times, it was called “stroke” and “partial withering” according to its acute onset and symptom characteristics. Stroke is a common acute disease, most of the patients are middle-aged and elderly people, and the disease is characterized by sudden fainting, unconsciousness, paraplegia, or confusion and lopsidedness of the mouth. In ancient literature, it was called “stroke” and “partial depression” according to its acute onset and symptom characteristics. According to the depth of the disease and the severity of the disease, it is divided into two types of symptoms, namely, middle meridian and middle viscera, as the basis for identification and treatment. This disease includes cerebral hemorrhage, cerebral thrombosis, cerebral infarction and other cerebrovascular accident diseases. The time of acupuncture intervention in stroke disease Cerebral hemorrhage, i.e. hemorrhagic stroke, is the most common type of hypertensive cerebral small artery rupture hemorrhage. Domestic statistics show that hypertensive patients have about 1/3 chance of cerebral hemorrhage. Cerebral hemorrhage is the most serious of acute cerebrovascular diseases with rapid onset and progression, and its death and disability rates are high. In addition, there are non-hypertensive causes such as cerebral artery amyloid angiopathy, cerebrovascular malformation, intracranial aneurysm and so on. Since the development of “brain stereotactic surgery” in our brain surgery department, the author has made a bold attempt to treat patients with cerebral hemorrhage with early postoperative acupuncture intervention. After the brain stereotactic surgery, the patients were in ICU custody, after the western medicine treatment, the vital signs were basically stable, 56 patients were randomly selected to be awake after the surgery, 31 men and 25 women; the youngest was 40 years old and the oldest was 84 years old. After acupuncture treatment, it was found that the patients responded differently to early intervention at different times after surgery. All the selected subjects were treated with acupuncture by taking Nei Guan, Sanyinjiao and body acupuncture of the affected limb, giving flat tonic and flat diarrhea method, electroacupuncture by selecting sparse and dense wave, and staying acupuncture for 30 minutes, and Tai Chong point was given heavy diarrhea to calm the liver and submerge Yang. Because of the strong stimulation of the Shuigou point, which can significantly promote cerebral blood circulation, the author did not dare to take it at this time. After treatment, it was found that in patients whose blood pressure was stable within 3 days after surgery (blood pressure 140/90-160/110 mmHg), blood pressure fluctuated significantly within one day after the needle, with 31 cases of elevated blood pressure, and some patients were more irritable than before the needle, especially about half an hour after the needle, blood pressure increased significantly, ranging from 20 to 40 mmHg, and no decrease in blood pressure was seen. In patients with stable vital signs for more than 3 to 7 days, acupuncture was given to the same method of treatment, and blood pressure fluctuations were significantly reduced. Therefore, for the early intervention of acupuncture in patients with cerebral hemorrhage, the change of blood pressure must be closely observed. In terms of stable improvement of the patient’s condition, the author believes that early intervention of acupuncture is appropriate at least after 3 days of stable vital signs. Cerebral thrombosis and cerebral infarction in stroke disease, i.e. ischemic stroke, the most common cause of cerebral thrombosis is cerebral atherosclerosis, clinically atherosclerotic thrombosis cerebral infarction is more common. Cerebral embolism is a foreign body from other parts of the body that enters the blood circulation, runs with the blood flow, and blocks the cerebral arteries, resulting in ischemia and hypoxia in the brain tissue of its blood supply area causing cerebral infarction. It is also divided into cardiogenic and non-cardiogenic cerebral embolism. The onset of cerebral embolism is rapid, and hemiparesis occurs without prodromal symptoms. Within the first week after the onset of cerebral thrombosis, the brain nerve cells in the center of the necrotic focus are already dead, which is irreversible damage, but there is a ring-shaped “semi-dark zone” of varying size between the necrotic nerve cells and the surrounding completely normal brain tissue. In the “semi-dark zone”, there are a large number of brain nerve cells that are less damaged and not dead, which are swollen, metabolically disturbed, and temporarily lost in function. If the clinical treatment is not timely and inappropriate, a large number of damaged brain nerve cells in the “semi-dark zone” may die, and the necrotic foci may expand, making the condition worse. In the first week of cerebral thrombosis, a large amount of harmful substances can be produced in the center of the necrotic foci, while there are different degrees of cerebral edema in the “semi-dark zone”. Cerebral embolism is the entry of emboli into the cerebral circulation and embolism in the cerebral arteries, causing cerebral infarction in the area supplied by the embolized blood vessels, and the pathological changes in the infarcted area are basically the same as cerebral thrombosis. For patients with stroke caused by cerebral thrombosis and cerebral embolism, acupuncture treatment should be carried out promptly and early, and it is better to carry out acupuncture treatment within the first week of onset. Early acupuncture intervention can reduce the pathological damage of brain nerve cells in the “semi-dark zone”, which can reduce the degree of disability, and anti-brain edema treatment is generally started by Western medicine at 3-6 hours after the onset of stroke, and continuous treatment for 5-7 days. Acupuncture treatment should be carried out at the same time. In our hospital, after the diagnosis of cerebral infarction was confirmed by CT, acupuncture and western medicine comprehensive treatment was performed, because most of the patients sought medical treatment more than 3-6 hours after the onset of the disease, and after the diagnosis was confirmed, acupuncture intervention was mostly performed 1 day after the onset of the disease, but the efficacy was significantly better than that of the previous patients after the acute phase of infarction of 1 to 2 weeks after the onset of the disease. Differential treatment between hemorrhagic and ischemic stroke Only acupuncture treatment is discussed here, mainly in the early phase after the onset of stroke, i.e., the acute phase stage. There is generally no major difference between the recovery period and the post-stroke period. With the rapid development of medicine nowadays, the treatment of stroke disease is now a combination of Chinese and Western medicine. Hemorrhagic stroke can be treated by “opening and closing the orifices” and “pacifying the liver and calming the wind”, with Neijingguan, Shuigou, Sanyinjiao, and Taichong as the main points. Neiguan is one of the eight meeting points and is connected to Yinwei, which is a ligament point of the sympathetic Yin pericardium meridian and has the function of nourishing the heart and tranquilizing the mind and unblocking qi and blood. Sanyinjiao is a rendezvous point of the Foot Taiyin Spleen, Foot Convulsive Yin Liver and Foot Shao Yin Kidney meridians, and has the function of tonifying the kidneys, nourishing Yin and generating marrow. The kidney is the master of essence, which generates marrow, and the brain is the sea of marrow, which promotes the recovery of the physiological functions of the brain. Shuigou is a point of convergence of the Directing Vessel and Yangming of the hands and feet. The Directing Vessel starts from the middle of the cell and moves up into the brain to reach the upside down, so diarrhea of Shuigou can adjust the Directing Vessel and open and close the orifices to strengthen the brain and calm the mind. I still use this method for patients with cerebral hemorrhage, after the condition has been stable for more than a week, to prevent the blood pressure from rising, and at the same time with the corresponding body acupuncture. For patients with cerebral hemorrhage, head acupuncture and tongue acupuncture are not used in the acute stage, and they are also used with caution in the recovery period. For patients with ischemic stroke, as long as the blood pressure is stable below 140/90 mmHg, use Baihui, the motor area and sensory area of head acupuncture; add the language area if there is language disorder, and match the corresponding body acupuncture, such as Fengchi, Quchi, Hegu, Neiguan, Feet Three Miles, Sanyinjiao, Taichong, etc. Tongue acupuncture can also be used for treatment. The criteria for judging the efficacy of acupuncture in the treatment of stroke are acceptable for the present period, but somewhat too simplified for future development. Can the criteria for determining the efficacy of acupuncture and moxibustion be refined and quantified with reference to the 6 levels of Brunnstrom’s hemiplegic motor function assessment in rehabilitation, as well as the assessment of activities of daily living such as PULSES assessment and Barthel index assessment, so as to make the criteria for determining the efficacy of acupuncture and moxibustion more complete and scientific. Acupuncture treatment for various concurrent disorders Acupuncture treatment for limb dysfunction: Yangming meridian is the main point, supplemented by Sun and Shaoyang meridian points. The acupuncture points can also be supplemented with Yin meridians. In addition to body acupuncture treatment, the method of “awakening the brain and opening the orifices” is applied. On the basis of manual acupuncture, electro-acupuncture is used for hard palsy with continuous waves and for soft palsy with sparse and dense waves. For upper limb palsy, shoulder, Quchi, Hand Sanli, Waiguan and Hegu points are used; for lower limb palsy, Huanjiao, Yanglingquan, Foot Sanli, Xiexi and Kunlun points are used. For hemiplegia, the well point on the affected side can be used, and the blood can be released by puncturing with a trigeminal needle; the motor zone, sensory zone, and foot transport sensory zone can be used for head acupuncture; tongue acupuncture can also be used for treatment. In the body acupuncture treatment to the healthy side and the affected limb at the same time or alternately, the efficacy is better than only taking the affected side or the healthy side. Language disorder: Patients manifested as a lapse or language speech. Acupuncture is given to head acupuncture language zone one, zone two, zone three, with Fengchi, Mute Gate, Lianquan and other points, also can be accompanied by tongue acupuncture. Facial palsy: Take Yangbai, Shanguan, Sun, Yingxiang, Dicang, Hegu, Fengchi and the motor zone of head acupuncture, the lower part of the sensory zone of the face. Dysphagia: take the motor zone of the head acupuncture, the lower part of the sensory zone and the Lianquan point. Incontinence: strong stimulation of Shuigou point, taking Baihui, Neiguan and Sanyinjiao to “awaken the brain and open the mind”, local acupuncture of Zhongji, Guangyuan and Qihai points. In addition, swelling of the hands and feet, numbness, eight evil, eight wind, phlegm can be taken Fenglong. The above acupuncture treatment is based on electro-acupuncture treatment. Precautions for acupuncture treatment of stroke disease When acupuncture treatment of stroke disease is intervened in the early stage, the change of blood pressure must be closely observed. For the recovery period and the post-stroke period, the tonicity of the acupuncture should be combined with the patient’s constitution and vary from person to person. When giving tongue acupuncture treatment to a stroke patient, the patient should be instructed not to speak or cough to prevent bleeding from penetration of the acupuncture needle.