Stratified Efficacy and Peripheral Neuroinflammatory Mechanisms of Jin's Tongue Triple Acupuncture as Adjunctive Therapy for Subacute Post-Stroke Broca Aphasia: A 1:1 PSM Retrospective Cohort Study.

Post-stroke Broca-type motor aphasia is characterized by impaired oral expression and naming function (Cătălin Jianu 2022). Single standardized speech rehabilitation requires a long period for neural remodeling and carries a high risk of long-term deterioration of language function. Jin's tongue triple acupuncture is a targeted tongue acupuncture therapy, which is widely adopted as an adjuvant aphasia intervention in multiple rehabilitation departments nationwide. Existing relevant clinical studies have limitations including small sample sizes, single outcome indicators, lack of stratified efficacy comparison, absence of biomarker detection, and merely qualitative safety description.We performed a 1:1 propensity score-matched retrospective cohort analysis to quantify intergroup disparities in language function, peripheral neuroinflammatory mediators, and graded acupuncture-related adverse reactions. We further clarified the target population and therapeutic boundaries of Jin's tongue triple acupuncture while avoiding overestimation of its clinical efficacy. We retrospectively retrieved consecutive inpatient rehabilitation medical records of stroke patients admitted to the Department of Rehabilitation Medicine, Jingzhou First People's Hospital from March 2025 to March 2026. Sample size calculation was performed based on effective rates reported in previous similar studies. Of the 614 initially screened patients, 188 were excluded according to predefined inclusion and exclusion criteria. The remaining 426 eligible patients were divided into a combined group (Jin's tongue triple acupuncture + standardized speech rehabilitation, n = 221) and a control group (standardized speech rehabilitation alone). To balance baseline confounding variables, 1:1 nearest-neighbor propensity score matching with a caliper of 0.05 was conducted; baseline covariates were regarded as balanced when the standardized mean difference (SMD) was less than 0.1. Primary outcomes covered the total score and four subscores (spontaneous speech, naming, repetition, auditory comprehension) of the Aphasia Battery of Chinese (ABC). Secondary outcomes referred to serum concentrations of BDNF, CGRP, ET-1, IL-1β and TNF-α measured via ELISA. Stratified subgroup analyses were carried out in accordance with aphasia severity, stroke subtype, age and type 2 diabetes status. All acupuncture-associated adverse reactions were counted by grading standards. Statistical analyses were completed with SPSS 26.0; propensity score matching was performed via the MatchIt package of R 4.2, and conditional logistic regression was conducted using the clogit function from the survival package Table 1. A total of 182 pairs of samples with balanced baseline data were obtained after matching. After continuous 30-day complete intervention, all ABC subscale scores were significantly improved compared with baseline in both groups. The total ABC score, spontaneous speech score and naming score in the combined group were significantly higher than those in the control group (all P < 0.001). No statistically significant intergroup differences were observed in repetition and auditory comprehension (P > 0.05, Table 2). serological detection revealed statistically significant yet moderate-magnitude changes in the expression levels of peripheral neurotrophic factors and inflammatory mediators in the combined group after intervention (all P < 0.001, Table 3). Stratified analysis revealed that Jin's tongue triple acupuncture yielded definite clinical benefits only in patients with mild and moderate motor aphasia Fig. 4. Patients with ischemic stroke, aged ≤ 65 years and without type 2 diabetes exhibited better intervention responses Fig. 5. The total incidence of acupuncture-related adverse events was 6.59%, all presenting as self-resolving mild reactions without moderate or severe complications Fig. 6. Propensity-matched real-world clinical data demonstrated that adjuvant Jin's tongue triple acupuncture selectively enhanced spontaneous speech and naming performance among subacute stroke survivors with mild-to-moderate ischemic Broca aphasia. The therapy also modulated circulating levels of peripheral neurotrophic factors and inflammatory mediators. This acupuncture therapy appeared to produce limited expressive language improvements in patients with severe aphasia and extensive bilateral cortical lesions; older age, hemorrhagic stroke, and type 2 diabetes might be associated with attenuated rehabilitation responses based on exploratory subgroup analyses. Formal interaction testing is needed to verify whether these factors significantly modify therapeutic efficacy. Mild acupuncture adverse reactions had low incidence and strong self-healing property, yet clear boundaries existed for applicable populations. Individualized rehabilitation protocols should be formulated according to stratified results to reasonably control rehabilitation expectations.