BACKGROUND: Although the curative effects of acupuncture have been confirmed by various treatments of cerebral infarction, few studies have investigated when acupuncture can attain the best clinical effect.OBJECTIVE: Four different time points were selected for acupuncture treatment of cerebral infarction to evaluate the appropriate time course for Xingnao Kaiqiao therapy in terms of improved neurological function. DESIGN: Controlled observation.SETTING: Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy of the Affiliated Hospital of Medical College of Chinese Armed Police Forces.PARTICIPANTS: A total of 120 inpatients with cerebral infarction of different stages, including 75 males and 45 females, aged 41-75 years, were selected from November 2005 to December 2006 at the Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy in Affiliated Hospital of Medical College of Chinese Armed Police Forces. Diagnostic criteria: in accordance with "main points of diagnosis on different cerebrovascular disease" secondly revised in the Second Cerebrovascular Disease Academic Meeting of Chinese Medicine Association in 1986. All accepted subjects provided confirmed consent, and the experiment received ethical permission from the hospitals ethics committee.METHODS: ① Experiment grouping: All inpatients were divided into four groups with non-stochastic concurrent control method according to the disease course: Group I (onset within 7 hours), group Ⅱ (onset from 7 hours to 3 days), group Ⅲ (onset within 4-7 days), and group Ⅳ (onset within 21-180 days). On the basis of symptomatic treatment with western medicine, each group received Xingnao Kaiqiao therapy after onset within 7 hours, 7 hours to 3 days, 4 to 7days, and 21 to 180 days. ② The principal acupoints were Neiguan, Renzhong, and Sanyinjiao. ③ The auxiliary acupoints were Jiquan, Chize, and Weizhong. ④Acupuncture manipulations: initially, Neiguan (PC6, bilateral) was needled at 0.5-1.0 cun vertically with a reducing technique achieved by rotating-swirling and lifting-inserting for 1 minute. Subsequently, Renzhong (GV26) was needled at 0.3-0.5 cun obliquely towards the nasal septum, with a heavy bird-pecking method until eyeballs were moist or shed tears. Sanyinjiao (SP6, affected limb) was needled at 1.0-1.5 cun obliquely along the medial border of the tibia with a 45° angle between the needle and skin. The technique of reinforcing was achieved by a lifting-inserting method until the affected lower limb twitched three times. The auxiliary acupoint, Jiquan, was selected when the patient extended the affected upper limb abduction. Jiquan was along the downward channel, 1 cun from the quondam Jiquan (HT1) acupoint; the armpit hair was avoided. Jiquan (affected limb) was needled vertically at 1.0-1.5 cun. The technique of reduction was achieved by lifting-inserting until the affected upper limb twitched three times. Chize (LU5) was selected when the patient flexed the elbow at 120°. Chize was vertically needled at 1 cun with a lifting-inserting reducing technique until the affected forearm and fingers twitched three times. Weizhong (BL40) was selected when the patients leg was raised straight in a supine position. Weizhong was vertically needled at 0.5-1.0 cun with a lifting-inserting reducing technique until the affected lower limb twitched three times. ⑤ Acupuncture manipulations were achieved by the doctor who is an associate chief physician and doctor of acupuncture and moxibustion and has aptitude for the posts specification. ⑥One course of treatment lasted for 10 days and each group was treated for two courses of treatment. ⑦Experiment evaluation: To apply neurological impairment scores for evaluating clinical curative effects before and after treatment with Xingnao Kaiqiao therapy on day 7, 14, and 21(range of 0-45; decreasing score indicates functional improvement).To evaluate clinical curative effect by clinical effective power：Basic recovery: equal to or more than 81%; significant improvement: 56% to 81% (including 56%); Improvement: between 36% to 56% (including 36%); Slight Improvement: 11% to 36% (including 11%); No change: less than 11%; Aggravation (including death): negative value. Total effective rate was computed at the same time.MAIN OUTCOME MEASURES: The total effective rate and amelioration of neurological impairment of the patients after treatment.RESULTS: All 120 patients with cerebral infarction were included in the final analysis, without deletion.① Comparison of the total effective rate: the total effective rate of group Ⅰ, group Ⅱ, group Ⅲ, and group Ⅳ was 97%, 93%, 93%, and 67%, respectively. There were significant differences of interclass synthetic curative effects (χ2 = 36.351 7, P < 0.01). ② Amelioration of neurological impairment: A decreased neurological impairment score was observed in group I on day 7, 14, and 21 after Xingnao Kaiqiao therapy. The differences between group IV and the remaining three groups were significant (P < 0.05).CONCLUSION: Xingnao Kaiqiao therapy is helpful for amelioration of neurological impairment in patients during the acute stage cerebral infarction.