Objective To explore the effects of warming-yang and tonifying-qi needling combined with electromyographic biofeedback therapy(EMGBFT)on brain image structure,surface myoelectric characteristics and neurotransmitters in patients with stroke rehabilitation.Methods A prospective research method was conducted in which 200 stroke rehabilitation patients admitted to the Third Hospital of Xingtai City from February 2021 to February 2022 were selected as the study subjects.According to the random principle,the patients were divided into a control group and an study group,with 100 cases in each group.Both groups received routine treatment for stroke,while the control group received a combination of EMGBFT.The study group received a combination of warming-yang and tonifying-qi acupuncture based on the control group,and both groups continued to receive treatment for 9 weeks.Observe the clinical efficacy of two groups of patients and compare the differences in National Institutes of Health Stroke Scale(NIHSS)scores,traditional Chinese medicine symptom scores,brain image structures,serum neurotransmitter levels,and surface electromyography levels before and after treatment,and observe the occurrence of adverse reactions.Results The effective rate of treatment in the study group was significantly higher than that in the control group(97.00％ vs.87.00％,P<0.05).After treatment,NIHSS score,traditional Chinese medicine symptom score,root-mean-square(RMS)of biceps and triceps,and synergistic contraction rate(SCR)were significantly lower than those before treatment in both groups,and the levels of cerebral blood flow(CBF)in the thalamus and frontal lobe,fractional anisotropy(FA),norepinephrine(NE),5-hydroxytryptamine(5-TH),and dopamine(DA)were significantly higher than those before treatment.After treatment,the NIHSS score(4.18±1.09 vs.6.89±1.54),traditional Chinese medicine symptom score(5.41±1.08 vs.9.46±1.55),and biceps RMS(μV:9.76±3.51 vs.16.36±3.44),triceps brachii RMS(μV:6.79±1.83 vs.10.61±2.87),and SCR[(28.08±8.73)％ vs.33.08±9.31)％]were significantly lower than those control group(all P<0.05),the CBF of the thalamus(mL·kg-1·min-1:278.97±86.32 vs.233.63±84.62),and the CBF of the frontal lobe(mL·kg-1·min-1:299.31±75.54 vs.262.81±87.18),FA(0.57±0.18 vs.0.48±0.14),serum 5-HT(ng/L:352.83±38.93 vs.306.71±32.54),NE(ng/L:160.83±17.25 vs.122.81±12.41),DA(μg/L:9.23±0.92 vs.7.36±0.71)were significantly higher than those of the control group(all P<0.05).The incidence of adverse reactions in the study group was significantly lower than that in the control group(3.00％ vs.14.00％,P<0.05).Conclusion Based on EMGBFT,the combination of warming-yang and tonifying-qi acupuncture can synergistically improve the clinical symptoms and brain image structure in stroke rehabilitation patients,and increase their serum neurotransmitter levels,with fewer adverse reactions,which is worthy of promotion.