Abstract：Objective：To observe the effect of the combination use of Wenjing Yangxue Tongmai Decoction and Sanjiao acupuncture therapy on the repair of sensory pathway injury，memory disorder，gray matter microstructure and blood-brain barrier in patients with thalamic infarction. Method：A total of 94 patients with thalamic infarction treated in Kaifeng People's Hospital from February 2022 to February 2024 were selected and divided into the control group and the combination group according to the random number table method，with 47 cases included in and 2 cases dropouts in each group. Both groups were given basic symptomatic treatment，the control group was additionally treated with Sanjiao acupuncture therapy， and the combination group was additionally treated with Wenjing Yangxue Tongmai Decoction based on the treatment in the control group. Both groups were treated for eight weeks. The clinical effects， and the changes in scores of China Stroke Scale （CSS）， Rivermead Behavioral Memory Test （RBMT） and Loewenstein Occupational Therapy Cognitive Assessment （LOTCA）， average diffusion coefficient of affected side， fractional anisotropy of affected side， sensory function score， ratio of Ktrans value （Ki/c） of cerebral infarction side to contralateral side of cerebral infarction， volume of gray matter， and levels of serum β-amyloid protein 1-42 （Aβ1-42）， tumor necrosis factor-α （TNF-α）， brain-derived nerve growth factor （BDNF） and reactive oxygen species （ROS） before and after treatment were compared between the two groups. Results： The total clinical effective rate was 95.56% （43/45） in the combination group and 77.78% （35/45） in the control group， the difference being significant （P＜0.05）. After treatment， the scores of RBMT and LOTCA in the two groups were elevated when compared with those before treatment （P＜0.05），and the CSS scores were reduced when compared with those before treatment （P＜0.05）；the scores of RBMT and LOTCA in the combination group were higher than those in the control group （P＜0.05）， and the CSS score was lower than that in the control group （P＜0.05）. After treatment， the fractional anisotropy of the affected side and sensory function scores in the two groups were up-regulated when compared with those before treatment （P＜0.05）， and the average diffusion coefficient of the affected side dwindled when compared with that before treatment （P＜0.05）；the fractional anisotropy of the affected side and sensory function score in the combination group were higher than those in the control group （P＜0.05），and the average diffusion coefficient of the affected side was lower than that in the control group （P＜0.05）. After treatment，the Ki/c values in the two groups were decreased when compared with those before treatment （P＜0.05）， and the volume of gray matter was increased when compared with that before treatment （P＜0.05）；the Ki/c value in the combination group was lower than that in the control group （P＜0.05），and the volume of gray matter was larger than that in the control group （P＜0.05）. After treatment， the levels of ROS and TNF- α in the two groups were reduced when compared with those before treatment （P＜0.05）， and the levels of Aβ1-42 and BDNF were increased when compared with those before treatment （P＜0.05）； the levels of ROS and TNF-α in the combination group were lower than those in the control group （P＜0.05）， and the levels of Aβ1-42 and BDNF were higher than those in the control group （P＜0.05）. Conclusion：The combination use of Wenjing Yangxue Tongmai Decoction and Sanjiao acupuncture therapy can inhibit the inflammatory responses and oxidative stress reaction of thalamic infarction， reduce the nerve injury， promote the repair of sensory pathway injury， improve the gray matter microstructure and blood-brain barrier， and enhance the cognitive function，memory function and curative effect.