Abstract：Objective：To observe the effect of blade-needle therapy based on the myofascial trigger point theory combined with individualized occupational therapy in the treatment of post-stroke upper limb spastic hemiplegia. Methods： A total of 66 patients with post-stroke upper limb spastic hemiplegia admitted to Hangzhou Hospital of Traditional Chinese Medicine from January 2023 to December 2024 were selected. They were divided into the conventional acupuncture group and the combined treatment group by the random number table method，with 33 cases in each group. The conventional acupuncture group received routine acupuncture treatment， while the combined treatment group received blade-needle therapy based on the myofascial trigger point theory combined with individualized occupational therapy. The clinical effect and incidence of adverse reactions were compared between the two groups. Changes in the spasm degree of the affected upper limb [Modified Ashworth Scale （MAS） scores]， motor function [Short-Form Fugl-Meyer Assessment of Upper Extremity （FMA）]， and serum amino acid neurotransmitters [glutamate （Glu）， γ -aminobutyric acid （GABA）] levels before and after treatment were also compared between the two groups. Results：The total effective rate of clinical effect was 93.94%（ 31/33） in the combined treatment group and 75.76% （25/33） in the conventional acupuncture group， there was statistically significant difference in clinical effect between the two groups （P＜0.05）. After treatment， the MAS scores of the affected upper limbs in both groups were decreased when compared with those before treatment （P＜0.05），and the FMA scores were increased when compared with those before treatment （P＜0.05）. The MAS score in the combined treatment group was lower than that in the conventional acupuncture group （P＜0.05），and the FMA score was higher than that in the conventional acupuncture group（ P＜0.05）. After treatment，the serum Glu levels in both groups were decreased when compared with those before treatment（ P＜0.05），and the GABA levels were increased when compared with those before treatment（ P＜0.05）. The serum Glu level in the combined treatment group was lower than that in the conventional acupuncture group （P＜0.05）， and the serum GABA level was higher than that in the conventional acupuncture group （P＜ 0.05）. The incidence of adverse reactions was 15.15% （5/33） in the combined treatment group and 9.09% （3/33） in the conventional acupuncture group， there being no significant difference in the incidence of adverse reactions between the two groups （P＞0.05）. Conclusion： Blade-needle therapy based on the myofascial trigger point theory combined with individualized occupational therapy can improve upper limb function and spasm degree in patients with post-stroke upper limb spastic hemiplegia，regulate amino acid neurotransmitters，enhance curative effect，and has high safety.