To investigate the clinical efficacy mechanisms of acupuncture combined with repetitive transcranial magnetic stimulation（rTMS）in treating post-stroke non-fluent aphasia using near-infrared brain functional imaging.

A total of 104 patients diagnosed with stroke and non-fluent aphasia at the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from June 2022 to March 2024 were randomly divided into an observation group and a control group，with 52 patients in each. All subjects underwent assessments using near-infrared brain functional imaging techniques. The control group received rTMS，while the observation group was treated with a combination of acupuncture and rTMS. Clinical outcomes，speech function，acoustic levels and aphasia scoring were compared between the two groups，along with brain activity assessments through near-infrared imaging.

The total effective rate was significantly higher in the observation group（98.00%，49/50）compared to that in the control group（70.00%，35/50）（P<0.05）. Post-treatment，both groups showed improved speech function scores，with the scores of the observation group exceeding those of the control group（P<0.05）. Additionally，the scores on the Communication Activities of Daily Living（CADL），Nonverbal Cognitive Assessment（NLCA）and the Barthel Index improved post-treatment，with the scores of the observation group outperforming those of the control group（P<0.05）. The changes in brain activity，specifically in the PMC，SMC and SMA，were statistically significant between two groups post-treatment（P<0.05）.

The treatment of post-stroke non-fluent aphasia with acupuncture combined with rTMS，followed by brain activation using near-infrared brain functional imaging，significantly enhances therapeutic outcomes and speech function，promotes patient recovery and demonstrates high clinical value.