Abstract： Objective： To observe the clinical effect of dragon- tiger contending needling method for ischemic stroke and its effects on miR- 431 and miR- 1247 in serum. Methods： A total of 98 cases of patients who had ischemic stroke with qi deficiency and blood stasis syndrome and treated from May 2020 to January 2022 were selected as study objects and randomly divided into two groups，with 49 cases in each group. Clinical effects and the scores of National Institute of Health stroke scale (NIHSS)，Fugal- Meyer Assessment Scale (FMA)， and Barthel Index (BI) were compared between the two groups. Inflammatory indicators [interleukin- 1β (IL- 1β)，interleukin 6 (IL- 6)，tumor necrosis factor- α (TNF- α)]， immune function (T-lymphocytes：CD3+，CD4+，CD8+ )，serum miR-431，serum miR-1247 and other indicators were compared between the two groups. Pearson correlation analysis was used to analyze the relationship between miR-431 and miR-1247 and inflammatory and immune indicators. Multifactor logistic regression and ROC curve were used to analyze the impact of miR- 431 and miR- 1247 on stroke recurrence. Results： After treatment， NIHSS scores in the two groups were lower than those before treatment，and the scores of FMA and BI were higher than those before treatment；NIHSS score in the observation group was lower than that in the control group， and the scores of FMA and BI in the observation group were higher than those in the control group，differences being significant (P＜0.05). After treatment，levels of IL-1β，IL-6，and TNF-α in the two groups were lower than those before treatment， and the three levels in the observation group were lower than those in the control group，differences being significant (P＜0.05)；the levels of T- lymphocyte including CD3 +，CD4 +，CD8 + in the two groups were higher than those before treatment，and the three levels in the observation group were higher than those in the control group，differences being significant (P＜0.05). After treatment，the levels of miR-431 and miR- 1247 in the two groups were lower than those before treatment， and the two levels in the observation group were lower than those in the control group， differences being significant (P＜0.05). There was a negative correlation between the levels of serum miR- 431 and miR-1247 and the levels of CD3+，CD4+， and CD8 + T lymphocytes (P＜0.01)，and a positive correlation between the levels of serum miR- 431 and miR- 1247 and the levels of IL- 1 β， IL- 6， and TNF- α (P＜0.01). MiR- 431 and miR- 1247 were independent risk factors for stroke recurrence (P＜0.05)，and the AUC was 0.942 for stroke recurrence with a combined forecast of miR- 431 and miR- 1247. Conclusion： For patients with ischemic stroke with qi deficiency and blood stasis syndrome，dragon-tiger contending needling method can improve their motor function，quality of life，and immune function and reduce inflammatory reactions and the levels of miR- 431 and miR-1247 in serum. The above two miRNAs are independent risk factors for stroke recurrence and have high clinical predictive values.