Abstract：Objective：To observe the clinical effect of Earth-Nourishing Acupuncture and Moxibustion Method combined with heat- sensitive moxibustion on spastic paralysis of limbs after stroke. Methods：A total of 124 cases of patients with spastic paralysis of limbs after stroke were divided into the routine treatment group and the acupuncture and moxibustion group according to the random number table method， with 62 cases in each group. The routine treatment group was treated with western medicine combined with rehabilitation training， the acupuncture and moxibustion group was treated with Earthnourishing Acupuncture and Moxibustion Method combined with heat-sensitive moxibustion based on the treatment of the routine treatment group. Both groups were treated for 3 months. The clinical effects，the scores of Clinical Spasticity Index (CSI)， Modified Ashworth Scale (MAS)， Fugl- Meyer Assessment (FMA)， Postural Assessment Scale for Stroke (PASS)， electromyographic indicators [surface electromyographic integral electromyographic values (iEMG) of the affected tibialis anterior muscle and gastrocnemius muscle during maximum isometric contraction， as well as the maximum amplitude of M wave (Mmax) and maximum amplitude of H wave (Hmax) of the affected limb]， three- dimensional gait parameters (stride frequency， stride speed， support phase， swing phase)， Kelch- like epichlorohydrinrelated protein-1 (Keap1)/nuclear factor E2-related factor 2 (Nrf2)/and antioxidant response element (ARE) signaling pathway were compared between the two groups. Results：After treatment，the total effective rate was 96.77% in the acupuncture and moxibustion group， higher than that of 82.26% in the routine treatment group (P＜0.05). The scores of CSI and MAS in the two groups were decreased when compared with those before treatment (P＜0.05)，and the scores of CSI and MAS in the acupuncture and moxibustion group were lower than those in the routine treatment group (P＜0.05). The iEMG of tibialis anterior muscle and gastrocnemius muscle in the two groups were increased when compared with those before treatment (P＜0.05)， and the iEMG of tibialis anterior muscle and gastrocnemius muscle in the acupuncture and moxibustion group were higher than those in the routine treatment group (P＜0.05). The values of Mmax and Hmax in the two groups were decreased when compared with those before treatment (P＜0.05)，and the values of Mmax and Hmax in the acupuncture and moxibustion group were lower than those in the routine treatment group (P＜0.05). The stride frequency，stride speed and support phase in the two groups were increased when compared with those before treatment (P＜0.05)，and stride frequency，stride speed and support phase in the acupuncture and moxibustion group were higher than those in the routine treatment group (P＜0.05). The swing phase in the two groups were decreased when compared with those before treatment (P＜0.05)， and the swing phase in the acupuncture and moxibustion group was lower than that in the routine treatment group (P＜0.05). The scores of FMA and PASS in the two groups were increased when compared with those before treatment (P＜0.05)，and the scores of FMA and PASS in the acupuncture and moxibustion group were higher than those in the routine treatment group (P＜0.05). The levels of Nrf2 and ARE in the two groups were increased when compared with those before treatment (P＜ 0.05)，and the levels of Nrf2 and ARE in the acupuncture and moxibustion group were higher than those in the routine treatment group (P＜0.05). The Keap1 levels in the two groups were decreased when compared with those before treatment (P＜0.05)，and the Keap1 level in the acupuncture and moxibustion group was lower than that in the routine treatment group (P＜0.05). Conclusion：Earth- Nourishing Acupuncture and Moxibustion Method combined with heat- sensitive moxibustion for spastic paralysis of limbs after stroke can regulate the Keap1/Nrf2/ARE signaling pathway， inhibit the excitability of spinal cord motor neurons， improve muscle tension， spasticity and three- dimensional gait parameters， and further improve clinical effects.