Objective To observe the curative effect of Shugan Tiaoshen（soothing liver and regulating mind）acupuncture combined with repetitive transcranial magnetic stimulation（rTMS） in the treatment of post-stroke depression（PSD）

and to explore its mechanism. Methods Ninety patients of PSD were randomly divided into an acupuncture+rTMS combination group（30 cases）

a rTMS combination group（30 cases

1 case dropped off） and a western medication group（30 cases

1 case dropped off）. The western medication group was treated with escitalopram oxalate tablets

10 mg orally each time

once a day; on the basis of the treatment in the western medication group

the rTMS combination group was additionally given rTMS

and the frequency was 20 Hz

20 min each time

once a day

5 times a week; on the basis of the treatment in the r TMS combination group

the acupuncture+rTMS combination group was additionally treated with Shugan Tiaoshen acupuncture at Baihui（GV 20）

Sishencong（EX-HN 1）

Yintang（GV 24+）

Shenting（GV 24）

etc. for 40 min each time

once a day

weekly 5 times

and each group was treated for 4 weeks. Before and after treatment

the scores of Hamilton depression scale-17（HAMD-17）

Montreal cognitive assessment scale（MoCA）

Pittsburgh sleep quality index（PSQI） were observed

and serum levels of 5-hydroxytryptamine（5-HT） and brain-derived neurotrophic factor（BDNF） were detected in each group. Results After treatment

the HAMD-17 scores in the three groups were lower than those before treatment（P<0.01）

and the PSQI scores in the acupuncture+rTMS combination group and the rTMS combination group were lower than those before treatment（P<0.01）; the above indexes in the acupuncture+rTMS combination group and the rTMS combination group were lower than those in the western medication group（P<0.05）

and the PSQI score in the acupuncture+rTMS combination group was lower than that in the rTMS combination group（P<0.05）. After treatment

the MoCA scores and serum BDNF levels in the acupuncture+rTMS combination group and the rTMS combination group were higher than those before treatment（P<0.01）

and the serum 5-HT levels in the three groups were higher than those before treatment（P<0.01）;and the above indexes in the acupuncture+rTMS combination group and the rTMS combination group were higher than those in the western medication group（P<0.05）

and which in the acupuncture+rTMS combination group were higher than those in the rTMS combination group（P<0.05）. Conclusion On the basis of western medication escitalopram oxalate

the addition of Shugan Tiaoshen acupuncture combined with rTMS therapy can effectively improve cognitive function and sleep quality in patients with PSD

and the effect is better than that of western medication alone or rTMS combined with western medication.Its mechanism of action may be related to the increase of peripheral serum 5-HT and BDNF levels.