Objective To compare the effect of acupuncture at ‘Quchi’（LI 11） and ‘Yanglingquan’（GB 34） acupoints

the modified Shaoyao Gancao Decoction（芍药甘草汤）

and the combination of two therapies on relieving limb spasticity after stroke

and to explore the possible mechanism. Methods Fifty-four SD rats were randomly divided into a blank group

a sham operation group

a model group

a combination therapy group

an herbal medicine group

and an electroacupuncture group

with nine rats in each group. The stroke rats model with limb spasticity was developed by modified Zea-Longa thread embolization and internal capsule syringe of N-methyl-D-aspartate receptor. After modeling

the rats in electroacupuncture group were given electroacupuncture at bilateral ‘Quchi’ and ‘Yanglingquan’ acupoints

30 minutes each time

once daily

for 5 days. The herbal medicine group was administered with 10 g/ml modified Shaoyao Gancao Decoction

once daily

for 5 days. The combination therapy group was given electroacupuncture and modified Shaoyao Gancao Decoction

in the same way with electroacupuncture group and herbal medicine group. The rats in model group and sham operation group were all blinding and received equal amount of normal saline by gavage. No intervention was implemented in the blank group. The behavioral scores were used to assess the neurological damage; the ultrastructure of hippocampal synapses was observed under electron microscope; and the mRNA and protein expression of synaptophysin（SYN） and postsynaptic compact 95（PSD95） in the hippocampus of rats were detected. Results There was significantly higher behavioral score in the model group compared to blank group and sham operation group（P<0.01）

as well as significantly lower score in all treatment groups compared to model group（P<0.05）; the comparison between six groups was not statistically significant（P>0.05）. Compared to blank group and sham operation group

the number of synapses significantly decreased in model group; the number of vesicles was reduced and the density was uneven; the front and back membranes and gaps were blurred; the terminal cytoplasm of postsynaptic cells was degenerated and dissolved significantly; and the density of the postsynaptic density zone also decreased. In all treatment groups

the structure of synapses was significantly relieved; and the synaptic cell vesicles in combination treatment group were clearly formulated with clear boundaries and regular gaps. The mRNA and protein expression of SYN and PSD95 were significantly lower in model group than blank group and sham operation group（P<0.01）

and were significantly higher in all treatment groups than model group（P<0.05; P<0.01）; the increase was more significant in combination treatment group compared to herbal medicine group and electroacupuncture group（P<0.05; P<0.01）. Conclusion Electroacupuncture at ‘Quchi’ and ‘Yanglingquan’ acupoints and modified Shaoyao Gancao Decoction

used alone or in combination

can alleviate the neurological damage caused by stroke limb spasticity

through improving synaptic ultrastructure and increasing plasticity protein expression; and the combination of electroacupuncture and herbal medicine is the most effective.