To observe the effects of Tuina on peripheral blood inflammatory mediators and peripheral blood mononuclear cell(PBMC) apoptosis and subtype balance in exercise-induced fatigue(EF) rats and explore the mechanism of Tuina in improving exercise-induced immune-inflammatory injury.Methods:Thirty Wistar rats were selected and six rats were assigned to the blank group.The remaining rats underwent model induction using a treadmill exercise method.Sixteen model rats were divided into a model group(n=8) and a Tuina group(n=8).The blank group did not undergo any treatment.The model group rested in the cage after exhaustive exercise every day，and the Tuina group received Tuina intervention once a day after exhaustive exercise for a total of 21 days.Enzyme-linked immunosorbent assay(ELISA) was used to measure the content of peripheral blood interleukin(IL)-1β and tumor necrosis factor(TNF)-α，while flow cytometry was used to measure PBMC apoptosis and Th1/Th2，Th17/Treg subtype distribution.Results:The content of IL-1β and TNF-α in the peripheral blood of the model group significantly increased as compared with that in the blank group(P<0.01).The content of IL-1β and TNF-α in the peripheral blood of the Tuina group significantly decreased as compared with that in the model group(P<0.01).The PBMC apoptosis rate in the model group was significantly higher than that in the blank group(P<0.01)，while the PBMC apoptosis rate in the Tuina group was significantly lower than that in the model group(P<0.05).Compared with the blank group，the model group showed increased Th1 and Th17 cells in PBMCs，decreased Th2 and regulatory T(Treg) cells，and shifted Th1 and Th17 cells，resulting in Th1/Th2 and Th17/Treg cell ratio up-regulation(P<0.01).Compared with the model group，the Th1/Th2 and Th17/Treg cell ratios in PBMCs of the Tuina group were significantly down-regulated(P<0.01，P<0.05).Conclusion:Tuina can improve the immunoinflammatory status of peripheral blood in EF rats，showing the effects of anti-inflammatory，anti-apoptosis，and immune regulation.