目的观察重复性外周磁刺激（RPMS）对脑卒中患者上肢屈肘肌痉挛的治疗疗效。 方法选取脑卒中偏瘫伴患侧上肢肱二头肌痉挛患者60例，采用随机数字表法将其分为观察组及对照组，每组30例。2组患者均给予常规药物治疗及康复训练，观察组患者在此基础上辅以重复性外周磁刺激治疗，对照组则辅以安慰性磁刺激治疗。于治疗前、治疗4周后分别采用表面肌电图测量肘关节被动伸展时肱二头肌积分肌电值（IEMG）；采用Fugl-Meyer运动功能评分(FMA)上肢部分评定患者上肢运动功能情况；采用改良Barthel指数（MBI）评定患者日常生活活动能力改善情况。 结果治疗4周后观察组及对照组患者肘关节被动伸展时肱二头肌IEMG［分别为(24.7±12.5)μV？s和(32.3±13.7)μV？s］、上肢FMA评分［分别(46.3±6.9)分和（41.4±7.7）分］及MBI评分［分别为(63.0±11.0)分和(56.2±11.6)分］均较治疗前明显改善（P<0.05），并且上述疗效指标均以观察组患者的改善幅度较显著，与对照组间差异均具有统计学意义（P<0.05）。 结论重复性外周磁刺激可减轻脑卒中患者偏瘫侧上肢屈肘肌痉挛，有助于改善患者上肢运动功能及日常生活活动能力，该疗法值得在脑卒中偏瘫患者中推广、应用。 Objective To explore the effects of repeated magnetic stimulation for improving upper limb spasticity in stroke survivors. MethodsSixty stroke survivors were randomly divided into a treatment group and a control group with 30 in each. All of the patients in both groups received basic medication and conventional rehabilitation treatment. In addition, the patients in the treatment group were given repetitive magnetic stimulation of the biceps brachii on the hemiplegic side, while the patients in the control group were given sham stimulation. Before and after 4 weeks of treatment, integrated electromyograms (IEMGs) of the biceps brachii were recorded using surface electromyography. The subjects′ upper limb motor function was evaluated using the Fugl-Meyer upper extremity assessment (FMA), and ability in the activities of daily of life was evaluated using the modified Barthel index. ResultsBefore the intervention there was no signification difference between the two groups in terms of any of the assessments. After 4 weeks of treatment, the average IEMG of the biceps brachii had improved significantly in both groups compared to those before treatment, as had the average FMA and Barthel index scores, but the improvements in the treatment group were all significantly greater, on average, than those in the control group. ConclusionRepetitive peripheral magnetic stimulation can reduce spasticity of the elbow flexors after a stroke and improve upper limb motor function and ability in the activities of daily life. It is worthy of applying in clinical practice
