中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (27): 7176-7181.doi: 10.12307/2026.443

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

低频重复经颅磁刺激改善脑卒中患者肢体运动功能与上肢肌肉痉挛的Meta分析

任鹏博1，李婷文2，蔡  峰3，张建华3   

  1. 1常州大学怀德学院，江苏省靖江市   214500；2闽南师范大学体育学院，福建省漳州市   363000；3西北师范大学体育学院，甘肃省兰州市   730070
  • 收稿日期:2025-11-18 接受日期:2026-01-23 出版日期:2026-09-28 发布日期:2026-05-25
  • 通讯作者: 李婷文，博士，讲师，硕士生导师，闽南师范大学体育学院，福建省漳州市 363000 并列通讯作者：张建华，硕士，二级教授，博士生导师，西北师范大学体育学院，甘肃省兰州市 730070
  • 作者简介:任鹏博，男，1988年生，甘肃省正宁市人，汉族，硕士，讲师，主要从事运动评估与健康促进研究。
  • 基金资助:
    国家社科基金项目(20BTY090)，项目负责人：张建华；教育部人文社会科学研究基金项目(24YJCZH145)，项目负责人：李婷文； 福建省社会科学研究基金项目(FJ2022C014) ，项目负责人：李婷文

Low-frequency repetitive transcranial magnetic stimulation improves limb motor function and upper limb muscles in stroke patients: a meta-analysis

Ren Pengbo1, Li Tingwen2, Cai Feng3, Zhang Jianhua3   

  1. 1Changzhou University Huaide College, Jingjiang 214500, Jiangsu Province, China; 2School of Physical Education, Minnan Normal University, Zhangzhou 363000, Fujian Province, China; 3School of Physical Education, Northwest Normal University, Lanzhou 730070, Gansu Province, China
  • Received:2025-11-18 Accepted:2026-01-23 Online:2026-09-28 Published:2026-05-25
  • Contact: Li Tingwen, PhD, Lecturer, Master’s supervisor, School of Physical Education, Minnan Normal University, Zhangzhou 363000, Fujian Province, China Co-corresponding author: Zhang Jianhua, MS, Professor (Level II), Doctoral supervisor, School of Physical Education, Northwest Normal University, Lanzhou 730070, Gansu Province, China
  • About author:Ren Pengbo, MS, Lecturer, Changzhou University Huaide College, Jingjiang 214500, Jiangsu Province, China
  • Supported by:
    National Social Science Foundation of China, No. 20BTY090 (to ZJH); Ministry of Education Humanities and Social Sciences Research Foundation, No. 24YJCZH145 (to LTW); Fujian Provincial Social Science Research Foundation, No. FJ2022C014 (to LTW)

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摘要：


文题释义：

重复经颅磁刺激技术：是经颅磁刺激技术的一种特定应用形式，指以固定频率重复发放脉冲的刺激模式(如 1 Hz、10 Hz 等)，通过连续、规律的脉冲序列对大脑皮质进行持续性调控，达到兴奋或抑制局部大脑皮质功能的目的，具有无创、无痛的特点。
Brunnstrom手运动功能评分：用于评估患者上肢和下肢的功能状态，包括痉挛程度、共同运动和分离运动的表现。Brunnstrom手运动功能评分分为6个阶段，从无随意运动到协调运动正常或接近正常，评定内容包括手指抓握、伸展、关节运动等。

摘要
目的：低频重复经颅磁刺激可显著改善脑卒中患者的上肢运动功能，但该技术改善脑卒中患者上肢肌肉痉挛的效果仍存在争议。因此，此次研究系统评价低频重复经颅磁刺激对脑卒中患者肢体运动功能与上肢肌肉痉挛的影响。
方法：通过计算机检索PubMed、EMBASE、ScienceDirect、Cochrane Library、Web of Science、中国期刊全文数据库、维普全文数据库、万方数据库以及中国生物医学文献数据库，筛选出低频重复经颅磁刺激治疗脑卒中患者的随机对照试验，试验组进行低频重复经颅磁刺激治疗或低频重复经颅磁刺激联合物理治疗/常规康复治疗，对照组进行常规康复治疗、假刺激或物理治疗，采用RevMan 5.3统计软件进行Meta分析。
结果：共纳入8篇高质量研究，涉及502例患者。Meta分析结果显示，与对照组相比，试验组Brunnstrom手运动功能评分、Fugl-Meyer运动功能量表评分、改良Barthel指数及Berg平衡量表评分均高于对照组[MD=1.51，95%CI(1.22，1.80)，P < 0.000 01；MD=5.69，95%CI(3.18，8.20)，P < 0.000 01；MD=8.55，95%CI(3.27，13.84)，P=0.002；MD=5.72，95%CI(3.13，8.32)，P < 0.000 1]，两组改良Ashworth评定评分比较差异无显著性意义[MD=-0.11，95%CI(-0.17，0.85)，P=0.82]。
结论：低频重复经颅磁刺激能有效改善脑卒中患者的肢体运动功能，尤其是提高手运动功能、肢体整体运动功能、日常生活活动能力和平衡能力方面的效果显著，然而在改善上肢肌肉痉挛方面未显出明显优势。该结论仍需要更多具有较高方法学质量、更长干预时间的研究和随访来进一步验证。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词:

Abstract: OBJECTIVE: Low-frequency repetitive transcranial magnetic stimulation significantly improves upper limb motor function in stroke patients, but its efficacy in reducing upper limb muscle spasticity remains controversial. Therefore, this study systematically evaluated the effects of low-frequency repetitive transcranial magnetic stimulation on limb motor function and upper limb muscle spasticity in stroke patients.
METHODS:  Utilizing computer search technology, this study meticulously screened randomized controlled studies targeting stroke patients undergoing low-frequency repetitive transcranial magnetic stimulation treatment from databases such as PubMed, EMBASE, ScienceDirect, Cochrane Library, Web of Science, CNKI, VIP Information, WanFang Data, and China Biology Medicine (CBM). The experimental group received low-frequency repetitive transcranial magnetic stimulation therapy, or low-frequency repetitive transcranial magnetic stimulation combined with physical therapy or conventional rehabilitation therapy. The control group received conventional rehabilitation therapy, sham stimulation, or physical therapy. Subsequently, a meta-analysis was conducted on these studies using the RevMan 5.3 statistical software package.
RESULTS: This meta-analysis included a total of 8 high-quality randomized controlled trials, encompassing 502 patients. The meta-analysis results revealed that compared with the control group, patients receiving low-frequency repetitive transcranial magnetic stimulation exhibited significant improvements in Brunnstrom hand function scores [mean difference (MD)=1.51, 95% confidence interval (CI): 1.22 to 1.80, P < 0.000 01], Fugl-Meyer motor function scores (MD=5.69, 95% CI: 3.18 to 8.20, P < 0.000 01), Modified Barthel Index scores (MD=8.55, 95% CI: 3.27 to 13.84, P=0.002), and Berg Balance Scale scores (MD=5.72, 95% CI: 3.13 to 8.32, P < 0.000 1). However, comparisons of Modified Ashworth Scale scores between the two groups after treatment showed no statistically significant difference (MD=-0.11, 95% CI: -0.17 to 0.85, P=0.82).
CONCLUSION: Low-frequency repetitive transcranial magnetic stimulation can significantly improve the limb motor function and upper limb muscle condition in stroke patients, particularly enhancing hand motor function, overall motor ability, daily living self-care skills, and balance capacity. However, in terms of alleviating upper limb muscle spasticity, low-frequency repetitive transcranial magnetic stimulation has not demonstrated a clear advantage. Nevertheless, this conclusion still requires further verification through more high-quality studies with longer intervention durations and follow-up data.

Key words: ">low-frequency repetitive transcranial magnetic stimulation, limb motor function, upper limb muscles, stroke, muscle tension, meta-analysis

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