Influence of Transcranial Magnetic Stimulation Combined with Rehabilitation Therapy forUpper Limb Motor Function and Neurotransmiter of Patients with Stroke Hemiplegia/JIANG Yan， YANG Yong. //Medical Innovation of China，2025，22（16）：108-112

[Abstract]Objective： To investigate the influence of transcranial magnetic stimulation combined with rehabilitation therapy for upper limb motor function and neurotransmitterof patients with stroke hemiplegia. Method：A totalof 82 patients with stroke hemiplegia admitted tothe Third AfliatedPeople's Hospitalof Fujian University of Traditional Chinese Medicine from August 2O23 to August 2O24 were divided into control group （ n =41）and observation group（ n =41）according to the random number table method.The control group received conventional rehabilitation therapyfor stroke hemiplegia，and the observation group was treated with transcranial magnetic stimulation on the basisof the control group.The total effectiverate，upper limb motor function [functional test forthe hemiplegic upper extremity-Hong Kong （FTHUE-HK）and Fugl-Meyer assessment scale（FMA）]， muscle strength score，electromyographic parameters [root mean square （RMS）of biceps brachi and triceps brachii] and neurotransmiters [5-hydroxytryptamine （5-HT）and dopamine （DA）] before and after treatment were compared between the two groups.Result： The total efective rate of the observation group was significantly higher than that of the control group，the difference was statistically significant （ P lt;0.05）.Before treatment， there were no statistically significant diferences in theFTHUE-HK，FMA scores，muscle strength scores，and electromyographic parameters and neurotransmitter between the two groups （ Pgt;0.05 ）.After2and4weeksoftreatment，theFTHUE-HK，FMA scoresand musclestrength scores，RMSof biceps brachii and triceps brachii，neurotransmiter in the observation group were significantly higher than those in the control group，the differences were statistically significant （ P lt;0.05）.

Conclusion： The application efect of transcranial magnetic stimulation combined with rehabilitation therapy in patients with stroke hemiplegia is relatively good，which can significantly improve the upperlimb motor function and neurotransmitter expression of patients.

[Key Words]Transcranial magnetic stimulationRehabilitation therapy Stroke hemiplegiaUpper limb motor function Neurotransmitter

First-author'saddress：Department of Rehabilitation Medicine I，the Third Affiliated People's IospitalofFujianUniversityof Traditional ChineseMedicine，Fuzhou 35o1o8，China doi：10.3969/j.issn.1674-4985.2025.16.026

脑卒中偏瘫患者的肢体运动功能障碍显著，严重影响患者的日常生活及生存质量，是本病患者康复阶段的重点评估与干预内容。上肢运动功能作为脑卒中偏瘫患者亟待改善的方面，除相关肢体功能评分外，肌力、肌电参数等的检测同样具有重要价值，可反映上肢运动功能状态[1-2]。另外，神经递质是本病患者表达显著失衡的指标，其中5-羟色胺（5-HT）多巴胺（DA）等的异常改变尤为突出，是本病治疗过程中的重点监测项目，也是治疗效果的重要评估指标。近年来，临床中采用经颅磁刺激治疗脑卒中后遗症的研究不断增多[3-5]，但其与常规康复治疗联合应用对脑卒中偏瘫患者上肢运动功能及神经递质的影响研究不足。故本研究现探究经颅磁刺激结合康复治疗对脑卒中偏瘫患者上肢运动功能及神经递质的影响，报道如下。

1资料与方法

1.1一般资料

选择2023年8月一2024年8月福建中医药大学附属第三人民医院收治的82例脑卒中偏瘫患者。纳入标准：20＼～75岁；脑卒中偏瘫。排除标准：合并糖尿病、慢性阻塞性肺疾病；恶性肿瘤；既往经颅磁刺激治疗史；精神病史；手术史；临床资料不完整。根据随机数字表法将患者分为对照组（ n=41 ）与观察组（ n=41 ）。本次研究经福建中医药大学附属第三人民医院医学伦理学委员会批准。患者或家属知情同意本研究，且签署同意书。

1.2 方法

对照组进行常规脑卒中后偏瘫康复治疗：指导患者尽早进行功能锻炼，先进行床上被动肢体关节活动及肌肉牵伸治疗，后根据患者康复情况进行下床活动，从轻微活动开始，逐步适当负重训练。……