现代仪器与医疗

间歇性θ爆发式刺激在脑卒中后上肢运动功能恢复中的有效性研究：一项随机对照试验

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陈松斌 ¹^,² , 黎晓彤 ² , 杨文清 ² , 陈文瑜 ² , 李海 ¹^,^*

现代仪器与医疗 | 专栏 2025,31(1): 16-21

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现代仪器与医疗 |专栏 2025 , 31 (1) : 16 -21

间歇性θ爆发式刺激在脑卒中后上肢运动功能恢复中的有效性研究：一项随机对照试验

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陈松斌¹^,², 黎晓彤², 杨文清², 陈文瑜², 李海¹^,^*

作者信息

^1.南方医科大学深圳医院康复医学科，深圳　518110

^2.广州市第一人民医院康复医学科，广州　510180

通讯作者:

李海，女，博士研究生，主任医师，研究方向：神经康复

作者简介:

陈松斌，男，硕士研究生，主管技师，研究方向：神经康复

The effectiveness of intermittent theta bust stimulation for upper limb motor recovery after stroke: A randomized controlled trial

Songbin Chen¹^,², Xiaotong Li², Wenqi Yang², Wenyu Chen², Hai Li¹^,^*

Affiliations

^1.Department of Rehabilitation Medicine, Shenzhen Hospital, Southern Medical University, Shenzhen 518110, China

^2.Department of Rehabilitation Medicine, Guangzhou First People's Hospital, Guangzhou 510180, China

出版时间: 2025-02-10 doi: 10.11876/mimt202501003

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摘要

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目的

探讨间歇性θ爆发式刺激（Intermittent Theta-Burst Stimulation，iTBS）对亚急性期脑梗死患者上肢运动功能的具体影响。

方法

本研究为一项随机对照试验，在2023年1月—2024年7月期间，从广州市第一人民医院康复医学科筛选并纳入了50例亚急性期脑梗死患者作为研究对象，随机分配至iTBS组（n=25）或假刺激组（n=25），iTBS组进行10次iTBS刺激，假刺激组进行10次假刺激干预，两组均接受常规康复治疗。在治疗前后进行Fugl-Meyer上肢运动功能评估量表（Fugl-Meyer Assessment of Upper Extremity，FMA-UE）、上肢动作研究量表（Action Research Arm Test，ARAT）、Wolf运动功能测试评分（Wolf Motor Function Test，WMFT）、改良Barthel指数（Modified Barthel Index，MBI）、上肢躯体运动诱发电位（Motor Evoked Potential，MEP）的测量，并对测量结果进行对比分析。

结果

治疗前后，两组FMA-UE评分比较，差异均无统计学意义（P>0.05）。治疗后，两组FMA-UE评分与本组治疗前比较，差异均有统计学意义（P<0.05）。治疗前后，两组动作评分比较，差异均无统计学意义（P>0.05）。治疗后，iTBS组的ARAT评分高于本组治疗前（P<0.05），而假刺激组与本组治疗前比较，差异无统计学意义（P>0.05）。治疗前后，两组WMFT评分比较，差异无统计学意义（P>0.05）。治疗后，iTBS组WMFT评分高于本组治疗前，差异有统计学意义（P<0.001），而假刺激组与本组治疗前比较，差异无统计学意义（P=0.532）。治疗前，两组患者MBI比较，差异无统计学意义（P>0.05）。治疗后，iTBS组MBI高于本组治疗前和同期假刺激组，差异有统计学意义（P=0.008）。治疗前后，在潜伏期和波幅方面，两组比较，差异无统计学意义（P>0.05）。治疗后，iTBS组的MEP潜伏期和波幅低于本组治疗前（P<0.05）。

结论

iTBS刺激能有效提升亚急性期脑卒中患者的上肢运动功能并促进功能独立性。这为将iTBS作为脑卒中患者标准康复方案中的有效辅助手段提供了有力的证据支持。

关键词

间歇性θ爆发式刺激 / 中风 / 运动功能 / 功能独立性 / 缺血性

Abstract

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Objective

The aim of this study is to explore the impact of intermittent theta burst stimulation (iTBS) on upper limb motor function in subacute cerebral infarction patients.

Methods

This study is a randomized controlled trial conducted from January 2023 to July 2024 at the Department of Rehabilitation Medicine, Guangzhou First People's Hospital. A total of 50 individuals were recruited for the study. Participants were randomly assigned to either the iTBS group (n=25) or sham stimulation group (n=25), each receiving 10 sessions of intervention, along with conventional rehabilitation therapy. The Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Wolf Motor Function Test (WMFT), Modified Barthel Index (MBI), and Motor Evoked Potential (MEP) were measured, and the results of these assessments were compared.

Results

Before and after treatment, there was no significant difference in FMA-UE scores between the two groups (P>0.05). After treatment, the FMA-UE score of the two groups was significantly different from that of the group before treatment (P<0.05). Before and after treatment, there was no significant difference in movement scores between the two groups (P>0.05). After treatment, the ARAT score of iTBS group was higher than that before treatment (P<0.05), but there was no significant difference between false stimulation group and before treatment (P>0.05). Before and after treatment, there was no significant difference in WMFT scores between the two groups (P>0.05). After treatment, WMFT score in iTBS group was higher than that before treatment, the difference was statistically significant (P<0.001), while there was no statistically significant difference between false stimulation group and before treatment (P>0.05). Before treatment, there was no significant difference in MBI between the two groups (P>0.05). After treatment, the MBI in iTBS group was higher than that before treatment and in spurious stimulation group at the same time, and the difference was statistically significant (P<0.05). Before and after treatment, there was no significant difference in latency and amplitude between the two groups (P>0.05). After treatment, the latency and amplitude of MEP in iTBS group were lower than before treatment (P<0.05).

Conclusion

iTBS stimulation improves upper extremity motor function and enhances functional independence of patients with subacute stroke. This provides strong evidence for the potential inclusion of iTBS as a key adjunctive therapy in stroke rehabilitation protocols.

Key words

Intermittent theta burst stimulation / Stroke / Motor function / Functional independence / Ischemic

引用本文

陈松斌, 黎晓彤, 杨文清, 陈文瑜, 李海. 间歇性θ爆发式刺激在脑卒中后上肢运动功能恢复中的有效性研究：一项随机对照试验. 现代仪器与医疗, 2025 , 31 (1) : 16 -21 . DOI: 10.11876/mimt202501003

Songbin Chen, Xiaotong Li, Wenqi Yang, Wenyu Chen, Hai Li. The effectiveness of intermittent theta bust stimulation for upper limb motor recovery after stroke: A randomized controlled trial[J]. Modern Instruments & Medical Treatment, 2025 , 31 (1) : 16 -21 . DOI: 10.11876/mimt202501003

基金

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深圳市科技计划(JCYJ20210324134401004)
深圳市医学研究专项资金(C2401028)
广东省医学科研基金(A2023367)
广州市卫生健康科技一般引导项目(20251A011002)

参考文献

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2025年第31卷第1期

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文章信息

doi: 10.11876/mimt202501003

首发时间：2026-10-23
出版时间：2025-02-10

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基金

深圳市科技计划(JCYJ20210324134401004)

深圳市医学研究专项资金(C2401028)

广东省医学科研基金(A2023367)

广州市卫生健康科技一般引导项目(20251A011002)

作者信息

^1.南方医科大学深圳医院康复医学科，深圳　518110

^2.广州市第一人民医院康复医学科，广州　510180

通讯作者:

李海，女，博士研究生，主任医师，研究方向：神经康复

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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