目的：探讨上肢康复机器人联合双侧序贯重复经颅磁刺激（rTMS）促进脑卒中患者康复的效果。方法：选取2022年1月— 2024 年 8 月达州市中西医结合医院收治的脑卒中住院患者 82 例，采用随机数字表法分为研究组（n=41）和对照组（n=41）。 对照组给予对症药物治疗及常规康复干预，研究组在对照组基础上接受上肢康复机器人训练联合双侧序贯 rTMS 干预。比较 两组在干预前、后上肢运动与手功能、腕关节活动度、运动诱发电位（MEP）水平的变化。结果：干预前，两组上述指标水 平比较，差异均无统计学意义（P>0.05）。干预后，研究组上肢运动功能 FMA-UE 评分、手功能 UEFI 评分、日常生活能力 MBI 评分高于对照组（P<0.05）；腕关节活动度的掌屈、背伸、桡偏、尺偏各项评分高于对照组（P<0.05）。干预后，研究 组 MEP 潜伏期、中枢运动传导时间低于对照组（P<0.05），MEP 波幅高于对照组（P<0.05）。干预后，两组患者上肢肌张 力各项指标较干预前均有不同程度改善（P<0.05），研究组改善程度更显著（P<0.05）。结论：上肢康复机器人联合双侧序 贯 rTMS 可促进脑卒中患者康复，能显著改善患者的上肢运动及手功能，提高腕关节活动度及改善运动诱发电位。

Objective: To explore the effect of upper limb rehabilitation robot combined with bilateral sequential repetitive transcranial magnetic stimulation (rTMS) on promoting rehabilitation of stroke patients. Methods: 82 stroke patients admitted to Dazhou Integrated TCM & Western Medicine Hospital from January 2022 to August 2024 were selected. They were divided into the study group (n=41) and the control group (n=41) using a random number table. Patients in the control group were given symptomatic drug treatment and conventional rehabilitation intervention, while the study group received upper limb rehabilitation robot training combined with bilateral sequential rTMS intervention on the basis of the control group. The changes of upper limb movement and hand function, wrist range of motion, and motor evoked potential (MEP) levels before and after intervention were compared between the two groups. Results: Before intervention, there was no significant difference in the above indicators between the two groups (P>0.05). After intervention, the FMAUE score of upper limb motor function, UEFI score of hand function, MBI score for activities of daily living, and the scores of each item of wrist range of motion (palmar flexion, dorsal extension, radial deviation, and ulnar deviation) in the study group were higher than those in the control group (P<0.05). After intervention, the MEP latency and central motor conduction time of the study group were lower than those of the control group (P<0.05), and the MEP wave amplitude of the study group was higher than that of the control group (P<0.05). All indicators of upper limb muscle tone improved to certain degree in both groups compared with that before intervention (P<0.05), and the improvement was more significant in the study group (P<0.05). Conclusion: Upper limb rehabilitation robot combined with bilateral sequential rTMS can promote the rehabilitation of stroke patients, significantly improve patients’ upper limb movement and hand function, increase wrist range of motion, and improve motor evoked potential.

基金项目：四川省中医药管理局课题（2020LC0106） 

Foundation Item: Project of Sichuan Provincial Administration of Traditional Chinese Medicine (2020LC0106) 

引用格式：熊兴娟，刘勋，王月，等 . 上肢康复机器人联合双侧序贯 rTMS 在促进脑卒中患者康复中的效果 [J]. 机器人外科学杂志（中英文）， 2025，6（4）：628-632. 

Citation: XIONG X J, LIU X, WANG Y, et al. Effect of upper limb rehabilitation robot combined with bilateral sequential rTMS on promoting  rehabilitation of stroke patients[J].Chinese Journal of Robotic Surgery, 2025, 6(4): 628-632. 

通讯作者（Corresponding Author）：刘勋（LIU Xun），Email：287954103@qq.com

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