目的：探讨低频重复经颅磁刺激（repetitive transcranial magnetic stimulation，rTMS）与盐酸替扎尼定联 合疗法改善脑卒中患者上肢屈肌痉挛症状的临床有效性。方法：收集2020年12月至2023年12月入住北京 博爱医院接受康复治疗的60例脑卒中后伴上肢屈肌痉挛患者的临床资料，按治疗方法不同将其分为对照 组和观察组各30例，对照组采用口服盐酸替扎尼定治疗，观察组采用盐酸替扎尼定联合低频rTMS治疗，2 组患者均接受脑卒中二级预防治疗和常规康复训练。在治疗开始前和第4周末，利用改良Ashworth痉挛量 表（modified Ashworth Spasm Scale，MAS）测量上肢肘部屈肌的痉挛程度，运用上肢 Fugl-Meyer 运动量表 （the upper limb Fugl-Meyer assessment，UFMA）衡量上肢运动功能的恢复程度，并应用改良 Barthel 指数 （modified Barthel index，MBI）来量化患者的日常生活活动能力（activities of daily living，ADL）水平。同时 记录2组患者不良反应的发生情况。结果：治疗前，2组患者的MAS、UFMA 及 MBI 评分差异无统计学意 义（P＞0.05）。治疗第4周末，2组患者的以上三项评分较治疗前均改善，观察组的UFMA、MBI评分的升高 及 MAS评分的降低上均优于对照组，且差异均有统计学意义（P＜0.05）。2组患者不良反应的发生较少且 轻微，发生率均为6.67%，主要表现为嗜睡和头晕等。结论：低频rTMS联合盐酸替扎尼定治疗脑卒中后上 肢屈肌痉挛相比单用盐酸替扎尼定可有效降低患者偏瘫侧上肢屈肌肌张力，改善患者上肢运动功能，提高 患者生活质量，且安全性较好。

To investigate the clinical effectiveness of the combined therapy of low-frequency repetitive transcranial magnetic stimulation (rTMS) and Tizanidine Hydrochloride in alleviating upper limb flexor spasticity symptoms in stroke patients. Methods: Clinical data were collected from 60 patients with upper limb flexor spasticity following stroke who received rehabilitation treatment at Beijing Boai Hospital from December 2020 to December 2023. These patients were divided into a control group and an observation group, with 30 patients in each group, according to different treatment methods. The control group was treated with oral Tizanidine Hydrochloride, while the observation group received a combination of Tizanidine Hydrochloride and low-frequency rTMS. Both groups of patients received secondary stroke prevention treatment and conventional rehabilitation training. Before treatment initiation and at the end of the 4th week of treatment, the Modified Ashworth Spasm Scale (MAS) was used to measure the degree of spasticity in the upper limb elbow flexors. The Upper Limb Fugl-Meyer Assessment (UFMA) was employed to evaluate the recovery of upper limb motor function, and the Modified Barthel Index (MBI) was applied to quantify the level of activities of daily living (ADL) in patients. Additionally, the occurrence of adverse reactions in both groups was recorded. Results: Prior to treatment, there were no statistically significant differences in MAS, UFMA, and MBI scores between the two groups (P>0.05). At the end of the 4th week of treatment, all three scores in both groups improved compared to those before treatment. The observation group showed superior performance to the control group in terms of the increase in UFMA and MBI scores and the decrease in MAS score, with all differences being statistically significant (P<0.05). Adverse reactions in both groups were infrequent and mild, with an incidence rate of 6.67% in each group, primarily manifested as drowsiness and dizziness. Conclusion: Compared to the use of Tizanidine Hydrochloride alone, the combination of low-frequency rTMS and Tizanidine Hydrochloride is effective in reducing the muscle tone of the upper limb flexors on the hemiplegic side, improving upper limb motor function, enhancing patients' quality of life, and demonstrating good safety in the treatment of upper limb flexor spasticity after stroke.