目的：研究体外冲击波疗法（extracorporeal shock wave therapy，ESWT）联合深部肌肉刺激仪（deep
muscle stimulator，DMS）对脑卒中患者小腿三头肌痉挛的影响。方法：69例卒中伴小腿三头肌痉挛患者随
机分为DMS组、ESWT组、综合组，每组23例。3组患者均接受常规康复手法治疗，未服用降低肌张力药物，
DMS组另予DMS治疗，ESWT组另予ESWT治疗，综合组给予DMS和ESWT治疗，共治疗4周。3组患者
在治疗前后均给予踝关节综合痉挛量表（compopsite spasticity scale，CSS）、改良 Ashworth 量表（modified
Ashworth scale，MAS）、踝背伸主动活动度（active ankle range of motion，AROM）、下肢Fugl-Meyer运动功能
评定（Fugl-Meyer assessment，FMA）评定，并比较分析。结果：治疗第2、4周后，3组患者CSS评分、MAS评
分、AROM度数、下肢FMA评分较治疗前均有改善（P＜0.05），且3组患者第4周各项评分均优于同组第2周
各项评分（P＜0.05）；与 DMS组相比，ESWT组的所有指标均有不同程度的改善（P＜0.05）；与DMS组、ES
WT组相比，综合组的所有指标得分均明显改善（P＜0.05）。结论：ESWT联合DMS能显著改善脑卒中患者
小腿三头肌痉挛，提高下肢功能，且疗程越长疗效越佳。
To investigate the effects of extracorporeal shock wave therapy (ESWT) combined with
deep muscle stimulator (DMS) on triceps surae spasticity in stroke patients. Methods: A total of 69 stroke
patients with triceps surae spasticity were randomly divided into the DMS group, the ESWT group, and the
combination group, with 23 cases in each group. All three groups received conventional rehabilitation manual
therapy and did not take any anti-spasticity medications. The DMS group received additional DMS treatment, the
ESWT group received additional ESWT treatment, and the combination group received both DMS and ESWT
treatment. The treatment course lasted for 4 weeks. All three groups were assessed before and after treatment
using the Composite Spasticity Scale (CSS), the Modified Ashworth Scale (MAS), the active range of motion of
ankle dorsiflexion (AROM), and the Fugl-Meyer Assessment (FMA) for the lower extremities. The results were
compared and analyzed among the three groups. Results: At the 2nd and 4th weeks of treatment, the CSS
scores, MAS scores, AROM values, and lower extremity FMA scores of all three groups were significantly
improved compared with those before treatment (P<0.05), and all outcome measures at the 4th week were
significantly better than those at the 2nd week within each group (P<0.05). Compared with the DMS group, the
ESWT group showed varying degrees of improvement in all outcome measures (P<0.05). Compared with both
the DMS group and the ESWT group, the combination group showed significantly higher scores in all outcome
measures (P<0.05). Conclusion: ESWT combined with DMS can significantly alleviate triceps surae spasticity
and improve lower extremity function in stroke patients, with better therapeutic effects observed with a longer
treatment duration.
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