目的：观察体外冲击波疗法（ESWT）联合针刺对脑卒中后上肢肌肉痉挛状态的疗效和安全性。方法： 伴上肢肌肉痉挛的脑卒中患者70例，随机分为对照组和ESWT组各35例。2组均予常规康复训练方法及针 刺治疗，ESWT组增加上肢肱二头肌EWST治疗，每周1次，治疗4周。采用改良Ashworth量表（MAS）、上肢 简化的 Fugl-Meyer 评分（U-FMA）、改良 Barthel 指数（MBI）及基于卒中病患者报告的临床结局评价量表 （PRO）分别于治疗前、治疗4周后对2组患者进行评估，并且应用PRO量表在治疗结束3月时评价远期临床 结局疗效。结果：治疗 4 周后，2 组患者 MAS、U-FMA、MBI 评分及 PRO 较组内治疗前均有显著改善（P< 0.05），ESWT组MAS、U-FMA、MBI评分及PRO评分较对照组明显改善（P<0.05）。治疗结束3月时随访，2组 的PRO积分较治疗前均有提高（P<0.05），ESWT组的PRO积分明显高于对照组（P<0.05）。结论：ESWT结合 针刺治疗可改善脑卒中后上肢痉挛，有效地提高患者的运动功能和日常生活能力，且有一定远期临床疗效。

To observe the efficacy and safety of extracorporeal shock wave therapy (ESWT) combined with acupuncture in the treatment of upper limb muscle spasm after stroke. Methods: A total of 70 patients with upper limb spastic hemiplegia post-stroke were randomly divided into control group and ESWT group with 35 patients in each. Both groups accepted routine rehabilitation training and acupuncture, and ESWT group additionally received extracorporeal shock wave therapy 1 time a week for 4 weeks. The 2 groups were assessed before and after 4 weeks of treatment with the modified Ashworth Scale (MAS), upper extremity Fugl-Meyer Assessment (U-FMA), modified Barthel Index (MBI), and Patient Reported Outcome (PRO) scores. Three months after treatment, the long-term clinical outcome were evaluated through PRO scores. Results: After 4 weeks of treatment, MAS, U-FMA, MBI, and PRO scores in the 2 groups were significantly improved compared to those before treatment (P<0.05), and the scores in the ESWT group were significantly better than those in the control group (P<0.05). At the 3-month follow-up, the PRO score of both groups had significantly improved compared to before treatment (P<0.05), and the PRO score of the ESWT group was significantly higher than that of the control group (P<0.05). Conclusion: ESWT combined with acupuncture can effectively improve motor function and activities of daily living and decrease upper limb spasm after stroke, and it can improve long-term clinical efficacy