目的：探讨重复经颅磁刺激（rTMS）联合神经肌肉电刺激（NMES）对单侧脑卒中吞咽障碍的治疗作 用。方法：单侧卒中后吞咽障碍患者96例，随机分为（rTMS+NMS）组、rTMS组、NMES组，每组32例，分别 给予（真rTMS+真NMES）、（真rTMS+假NMES）和（假rTMS+真NMES）治疗。在基线、治疗2周后、治疗结 束1月后采用标准吞咽功能评估量表（SSA）、吞咽 X 线荧光透视检查（VFSS）下Rosenbek渗透-误吸量表评 估（PAS）评估吞咽功能。结果：90例进入结果分析，3组在基线、治疗2周后及治疗1月后，SSA评分（F(2,86)= 322.85；P<0.001）、PAS评分（F(2,86)=482.44；P<0.001）均显著下降；治疗2周后（rTMS+NMES）联合组PAS评分 及SSA评分均低于rTMS组（PSSA=0.031，PPAS=0.000），且低于NMES组（PSSA=0.007，PPAS=0.001）。结论：患侧 高频rTMS 刺激后立即进行NMES治疗可以显著改善吞咽功能，其疗效优于单独rTMS治疗及NMES治疗。

To assess therapeutic effect of repetitive transcranial magnetic stimulation (rTMS) combined with neuromuscular electrical stimulation (NMES) on dysphagia after unilateral stroke. Methods: A total of 96 patients with poststroke dysphagia were enrolled. They were randomly divided into the (rTMS + NMES) group, rTMS group, or NMES group (each n=32) and treated respectively with rTMS and NMES, rTMS and sham NMES, or sham rTMS and NMES. At baseline, 2 weeks after treatment, and 1 month after treatment, the standardized swallowing assessment (SSA), videofluoroscopic swallow study (VFSS), and Rosenbek’s penetration aspiration scale (PAS) were used to assess swallowing function. Results: Ninety cases were enrolled in the analysis. At baseline, 2 weeks after treatment, and 1 month after treatment, SSA score (F(2,86)= 322.85, P<0.001) and PAS score (F(2,86)=482.44, P<0.001) were significantly decreased in all 3 groups. After 2 weeks of treatment, PAS and SSA scores in the (rTMS+NMES) group were lower than that of both the rTMS group (PSSA=0.031, PPAS=0.000) and NMES group (PSSA=0.007, PPAS=0.001). Conclusion: High frequency rTMS stimulation followed immediately by NMES therapy in the affected side can significantly improve swallowing function, and its efficacy is superior to that of rTMS or NMES alone.