中文摘要：

目的研究经颅直流电刺激（tDCS）对缓解卒中患者上肢痉挛的疗效。方法采用前瞻性设计，将50例卒中上肢痉挛患者按数字法随机分为tDCS组和对照组，各25例。对tDCS组患者进行经颅直流电刺激治疗，方法为阴极刺激患侧初级运动感觉区，行结合运动训练，而对照组只进行运动训练。治疗时间均为1个月。比较两组患者治疗前、后改良Ashworth肌痉挛量表（MAS）、Fugl-Meyer运动功能评定（FMA）和日常生活活动能力Barthel指数（BI）的评定情况。FMA评分呈非正态分布，结果采用中位数（范围）表示。结果tDCS组MAS、FMA和BI治疗前、后比较，差异均有统计学意义，治疗前评分分别为2.1±0.9、12（5-44）、64±17，治疗后分别为1.5±0.8、20（5-50）、74±16，P〈0.01；对照组仅FMA计分治疗后与治疗前相比差异有统计学意义，治疗前为5（2-35），治疗后为8（4-37），P〈0.01结论tDCS可以缓解卒中后上肢痉挛，配合恰当的康复治疗，能够改善患者的肢体运动功能，并提高患者的日常生活能力。

英文摘要：

Objective To study the effect of transcranial direct current stimulation （tDCS） on relieving upper-limb spasticity after stroke. Methods Fifty patients alter stroke were divided randomly into tDCS group（ 25 cases） and control group （25 cases ）. The tDCS group received tDCS （ primary sensorimotor eortex of affected side with eathodal stimulalion） and physieal therapy, while the control group received physical therapy only. The treatments were carried on for 1 month. Modified Ashworth Scale of muscle spastieity （MAS） , Fugl-Meyer Assessment of Motor Recovery. （FMA） and Barthel Index （BI） were compared between the two groups before and after treatments. Results Compared with pre-treatrnent measurement of MAS, FMA and BI, there was significant difference for the tDCS group after treatment [pretreatment 2.1±0.9, 12（5-44） and 64±17, post-treatment 1.5±0.8, 20（5-50） and 74±16 respectively, P 〈0.01]. For the control group, there was significant difference of FMA only [pre-treatment 5（2 - 35）, post-treatment 8 （4 - 37） , P 〈 0.01]. Conclusion Upper-limb spasticity after stroke could be relieved by tDCS. Combined with proper rehabilitation treatment, tDCS could improve the motor tunetion and activities of daily living （ADL）.