基于闭环康复理论的重复经颅磁刺激治疗方案在脑卒中后神经源性膀胱患者中的应用

熊晓琴; 张晴; 雷雨迟; 杨芳; 柯洁

doi:10.14188/j.1671-8852.2025.1014

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基于闭环康复理论的重复经颅磁刺激治疗方案在脑卒中后神经源性膀胱患者中的应用

临床医学研究 | 更新时间：2026-11-05

- 基于闭环康复理论的重复经颅磁刺激治疗方案在脑卒中后神经源性膀胱患者中的应用
- Application of a repetitive transcranial magnetic stimulation treatment program based on closed⁃loop rehabilitation theory in patients with neurogenic bladder after stroke
- 武汉大学学报（医学版） 2026年47卷第10期页码：1366-1371
- 作者机构：
  
  1.武汉大学中南医院，神经康复科，湖北武汉 430071
  2.武汉大学中南医院，全科医学科，湖北武汉 430071
- 作者简介：
  
  熊晓琴，女，1989—，主管护师，主要从事康复护理方向研究，E‑mail：xiong5890030@sina.com。
  柯洁，E‑mail：137697339@qq.com。
- 基金信息：
  
  武汉大学临床护理专项科研培育基金项目(LCHL202323)
- DOI：10.14188/j.1671-8852.2025.1014
  中图分类号： R741.05
- 收稿：2025-09-08，
  
  纸质出版：2026-10-25
- 稿件说明：
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熊晓琴,张晴,雷雨迟等.基于闭环康复理论的重复经颅磁刺激治疗方案在脑卒中后神经源性膀胱患者中的应用[J].武汉大学学报（医学版）,2026,47(10):1366-1371.

XIONG Xiaoqin,ZHANG Qing,LEI Yuchi,et al.Application of a repetitive transcranial magnetic stimulation treatment program based on closed⁃loop rehabilitation theory in patients with neurogenic bladder after stroke[J].Medical Journal of Wuhan University,2026,47(10):1366-1371.
熊晓琴,张晴,雷雨迟等.基于闭环康复理论的重复经颅磁刺激治疗方案在脑卒中后神经源性膀胱患者中的应用[J].武汉大学学报（医学版）,2026,47(10):1366-1371. DOI： 10.14188/j.1671-8852.2025.1014.

XIONG Xiaoqin,ZHANG Qing,LEI Yuchi,et al.Application of a repetitive transcranial magnetic stimulation treatment program based on closed⁃loop rehabilitation theory in patients with neurogenic bladder after stroke[J].Medical Journal of Wuhan University,2026,47(10):1366-1371. DOI： 10.14188/j.1671-8852.2025.1014.

摘要

目的

探索基于闭环康复理论的治疗方案对脑卒中患者神经源性膀胱的治疗效果。

方法

选择2023年1月—2024年6月武汉大学中南医院康复科64例脑卒中后神经源性膀胱尿潴留患者，采用计算机生成随机数字分为两组，试验组使用间歇导尿联合重复经颅磁刺激(rTMS)的治疗方案，对照组使用间歇导尿及假性rTMS治疗，两组每周接受7次rTMS(或假性rTMS)治疗，经过3周治疗后，比较两组患者之间残余尿量(RUV)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)、间歇导尿次数，恢复自主排尿例数，并发症情况等指标。

结果

治疗后试验组患者的RUV、IPSS、QOL，间歇导尿次数，自主排尿恢复率等指标的改善程度均优于对照组，结果比较差异存在统计学意义（

0.05）；治疗后两组在并发症方面差异无统计学意义（

0.05）。

结论

基于闭环康复理论的治疗方案能减少神经源性膀胱尿潴留患者的残余尿量，有效改善患者的排尿情况和生活质量。

Abstract

Objective

To investigate the therapeutic effects of a repetitive transcranial magnetic stimulation (rTMS) treatment program based on closed⁃loop rehabilitation theory on neurogenic bladder in stroke patients.

Methods

Sixty⁃four stroke patients with neurogenic bladder and urinary retention admitted to the Department of Rehabilitation

Zhongnan Hospital of Wuhan University from January 2023 to June 2024 were selected and randomly divided into two groups using computer⁃generated random numbers. The experimental group received intermittent catheterization combined with rTMS

while the control group received intermittent catheterization combined with sham rTMS. Both groups received rTMS （or sham rTMS） treatment 7 times a week for 3 weeks. After the 3⁃week treatment

the residual urine volume (RUV)

international prostate symptom score (IPSS)

quality of life (QOL) score

frequency of intermittent catheterization

rate of restored spontaneous urination

and incidence of complications were compared between the two groups.

Results

After treatment

the experimental group showed significantly greater improvements in RUV

IPSS

QOL score

and reduction in the frequency of intermittent catheterization compared with the control group. Additionally

the rate of restored spontaneous urination was significantly higher in the experimental group (all

0.05). However

there was no significant difference in the incidence of complications between the two groups (

0.05).

Conclusion

The treatment program based on closed⁃loop rehabilitation theory can effectively reduce residual urine volume

improve urination function

and enhance the quality of life in patients with neurogenic urinary retention after stroke.

关键词

Keywords

references

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