脑-肢协同康复模式在脑卒中上肢功能障碍中的临床应用进展*

程联凤; 严璐; 刘永香; 张沙沙; 田楠; 罗世芬

doi:10.16833/j.cnki.jbmc.2026.05.014

包头医学院学报 >

2026 , Vol. 42 >Issue 5: 83 - 88

DOI: https://doi.org/10.16833/j.cnki.jbmc.2026.05.014

综述

脑-肢协同康复模式在脑卒中上肢功能障碍中的临床应用进展^*

程联凤 ,
严璐 ,
刘永香 ,
张沙沙 ,
田楠 ,
罗世芬

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贵州中医药大学,贵州贵阳 550025

严璐

收稿日期: 2025-12-12

网络出版日期: 2026-07-16

基金资助

^*贵州省研究生教育创新计划项目建设(2024YJSKYJJ369)

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Clinical application progress of brain-limb collaborative rehabilitation technology model in upper limb dysfunction after stroke

CHENG Lianfeng ,
YAN Lu ,
LIU Yongxiang ,
ZHANG Shasha ,
TIAN Nan ,
LUO Shifen

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School of Nursing, Guizhou University of Traditional Chinese Medicine, Guiyang 550025,China

Received date: 2025-12-12

Online published: 2026-07-16

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摘要

脑卒中后上肢功能障碍严重影响患者的日常生活能力和生活质量,其康复治疗是临床重点。基于脑可塑性理论,脑-肢协同康复模式整合中枢与外周干预技术,通过多靶点协同刺激促进神经功能重组与运动功能恢复。该模式按干预技术可分为现代康复、中医康复及中西医结合康复三类;按时序可分为同步与非同步两种干预策略。本文系统综述脑-肢协同康复模式(brain-limb collaborative rehabilitation model)的基本内涵、分类方法以及其在脑卒中上肢康复中的临床应用,涵盖重复经颅磁刺激、经颅直流电刺激、脑机接口、镜像疗法以及头针等技术的联合应用,以期为患者提供更精准的康复方案。

关键词： 脑-肢协同康复模式; 脑卒中; 上肢功能障碍; 应用进展

本文引用格式

程联凤 , 严璐 , 刘永香 , 张沙沙 , 田楠 , 罗世芬 . 脑-肢协同康复模式在脑卒中上肢功能障碍中的临床应用进展^*[J]. 包头医学院学报, 2026 , 42(5) : 83 -88 . DOI: 10.16833/j.cnki.jbmc.2026.05.014

Abstract

Upper limb dysfunction after stroke seriously affects the daily living ability and quality of life of patients, and its rehabilitation treatment is the clinical focus. Based on the theory of brain plasticity, the brain-limb collaborative rehabilitation model integrates central and peripheral intervention techniques to promote neurological function reorganization and motor function recovery through multi-target collaborative stimulation. According to the intervention technology, the model can be divided into three categories: modern rehabilitation, traditional Chinese medicine rehabilitation and integrated traditional Chinese and Western medicine. According to the timing, it can be divided into synchronous and non-synchronous strategies. This paper systematically reviews the basic connotation, classification methods and clinical application of brain-limb collaborative rehabilitation technology (BLCRM) in upper limb rehabilitation of stroke, covering the combined application of repetitive transcranial magnetic stimulation, transcranial direct current stimulation, brain-computer interface, mirror therapy and scalp acupuncture, in order to provide more accurate rehabilitation programs for patients.

Key words： Brain-limb collaborative rehabilitation technology; Stroke; Upper limb dysfunction; Application progress

参考文献

[1] 宋丹, 李世杰, 宋研博, 等. 黄芪治疗缺血性脑卒中的研究进展[J/OL]. 中华中医药学刊, [2025-1-17][2025-12-08]. https://link.cnki.net/urlid/21.1546.R.20250507.1009.004.
[2] 刘致含, 吴学森, 张景春, 等. 基于用户体验蜂窝模型探讨任务导向性脑卒中上肢康复机器人训练体验的质性研究[J]. 中国康复医学杂志, 2025, 40(4): 508-515.
[3] Wen X, Li L, Li Xl, et al. Therapeutic role of additional mirror therapy on the recovery of upper extremity motor function after stroke: a single_blind, randomized controlled trial[J]. Neural Plast, 2022, 2022: 8966920.
[4] 燕铁斌. 积极开展“脑-肢协同治疗技术”的临床应用研究[J]. 中国康复医学杂志, 2021, 36(10): 1195-1197.
[5] 许琦, 张芸, 燕铁斌. 中西医结合脑-肢体协同调控技术治疗脑病的康复模式构建[J]. 中华中医药杂志, 2023, 38(11): 5357-5360.
[6] 燕铁斌, 孙倩倩. 推进中西医结合脑-肢协同康复技术模式的构建[J]. 中国康复医学杂志, 2024, 39(4): 457-460.
[7] 贾杰. “中枢-外周-中枢” 闭环康复:脑卒中后手功能康复新理念[J]. 中国康复医学杂志, 2016, 31(11): 1180-1182.
[8] 黄美松. 本体感觉神经肌肉促进技术联合重复经颅磁刺激对缺血性脑卒中上肢功能障碍患者的影响[J]. 中国医学创新, 2025, 22(8): 6-10.
[9] 刘鹏程, 屈萌艰, 龙黎萍, 等. 多重感觉刺激模态的气电手训练系统联合低频重复经颅磁刺激对脑卒中患者手部运动和触压觉的效果[J]. 中国康复理论与实践, 2025, 31(4): 458-465.
[10] 陈甜甜, 徐东平, 孙凤宝, 等. 经颅直流电刺激联合对侧控制型功能性电刺激对脑卒中患者上肢功能的效果[J]. 中国康复理论与实践, 2023, 29(5): 527-532.
[11] Liao WW, Chiang W, Lin K, et al. Timing-dependent effects of transcranial direct current stimulation with mirror therapy on daily function and motor control in chronic stroke: a randomized controlledpilot study[J]. J Neuroeng Rehabil, 2020, 17(1): 101.
[12] Pang SJ, Cunningham DA, Plow E, et al. It takes two: noninvasive brain stimulation combined with neurorehabilitation[J]. Arch Phys Med Rehabil, 2015, 96(4): S89-S93.
[13] 冯常武, 朴政文, 柯志钢. 经颅直流电刺激联合改良强制性使用技术在脑卒中患者中的疗效观察[J]. 中国康复, 2023, 38(8): 470-474.
[14] Brunner I, Lundquist CB, Pedersen AR, et al. Brain computer interface training with motor imagery and functional electrical stimulation for patients with severe upper limb paresis after stroke: a randomized controlled pilot trial[J]. J Neuroeng Rehabil, 2024, 21(1): 10.
[15] 唐千乇, 张通. 脑机接口控制的功能性电刺激对脑卒中患者上肢功能障碍的康复效果[J]. 中国康复理论与实践, 2021, 27(7): 802-806.
[16] Chung E, Kim JH, Park DS, et al. Effects of brain-computer interface-based functional electrical stimulation on brain activation in stroke patients: a pilot randomized controlled trial[J]. J Phys Ther Sci, 2015, 27(3): 559-562.
[17] Rodgers H, Bosomworth H, Krebs HI, et al. Robot assisted training for the upper limb after stroke (RATULS): a multicentre randomised controlled trial[J]. Lancet, 2019, 394(10192): 51-62.
[18] Yuan K, Wang X, Chen C, et al. Interhemispheric functional reorganization and its structural base after BCI-guided upper-limb training in chronic stroke[J]. IEEE Trans Neural Syst Rehabil Eng, 2020, 28(11): 2525-2536.
[19] Lau CCY, Yuan K, Wong PCM, et al. Modulation of functional connectivity and low-frequency fluctuations after brain-computer interface-guided robot hand training in chronic stroke: a 6-month follow-up study[J]. Front Hum Neurosci, 2021, 14: 611064.
[20] 张凌云, 穆建坤. 镜像疗法联合功能性电刺激治疗对脑卒中合并肩手综合征患者上肢功能的影响[J]. 反射疗法与康复医学, 2024, 5(21): 50-52, 60.
[21] 张云涵, 吕文艳, 刘家宝. 镜像疗法联合任务导向性训练对脑卒中偏瘫患者肢体功能恢复的影响[J]. 四川大学学报(医学版), 2023, 54(5): 1046-1051.
[22] Lin KC, Huang PC, Chen YT, et al. Combining afferent stimulation and mirror therapy for rehabilitating motor function, motor control, ambulation, and daily functions after stroke[J]. Neurorehabil Neural Repair, 2014, 28(2): 153-162.
[23] Ding L, He JY, Yao L, et al. Mirror visual feedback combining vibrotactile stimulation promotes embodiment perception: An electroencephalogram (EEG) pilot study[J]. Front Bioeng Biotechnol, 2020, 8: 553270.
[24] 卢晓茵, 高珺, 赵增趁, 等. 头针联合MOTOmed康复训练改善中风患者上肢运动功能26例总结[J]. 湖南中医杂志, 2023, 39(1): 71-73, 84.
[25] 江宗霞. 头皮针徐疾补泻法联合电针曲池合谷治疗脑梗死恢复期上肢功能障碍的效应研究[D]. 泸州: 西南医科大学, 2024.
[26] 赵海霞. 头针结合电针治疗缺血性卒中后上肢运动障碍临床疗效分析[D]. 天津: 天津中医药大学, 2022.
[27] 王子欣. 腹针结合头针治疗中风后痉挛性偏瘫的疗效研究[D]. 济南: 山东中医药大学, 2022.
[28] 王子豪, 胡川, 张海泉, 等. 互动式头针结合上肢外骨骼机器人对脑卒中患者上肢功能的影响[J]. 康复学报, 2024, 34(1): 28-33.
[29] 祁丽丽, 韩振翔, 周一心, 等. 互动式头针结合PNF技术对缺血性卒中痉挛性偏瘫上肢功能的影响[J]. 中国针灸, 2018, 38(3): 234-238.
[30] 徐磊, 张泽荣, 许为勇, 等. 互动式头针结合悬吊下数字作业疗法治疗脑卒中后上肢运动功能障碍:多中心随机对照试验[J]. 中国针灸, 2024, 44(2): 129-133.
[31] Xu Y, Lin SF, Jiang C, et al. Synergistic effect of acupuncture and mirror therapy on post-stroke upper limb dysfunction: a study protocol for a randomized controlled trial[J]. Trials, 2018, 19(1): 303.
[32] 刘艳芳, 毛浩亮, 李彦娇, 等. 互动式头针治疗缺血性脑卒中偏瘫上肢功能障碍: 随机对照试验[J]. 中国针灸, 2023, 43(10): 1109-1113.
[33] 厚晓昀, 才仁措. 重复经颅磁刺激联合电针治疗脑卒中屈肘肌痉挛患者的临床疗效观察[J]. 青海医药杂志, 2025, 55(1): 57-60.
[34] 张振发, 胡晓华, 盛敏丽, 等. 针刺联合重复经颅磁刺激治疗缺血性脑卒中后软瘫期上肢功能障碍临床研究[J]. 新中医, 2024, 56(23):118-123.
[35] 孙莉敏, 黄昊, 章季芳, 等. 推拿康复联合低频重复经颅磁刺激对脑卒中偏瘫患者脑血流动力学及肌张力的影响[J]. 中国实用神经疾病杂志, 2024, 27(10): 1274-1278.
[36] 胡万春, 张畅畅, 赵曼曼, 等. 超微针刀联合高低频重复经颅磁刺激治疗脑卒中后上肢痉挛的临床观察[J]. 广州中医药大学学报, 2024, 41(9): 2259-2265.
[37] 苏悦. 针刺联合经颅直流电刺激治疗缺血性脑卒中后上肢痉挛性偏瘫的临床研究[D]. 合肥: 安徽中医药大学, 2024.
[38] 王海云, 王寅, 周信杰, 等. 基于“中枢-外周-中枢” 理论的经颅直流电刺激结合针刺干预脑卒中患者中枢及上肢功能的效果[J]. 中国康复理论与实践, 2023, 29(8): 919-925.
[39] 张洁, 王春方, 孙长城, 等. 穴位刺激联合经颅直流电刺激对脑卒中偏瘫患者上肢运动功能的影响[J]. 天津护理, 2022, 30(3): 356-359.

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