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目的 探讨运动疗法联合重复经颅磁刺激与A型肉毒毒素治疗痉挛型脑瘫患儿的临床疗效.方法 将94例痉挛型脑瘫患儿按抽签法分为两组,每组47例.两组均给予常规运动疗法治疗,观察组在此基础上联合重复经颅磁刺激与A型肉毒毒素治疗.疗程3个月,随访1 a.比较两组临床疗效、治疗前后双下肢肌肉痉挛程度量表评分及粗大运动功能量表评分,比较治疗前与随访1年两组日常生活能力量表评分.结果 观察组总有效率为89.4％,对照组为70.2％,观察组显著高于对照组(P＜0.05).治疗后两组肌肉痉挛程度量表评分均显著低于治疗前(P＜0.01),粗大运动功能量表评分均显著高于治疗前(P＜0.01),观察组较对照组变化更显著(P＜0.01).随访1 a两组日常生活能力量表评分均较治疗前显著升高(P＜0.01),观察组较对照组升高更显著(P＜0.01).结论 运动疗法联合重复经颅磁刺激与A型肉毒毒素治疗痉挛型脑瘫患儿疗效显著,可显著减轻患儿双下肢肌肉痉挛程度,提高其运动功能及日常生活能力.“,”Objective To investigate the clinical effect of kinesitherapy combined with rTMS and BOTOX-A in the treatment of cerebral palsy. Method 94 cases with cerebral palsy were randomly divided into two groups, 47 cases in each group. The two groups were all given kinesitherapy, the observation group was plus rTMS and BOTOX-A on this basis. The course of treatment was 3 months, and the patients were followed up for l year. The clinical effect, MAS scores and GMFM-88 scores of the two groups were compared. ADL scores of the two groups before treatment and after 1 year follow up were compared. Results Total effective rate of the observation group (89.4％) was higher than that of the control group (70.2％)(P＜0.05). MAS scores of the two groups after treatment were significantly lower than those before treatment (P ＜ 0.01),GMFM-88 scores were significantly higher than those before treatment (P ＜0.01),the observation group changed more significantly than the control group (P＜0.01). After 1 year follow up, the ADL scores of the two groups were all significantly increased (P＜0.01),the observation group improved more significantly than the control group (P＜0.01). Conclusion The application of kinesitherapy combined with rTMS and BOTOX-A in the treatment of cerebral palsy has significant curative effect, it can significantly alleviated the muscle spasm degree of both lower limbs, and improve the motor function and activity of daily living.