目的 观察重复经颅磁刺激（rTMS）联合中频电疗法（MFE）在脑卒中后神经源性膀胱（PSNB）患者中的临床疗效。 方法 2024年10月到2025年12月，选取PSNB患者随机分为对照组（n = 30，常规治疗及康复+ MFE）和观察组（n = 30，常规治疗及康复+ rTMS+ MFE）。两组均治疗2周，并随访1个月。比较治疗前后两组临床指标：尿流动力学参数［最大尿流率（Q_max）、最大尿流率时最大逼尿肌压力（P_detQmax）、初始尿意容量（FDV）、最大膀胱容量（MCC）、最大充盈时膀胱内压（P_{ves at MCC}）］、残余尿量（RUV）、排尿日记（日均排尿次数、日均漏尿次数、单次排尿量）、神经源性膀胱症状评分（NBSS）、生活质量指数评分（Qualiveen量表）并评价两组患者疗效及安全性。 结果 治疗后，两组患者FDV、MCC、Q_max、P_detQmax及日均单次排尿量均增加，且观察组高于对照组（P < 0.05）；P_ves、RUV、日均排尿及漏尿次数、NBSS、Qualiveen量表评分均降低，且观察组低于对照组（P < 0.05）；观察组患者总有效率93.33%高于对照组73.33%（P < 0.05）。两组患者均未出现严重不良反应。 结论 rTMS结合MFE应用于PSNB患者康复疗效明显，对改善临床症状、膀胱功能、生活质量有积极意义，且安全性高，患者获益显著。

Objective To explore the clinical efficacy and practical application value of repetitive transcranial magnetic stimulation （rTMS） combined with medium-frequency electrotherapy in the rehabilitation management of patients with post-stroke neurogenic bladder. Methods From October 2024 to December 2025， patients with PSNB were randomly assigned to a control group （n = 30， receiving conventional treatment， rehabilitation， and medium-frequency electrotherapy） and an observation group （n = 30， receiving conventional treatment， rehabilitation， rTMS， and medium-frequency electrotherapy）. Both groups underwent treatment for 2 weeks and were then followed up for 1 month. The clinical indicators of the two groups were compared before and after treatment， including urodynamic parameters ［initial urge volume （FDV）， maximum bladder capacity （MCC）， filling phase bladder pressure （P_{ves at MCC}）， maximum urine flow rate （Q_max）， maximum detrusor pressure at maximum urine flow rate （P_detQmax）］， residual urine volume （RUV）， voiding diary （average daily voiding frequency， average daily leakage frequency， single void volume）， neurogenic bladder symptom score （NBSS）， and quality of life index score （Qualiveen scale）. The efficacy and safety of the two groups of patients were also evaluated. Results After treatment， the FDV， MCC， Q_max， P_detQmax， and the average daily single urine volume of both groups increased. Statistically， the levels in the observation group were higher than those in the control group （all P < 0.05）. Meanwhile， P_ves， RUV， the average daily urine volume， the number of leakage episodes， the NBSS score， and the Qualiveen scale score all decreased. Significantly， the values in the observation group were lower than those in the control group （all P < 0.05）. The total effective rate in the observation group （93.33%） was significantly higher than that in the control group （73.33%） （P < 0.05）. During the entire intervention period， neither group experienced serious adverse events. Conclusions The combination of rTMS and medium-frequency electrotherapy has demonstrated remarkable efficacy in the rehabilitation treatment of patients with PSNB. It plays a positive role in enhancing clinical symptoms， bladder function， and the quality of life. Moreover， it is highly safe， bringing substantial benefits to patients.