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目的：研究直肠电刺激（ＲＰＥＳ）缓解脊髓损伤（ＳＣＩ）后痉挛状态的作用机理。方法：１０例ＳＣＩ后痉挛患者和１０例偏瘫后痉挛患者，在ＲＰＥＳ治疗和口服Ｂａｃｌｏｆｅｎ前后进行康复评分和电生理指标测定，包括Ｆ波，屈肌反射，Ｈ反射，Ｔ反射。结果：ＳＣＩ患者经ＲＰＥＳ治疗后，下肢康复评分显著降低（Ｐ＜０．００１），Ｆ波振幅、时程、Ｆ／Ｍ比显著降低（Ｐ＜０．０５），屈肌反射振幅、时程显著降低（Ｐ＜０．０１），Ｂａｃｌｏｆｅｎ治疗后，康复评分显著降低，Ｆ波振幅、时程、Ｆ／Ｍ比显著降低（Ｐ＜０．０５）。偏瘫患者患侧下肢康复评分和电生理指标均无显著变化。结论：ＲＰＥＳ对降低ＳＣＩ后痉挛状态有较好的疗效，主要作用部位在脊髓节段，作用机理与降低α运动神经元活性和一般中间神经元活性有关，而与γ运动神经元及Ｒｅｎｓｈａｗ细胞活性无关。其解痉作用可能部分与γ氨基丁酸相关，但仍有其它神经介质参与。
Objective: To study the mechanism of rectal electrostimulation (RPES) in relieving spasticity after spinal cord injury (SCI). Methods: Ten patients with post-SCI spasm and 10 patients with post-hemiplegia were tested for rehabilitation scores and electrophysiological parameters before and after RPES treatment and oral Baclofen, including F wave, flexor reflex, H reflex and T reflex. Results: The rehabilitation scores of lower extremities in SCI patients after RPES were significantly lower (P <0.001). The amplitude of F wave, time course and F / M ratio were significantly lower (P <0.05). The amplitude of flexor reflex, (P <0.01). After treatment with Baclofen, the rehabilitation score decreased significantly, and the F wave amplitude, duration and F / M ratio decreased significantly (P <0.05). Patients with hemiplegia suffered lower limb rehabilitation scores and electrophysiological indicators did not change significantly. CONCLUSION: RPES is effective in reducing the spasticity after SCI. The main site of action is in the spinal cord segment. The mechanism of action is related to the decrease of α-motor neuron activity and the general activity of intermediate neurons, but not to the activity of γ-motor neurons and Renshaw cells Nothing to do Its antispasmodic effect may be partly related to γ aminobutyric acid, but there are still other neurotransmitters involved.