中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (33): 8802-8810.doi: 10.12307/2026.386

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    下一篇

不同非侵入性脑刺激方案对脑卒中后单侧忽略患者影响的网状Meta分析

王德花1，梁春婷1，成小菲1，李思慧1，姚筱朵2，汤继芹3   

  1. 山东中医药大学，1康复医学院，3继续教育学院，山东省济南市   250355；2山东第二医科大学康复医学院，山东省潍坊市   261053
  • 收稿日期:2025-07-11 修回日期:2025-10-15 出版日期:2026-11-28 发布日期:2026-06-17
  • 通讯作者: 汤继芹，副教授，硕士研究生导师，山东中医药大学继续教育学院，山东省济南市 250335
  • 作者简介:王德花，女，2001年生，山东省临沂市人，汉族，山东中医药大学在读硕士，主要从事脑功能康复的临床研究。
  • 基金资助:
    山东省老年医学学会科技攻关计划项目(LKJGG2021Z018)，项目负责人：汤继芹

Effects of different non-invasive brain stimulation modalities on unilateral spatial neglect after stroke: a network meta-analysis

Wang Dehua1, Liang Chunting1, Cheng Xiaofei1, Li Sihui1, Yao Xiaoduo2, Tang Jiqin3   

  1. 1College of Rehabilitation Medicine, 3College of Continuing Education, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China; 2College of Rehabilitation, Shandong Second Medical University, Weifang 261053, Shandong Province, China
  • Received:2025-07-11 Revised:2025-10-15 Online:2026-11-28 Published:2026-06-17
  • Contact: Tang Jiqin, Associate professor, Master’s supervisor, College of Continuing Education, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
  • About author:Wang Dehua, MS candidate, College of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
  • Supported by:
    Science and Technology Research Program of Shandong Society of Geriatrics, No. LKJGG2021Z018 (to TJQ)

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摘要：



文题释义：
非侵入性脑刺激：是指通过非侵入的刺激方式调节大脑皮质神经活动的技术，无需手术就能激活神经活动，广泛应用于肢体运动、认知、言语等功能障碍的康复治疗，常用方法包括经颅磁刺激及经颅直流电刺激等。
单侧忽略：是脑卒中后常见的行为认知功能障碍，主要发生在右侧大脑半球损伤的患者。患者对脑损伤病灶对侧空间刺激的感知与应答能力缺失。

目的：采用网状Meta分析方式评估不同非侵入性脑刺激方案对脑卒中后单侧忽略患者的疗效差异，为临床治疗方案的选择提供科学依据。
方法：研究人员独立检索Scopus、PubMed、中国知网、万方数据库等常用的中英文文献库，收集从建库至2025-06-24发表的非侵入性脑刺激治疗脑卒中后单侧忽略的随机对照试验。采用Cochrane随机对照试验偏倚风险评价工具Rob 2对纳入的文献进行质量评价；分别运用RevMan 5.3、Stata 17进行传统及网状Meta分析，绘制网络证据图及偏倚漏斗图等；最后采用GRADE对各个结局指标进行证据等级评价。
结果：①共纳入20篇文献，总样本量为900例，3篇文献被评为低风险，其余17篇文献被评为存在一定风险，无高风险文献；②网状Meta分析结果显示：单通道经颅直流电刺激右侧顶叶在改善单侧忽略患者线段二等分试验及简易精神状态检查量表评分方面疗效最佳；而连续性θ爆发式经颅磁刺激左侧顶叶在改善改良Barthel指数、Fugl-Meyer运动功能量表评分方面疗效最佳；③GRADE证据等级评价结果：线段二等分试验、改良Barthel指数、Fugl-Meyer运动功能量表评分3项证据等级均为低级，简易精神状态检查量表评分为中级。
结论：现有的中低等强度的临床证据表明非侵入性脑刺激疗法可有效改善脑卒中后单侧忽略患者的认知、运动及日常生活能力。但受纳入研究的文献数量及质量的影响，该结论仍需更多高质量的研究进一步验证。
https://orcid.org/0009-0008-6569-7255 (王德花)


中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 非侵入性脑刺激, 刺激方案, 单侧忽略, 脑卒中, 网状Meta分析

Abstract: OBJECTIVE: Using network Meta-analysis to systematically evaluate the effects of various non-invasive brain stimulation modalities for unilateral spatial neglect after stroke and provide a scientific basis for selecting clinical treatment options.
METHODS: The researchers independently searched Scopus, PubMed, CNKI, WanFang Database, and other commonly used Chinese and English literature databases to collect relevant randomized controlled trials of non-invasive brain stimulation for the treatment of unilateral spatial neglect after stroke from the establishment of the database to June 24, 2025. The quality of the included studies was assessed by Version 2 of the Cochrane Tool for Assessing Risk of Bias in Randomized Trials (Rob 2). RevMan 5.3 and Stata 17 were used to conduct traditional and network meta-analysis, draw the network evidence map, and offset funnel plot. Finally, GRADE was used to evaluate the level of evidence for each outcome.
RESULTS: (1) A total of 20 articles with a total sample size of 900 were included, 3 of which were rated as low-risk, 17 were classified as having some risk, and none were classified as high-risk. (2) The results of network meta-analysis showed that single channel transcranial direct current stimulation was conducted to the right parietal lobe with the best efficacy in improving the line bisection test and mini-mental state examination in patients with unilateral spatial neglect. The continuous theta burst transcranial magnetic stimulation targeted the left parietal lobe with the best effect in improving the modified Barthel index and the Fugl-Meyer assessment scale. (3) The GRADE evidence level evaluation results showed that the three levels of evidence were low for line bisection test, Modified Barthel index, and the Fugl-Meyer assessment scale, and were moderate for the Mini-Mental State Examination.
CONCLUSION: The available clinical evidence of low to moderate intensity suggests that non-invasive brain stimulation is effective in improving cognitive, motor, and daily living abilities in patients with unilateral spatial neglect after stroke. However, due to the number and quality of the included studies, this conclusion still needs to be further verified by more high-quality studies.


Key words: non-invasive brain stimulation, stimulation modalities, unilateral spatial neglect, stroke, network meta-analysis

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