中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (10): 2550-2559.doi: 10.12307/2026.649

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

非侵入性神经调控技术对孤独症谱系障碍疗效的网状Meta分析

高世爱1，于子夫2，陈金慧1，曹新燕1，冷晓轩1，刘西花3   

  1. 1山东中医药大学康复医学院，山东省济南市  250355；2山东省疾病预防控制中心，山东省济南市  250014；3山东中医药大学附属医院康复科，山东省济南市  250014

  • 收稿日期:2025-04-09 接受日期:2025-06-26 出版日期:2026-04-08 发布日期:2025-08-30
  • 通讯作者: 刘西花，博士，副主任医师，硕士生导师，山东中医药大学附属医院康复科，山东省济南市 250014
  • 作者简介:高世爱，女，2001年生，山东中医药大学在读硕士，主要从事神经与心肺疾病康复基础与临床研究。
  • 基金资助:
    国家自然科学基金青年基金项目(81802239)，项目负责人：刘西花；山东省中医药科技项目(M-2023142)，项目负责人：刘西花；山东省医务职工科技创新计划项目(SDYWZGKCJH2022024)，项目负责人：刘西花

Efficacy of non-invasive neuromodulation techniques on autism spectrum disorder: a network meta-analysis

Gao Shiai1, Yu Zifu2, Chen Jinhui1, Cao Xinyan1, Leng Xiaoxuan1, Liu Xihua3   

  1. 1School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China; 2Shandong Center for Disease Control and Prevention, Jinan 250014, Shandong Province, China; 3Department of Rehabilitation, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
  • Received:2025-04-09 Accepted:2025-06-26 Online:2026-04-08 Published:2025-08-30
  • Contact: Liu Xihua, PhD, Associate chief physician, Master’s supervisor, Department of Rehabilitation, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
  • About author:Gao Shiai, MS candidate, School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
  • Supported by:
    National Natural Science Foundation of China for the Youth, No. 81802239 (to LXH); Shandong Provincial Traditional Chinese Medicine Science and Technology Project, No. M-2023142 (to LXH); Shandong Provincial Medical Staff Science and Technology Innovation Program, No. SDYWZGKCJH2022024 (to LXH)

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摘要：


文题释义：
非侵入性神经调控技术：如经颅直流电刺激、经颅磁刺激、虚拟现实技术、神经反馈等，旨在通过神经刺激调节中枢神经系统的活动，促进患者大脑功能的恢复和重建。
孤独症谱系障碍：一种复杂的神经发育障碍，核心症状包括社交互动困难、兴趣范围局限及重复刻板行为。

目的：采用网状Meta分析系统评价不同非侵入性神经调控技术对孤独症谱系障碍儿童的康复疗效。
方法：系统检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、Embase数据库，选择不同非侵入性神经调控技术改善孤独症谱系障碍的随机对照试验，检索时限为各数据库建库至2025年1月，由2名研究者独立进行文献筛选、数据提取并对纳入的研究进行质量评价，应用Stata 18.0软件对数据进行网状Meta分析。
结果：共纳入32个随机对照试验，涉及8种干预方式。网状Meta分析结果显示，在常规康复训练的基础上，在改善孤独症行为量表评分方面，虚拟现实技术效果最佳[SMD=-12.55，95%CI(-20.85，-4.25)，P < 0.05]，其次为θ爆发式磁刺激[SMD=-11.34，95%CI(-20.94，-1.74)，P < 0.05]、重复经颅磁刺激[SMD=-9.28，95%CI(-12.80，-5.77)，P < 0.05]、神经反馈技术[SMD=-8.75，95%CI(-15.26，-2.23)，P < 0.05]；在儿童孤独症评定量表评分方面，虚拟现实技术改善效果最为显著[SMD=-6.36，95%CI(-9.61，-3.11)， P < 0.05]，其次为重复经颅磁刺激[SMD=-5.98，95%CI(-9.46，-2.51)，P < 0.05]、神经反馈技术[SMD=-4.63，95%CI(-9.14，-0.13)，P < 0.05]、经皮神经电刺激[SMD=-4.14，95%CI(-5.73，-2.55)，P < 0.05]；在孤独症治疗评估量表评分方面，神经反馈技术改善效果最显著[SMD=-16.44，95%CI(-24.10，-8.78)，P < 0.05]，其次为虚拟现实技术[SMD=-14.09，95%CI(-22.45，-5.73)，P < 0.05]、重复经颅磁刺激[SMD=-12.06，95%CI(-16.45，-7.68)，P < 0.05]、经皮神经电刺激[SMD=-10.58，95%CI(-20.44，-0.72)，P < 0.05]、经颅直流电刺激[SMD=-9.75，95%CI(-18.62，-0.88)，P < 0.05]。
结论：当前证据表明，在常规康复训练基础上，不同非侵入性神经调控技术对孤独症谱系障碍的改善效果存在差异。虚拟现实技术在改善孤独症行为量表和儿童孤独症评定量表评分方面表现出最佳效果，而神经反馈技术在孤独症治疗评估量表评分方面的改善效果最为显著。受纳入研究数量和质量的限制，上述结论尚待更多高质量研究予以验证。
https://orcid.org/0009-0006-2294-061X(高世爱)

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: 孤独症谱系障碍, 非侵入性神经调控技术, 虚拟现实技术, 网状Meta分析, 随机对照试验

Abstract: OBJECTIVE: To systematically evaluate the rehabilitation efficacy of different non-invasive neuromodulation techniques in children with autism spectrum disorder by network meta-analysis. 
METHODS: A literature search was conducted in CNKI, VIP, WanFang, China Biomedical Literature Database, PubMed, Web of Science, Cochrane Library, and Embase for randomized controlled trials of different non-invasive neuromodulation techniques to improve autism spectrum disorders. The search time was from database inception to January 2025, and two reviewers independently screened the literature, extracted the data, and evaluated the quality of the included studies, and used Stata 18.0 to perform a network meta-analysis of the data. 
RESULTS: A total of 32 randomized controlled trials involving 8 intervention modalities were included. The results of network meta-analysis showed that based on the application of conventional rehabilitation training, virtual reality technology had the best effect in improving the score of the Autism Behavior Scale [standardized mean difference (SMD)=-12.55, 95% confidence interval (CI) (-20.85, -4.25), P < 0.05], followed by Theta burst magnetic stimulation [SMD=-11.34, 95% CI (-20.94, -1.74), P < 0.05], repetitive transcranial magnetic stimulation [SMD=-9.28, 95% CI (-12.80, -5.77), P < 0.05], and neurofeedback technology [SMD=-8.75, 95% CI (-15.26, -2.23), P < 0.05]. In terms of the Childhood Autism Rating Scale score, virtual reality technology had the most significant improvement effect [SMD=-6.36, 95% CI (-9.61, -3.11), P < 0.05], followed by repetitive transcranial magnetic stimulation [SMD=-5.98, 95% CI (-9.46, -2.51), P < 0.05], neurofeedback technology [SMD=-4.63, 95% CI (-9.14, -0.13), P < 0.05], and transcutaneous electrical nerve stimulation [SMD=-4.14, 95% CI (-5.73, -2.55), P < 0.05]. In terms of Autism Treatment Assessment Scale score, neurofeedback technology had the most significant improvement effect [SMD=-16.44, 95% CI (-24.10, -8.78), P < 0.05], followed by virtual reality technology [SMD=-14.09, 95% CI (-22.45, -5.73), P < 0.05], repetitive transcranial magnetic stimulation [SMD=-12.06, 95% CI (-16.45, -7.68), P < 0.05], transcutaneous electrical nerve stimulation [SMD=-10.58, 95% CI (-20.44, -0.72), P < 0.05], and transcranial direct current stimulation [SMD=-9.75, 95% CI (-18.62, -0.88), P < 0.05].
CONCLUSION: The current evidence suggests that different non-invasive neuromodulation techniques have different effects on the improvement of autism spectrum disorder on the basis of conventional rehabilitation training. Virtual reality shows the best effect in improving Autism Behavior Scale and Child Autism Rating Scale scores, while neurofeedback technology shows the most significant improvement in Autism Treatment Assessment Scale scores. Due to the limitations of the number and quality of included studies, these conclusions need to be validated by more high-quality studies.


Key words: autism spectrum disorder, non-invasive neuromodulation techniques, virtual reality technology, network meta-analysis, randomized controlled trials

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