中医药治疗绝经后骨质疏松的疗效及安全性系统评价

Effects and Safety of Traditional Chinese Medicine for Treating Postmenopausal Osteoporosis: A Systematic Review

目的 分析中医药治疗绝经后骨质疏松症的效果和可能的不良反应。方法 电子检索:MEDLINE(1966～2003)、EMBASE(1974～2003)、CochraneLibrary2003年第4期的ControlledTrialsRegister、CurrentCon trolledTrials、TheNationalResearchRegister、中国生物医学文献数据库(1978～2003)和中文科技期刊全文数据库(1977～2003)、中文学术期刊全文数据库(1994～2003),并手工检索相关领域杂志。检索截止至2003年11月。所有检索均不受语种限制。纳入以绝经后妇女为研究对象、比较中医药与其它疗法疗效的随机或半随机对照试验,评价纳入研究的质量,并用RevMan4 2软件进行Meta分析。结果 共纳入33个研究,包括2337例患者和27种中药。部分中药或中西医结合治疗对提高患者骨密度、血清雌二醇、血清钙可能有一定疗效。例如补肾益骨膏和补肾强骨胶囊调节绝经后妇女雌激素的效果优于安慰剂,其WMD和95%CI分别为[0 76(0 65,0 87)]和[39 94(35 12,44 76)];其余中药因研究数较少或结论不一致尚未发现较明显的趋势。中药治疗未发现明显的副作用。结论 中医药治疗绝经后骨质疏松症的疗效证据仍十分有限,尚需更多高质量研究以增加证据的强度。

Objective To assess the benefits and harms of traditional Chinese medicine in the treatment of postmenopausal osteoporosis Methods We electronically searched MEDLINE (1966～2003), EMBASE (1974～2003), Controlled Trials Register and The National Research Register, The Cochrane Library Issue 4, 2003, CBM disc,VIP,CNKI, and CMCC. We also handsearched some related journals The search was conducted in Nov., 2003 The quality of included randomized controlled trials was evaluated and meta analysis was conducted by RevMan 4 2 2 Results We identified 33 studies including 2 337 patients and 27 traditional Chinese medicines Some traditional Chinese medicines alone or integrated Chinese and Western medicine may be effective for improving patients bone mineral density, serum oestradiol and serum calcium For example, Compared with placebo, Bushen Yigu soft extraction with WMD 0 76, 95% confidence interval 0 65 to 0 87, Bushen Qianggu capsule with WMD 39 94, 95% confidence interval 35 12 to 44 76 were effective for improving the level of serum oestradiol There were no confirmed results of the other traditional Chinese medicines because of the small number of studies or inconsistent conclusions among studies We didn’t find obvious side effects Conclusions Some traditional Chinese medicines may be effective for treating postmenopausal osteoporosis Due to the limited evidence identified, we can not draw a firm conclusion. More randomised controlled trials of high quality are needed for stronger evidence