绝经后女性应用伊班膦酸钠治疗骨质疏松效果的系统评价

Differences of the Effect of Ibandronate and Alendronate Sodium in Treatment of Postmenopausal Osteoporosis: System Evaluation

目的探讨绝经后女性使用伊班膦酸钠治疗骨质疏松的临床效果。方法检索1994年8月—2014年8月英国医学会电子全文期刊数据库(BMA)、荷兰医学文摘数据库(EMbase)、学术期刊集成全文数据库(ASP)、考克兰图书馆(The Cochrane Library)、西文生物医学期刊文献数据库(EMCC)、美国国立医学图书馆生物医学信息检索系统(Pubmed)、万方数据库(CECDB)、维普中文科技期刊全文数据库(CQVIP)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)相关的随机对照试验(RCT)研究,对纳入文献的质量进行严格评价和资料提取,使用Stata/SE version 12.0软件对纳入的RCT文献进行系统评价。结果本研究最终纳入10篇RCT文献共725例,其中379例使用伊班膦酸钠,346例使用阿仑膦酸钠。结果显示:与使用阿仑膦酸钠者比较,予伊班膦酸钠治疗6个月时,患者腰椎骨密度(BMD)含量显著升高[P=0.174,I2=29.4%,加权均数差(WMD)=0.03,95%可信区间(CI)=(0.01,0.04)],1年内的骨折发生率显著降低[P=5.810,I2=0,比值比(OR)=0.32,95%CI=(0.10,1.00)]。但两药物治疗1年时腰椎BMD及治疗半年内骨折发生率比较,系统评价显示差异均无统计学意义。结论伊班膦酸钠治疗绝经后骨质疏松,可提升患者治疗6个月时的腰椎BMD,降低治疗1年内的骨折发生率。

Objective To investigate the difference of curative effect of ibandronate and alendronate on postmenopa-usal osteoporosis. Methods By searching the RCT PubMed, BMA, EMbase, ASP, The Cochrane Library, EMCC, CBM, CNKI, CECDB, CQVIP, VIP database during August 1994 and November 2014 period, strict appraisal and data extraction on the quality of the included studies were evaluated, using Stata/SE version 12 software systematic evaluation of included stud-ies. Results Finally, 10 RCT articles were included with, a total of 725 cases, including 379 cases of the use of sodium ibandronate, 346 cases with alendronate sodium. The results showed that： compared with alendronate, BMD content in pa-tients with lumbar acid sodium ibandronate significantly increased 6 months after treatment [P=0. 174, I2 =29. 4%, WMD=0. 03, 95%CI= （0. 01, 0. 04）];fracture incidence within one year significantly decreased [P=5. 810, I2 =0, OR=0. 32, 95%CI=（0. 10, 1. 00）]. But 1 year after treatment of lumbar BMD and 6 months after treatment, the fracture rate was com-pared and system evaluation showed no significant differences between the two medications. Conclusion Sodium ibandronate in treatment of postmenopausal osteoporosis, can improve the lumbar BMD 6 months after treatment, reduce the risk of fracture within one year after treatment.