中药内服治疗原发性骨质疏松的系统评价

Systematic review of oral traditional Chinese medicine on primary osteoporosis

目的探讨内服中药治疗原发性骨质疏松的疗效。方法计算机检索Cochrane Library、MEDLINE、EMbase、CBM、CNKI、VIP等数据库,人工检索相关临床随机对照研究文献,依据统一的纳入排除标准,对纳入研究的文献质量进行评估。采用Rev Man5.3进行Meta分析,对患者用药后总体疗效、腰椎、股骨颈、股骨大粗隆、ward三角、跟骨骨密度以及肝肾功能、血液流变学指标进行评价。结果纳入9篇文献,共计1 372例原发性骨质疏松患者。内服中药治疗组较对照组总体有效率高(P<0.01);内服中药能够显著提高患者腰椎和股骨颈骨密度(P<0.01),但股骨粗隆、ward三角以及跟骨密度无统计学差异(P>0.05)。此外,中药能够增加患者血清中骨钙素、1,25(OH)2D3含量,同时改善血液流变学相关指标。结论内服中药对原发性骨质疏松具有一定疗效。

Objective To evaluate therapeutic effect and quality of published clinical randomized controlled trial（ RCT） about the treatment of oral traditional Chinese medicine（ TCM） on primary osteoporosis,in order to provide theoretical basis for clinical reference.Methods To search the databases such as Cochrane Library,MEDLINE,EMbase,CBM,CNKI,VIP by PC and relevant clinical RCTs were manually retrieved to evaluate the quality of articles on the basis of unified into exclusion criteria.Meta-analysis was made by Rev Man5.3,and indexes such as general effect,bone mineral density（ BMD） of lumbar,collum femoris,ward triangle,Trochanter and calcaneus,as well as BGP,1,25（ OH2） D3,ESR,FIB,plasma viscosity and RBC aggregation index. Results 9 articles which had 1 372 cases were included.The analysis results showed that the general effect of treatment group with oral TCM was better than that of control group（ P〈0.01）.Oral TCM could significantly improve BMD of lumbar and femoral neck（ P〈0.01）.There were no statistically significant differences in BMD of the femoral trochanter and ward triangle（ P〉0.05）.In addition,TCM could increase patients＇ serum osteocalcin,1,25（ OH2） D3,and improve blood rheology related parameters.Conclusions Oral TCM has certain therapeutic effect on primary osteoporosis.