中西医结合治疗骨质疏松性胸腰椎压缩性骨折的疗效性及安全性Meta分析

A Meta-analysis on the efficacy and safety of integrated traditional Chinese and western medicine treatment of osteoporotic thoracolumbar vertebral compression fracture

目的:系统评价中西医结合治疗骨质疏松性胸腰椎压缩性骨折的疗效性及安全性。方法:检索中国知网(CNKI)、万方数据库(WANFANG DATA)、维普(VIP)、中国生物医学文献(SinoMed)、英文数据库PubMed等,按照设定的纳入与排除标准筛选随机对照试验,应用风险评估工具进行研究质量评价,提取数据后运用Revman 5.3软件进行Meta分析。共检索到324篇文献,纳入12个研究,总样本数为1 030例,试验组521例和对照组509例。结果:中西医结合治疗骨质疏松性胸腰椎压缩性骨折,与单纯西医治疗相比,能提高总有效率[RR=1.21,95%CI(1.15,1.27)];减小Cobb角度[MD=-5.43,95%CI(-6.12,-4.73)];降低视觉模拟评分法(Visual Analogue Scale,VAS)疼痛评分[MD=-1.45,95%CI(-2.06,-0.84),P<0.000 01];增加骨密度[MD=0.78,95%CI(0.49,1.06),P<0.000 01];减少并发症[OR=0.10,95%CI(0.02,0.43),P=0.002]。结论:与单纯西医治疗相比较,中西医结合治疗骨质疏松性胸腰椎压缩性骨折疗效性和安全性更佳。

Objective: To systematically evaluate the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of osteoporotic thoracolumbar vertebral compression fracture. Methods: CNKI, WANFANG DATA, VIP, SinoMed, PubMed,etc. were retrieved by computer, randomized controlled clinical trials were screened according to pre-set inclusion and exclusion criteria,risk assessment tools were used to evaluate the study quality, data were extracted, and Revman 5.3 software was used for meta-analysis. A total of 324 articles were retrieved and 12 studies were included, with a total sample size of 1030, with 521 in the experimental group and509 in the control group. Results: The combined treatment of traditional Chinese and western medicine for osteoporotic thoracolumbar compression fractures increased the total effective rate compared with western medicine alone [RR=1.21, 95%CI(1.15, 1.27)]. It reduced Cobb Angle [MD=-5.43, 95%CI(-6.12,-4.73)] and visual analogue scale(VAS) [MD=-1.45, 95%CI(-2.06,-0.84), P<0.000 01] and increased bone density [MD=0.78, 95%CI(0.49, 1.06), P<0.000 01];[OR=0.10, 95%CI(0.02, 0.43), P=0.002]. Conclusion: Compared with western medicine alone, combination of Chinese and western medicine is more effective and safe in treating osteoporotic thoracolumbar compression fracture, and its clinical application is worthy of promotion.