补肾中药治疗围绝经期骨质疏松的Meta分析

A meta-analysis of the treatment of perimenopausal osteoporosis with Trad itional Chinese medicine for tonifying kidney

目的:系统评估补肾中药治疗围绝经期骨质疏松的有效性,进一步为临床提供循证参考。方法:用计算机检索CNKI、VIP、CBM、万方等数据库中涉及补肾中药治疗围绝经期骨质疏松临床随机试验的文献,检索时限为建库至2022年3月。根据纳入及排除标准,进行文献筛选、文献资料提取及文献质量评价后,用Revmen5.3软件进行Meta分析。结果:共纳入14篇随机对照文献。进行Meta分析的结果显示,观察组患者治疗的总有效率显著高于对照组患者,差异有统计学意义[OR=4.35,95%CI(2.98,6.35)]。治疗后,观察组患者雌二醇提高的幅度大于对照组患者,差异有统计学意义[MD=8.46,95%CI(4.24,12.68),P<0.0001]。治疗后,观察组患者黄体生成素下降的幅度大于对照组患者,差异有统计学意义[MD=-20.65,95%CI(-24.46,-18.84),P<0.0001]。治疗后,观察组患者ALP下降的幅度大于对照组患者,差异有统计学意义[MD=-11.43,95%CI(-14.27,-1.43),P=0.02]。治疗后,观察组患者腰椎骨密度上升的幅度大于对照组患者,差异有统计学意义[MD=0.07,95%CI(0.05,0.09),P<0.00001]。治疗后,两组患者BGP的变化情况相比,差异无统计学意义[MD=0.51,95%CI(1.44,0.42),P=0.28]。治疗后,两组患者股骨颈骨密度的变化情况相比,差异无统计学意义[MD=0.14,95%CI(-0.08,0.36),P=0.21]。结论:用补肾中药联合西药治疗围绝经期骨质疏松的总体疗效优于单用西药,但上述研究结论仍需通过进行更多高质量的随机对照试验来证实。

Objective:To systematically evaluate the effectiveness of kidney-tonifying Traditional Chinese medicine in the treatment of perimenopausal osteoporosis,and to provide evidence-based reference for clinical practice.Methods:The literatures related to the clinical randomized trials of kidney-tonifying TCM in the treatment of perimenopausal osteoporosis were searched by computer from CNKI,VIP,CBM and Wanfang databases,and the retrieval time was established until March 2022.According to inclusion and exclusion criteria,literature screening,literature data extraction and literature quality evaluation were carried out,and Meta-analysis was conducted with Revmen5.3 software.Results:A total of 14 randomized controlled literatures were included.Meta-analysis results showed that the total effective rate in the observation group was significantly higher than that in the control group,and the difference was statistically significant[OR=4.35,95%CI(2.98,6.35)].After treatment,the increase of estradiol in observation group was greater than that in control group,the difference was statistically significant[MD=8.46,95%CI(4.24,12.68),P<0.0001].After treatment,the decrease of luteinizing hormone in observation group was greater than that in control group,the difference was statistically significant[MD=-20.65,95%CI(-24.46,-18.84),P<0.0001].After treatment,ALP decreased more in t he observation group than in the control group,t he difference was statistically significant[MD=-11.43,95%CI(-14.27,-1.43),P=0.02].After treatment,the increase of lumbar vertebra bone density in the observation group was greater than that in the control group,and the difference was statistically significant[MD=0.07,95%CI(0.05,0.09),P<0.00001].After treatment,there was no significant difference in THE changes of BGP between the two groups[MD=0.51,95%C I(1.44,0.42),P=0.28].After treatment,there was no significant difference in the changes of femoral neck BMD between the two groups[MD=0.14,95%CI(-0.08,0.36),P=0.21].Conclusion:The overall efficacy of kidney-tonifying Chinese herbal medicine combined with Western medicine in the treatment of perimenopausal osteoporosis is better than that of western medicine alone,but the above conclusions need to be confirmed by more high-qua lity randomized controlled trials.