仙灵骨葆胶囊治疗骨质疏松性椎体压缩性骨折的meta分析

Meta-analysis of Xianling Gubao Capsule in the Treatment of Osteoporotic Vertebral Compression Fracture

目的系统评价椎体成形术(percutaneous vertebroplasty,PVP)/椎体后凸成形术(percutaneous kyphoplasty,PKP)术后联用仙灵骨葆胶囊对骨质疏松性椎体压缩性骨折的疗效及安全性。方法计算机检索CNKI、VIP、Wangfang、CBM、PubMed、Embase、CochraneLibrary数据库,检索时间限定为建库至2021年12月31日,收集PVP/PKP术后联用仙灵骨葆胶囊治疗骨质疏松性椎体压缩性骨折的随机对照研究。根据Cochrane系统评价手册5.1.0进行质量评价后,采用RevMan 5.3软件进行meta分析。结果纳入19项随机对照研究,共计1715例患者。Meta分析结果显示,与对照组相比,试验组临床疗效较高,能够更好地降低VAS评分(治疗3月后、治疗6月后)、Oswestry功能障碍指数、椎体后凸Cobb角及不良事件的发生率;有效提高腰椎BMD(治疗3月后、治疗6月后)、腰椎JOA评分、椎体后凸Cobb角恢复率,差异均具有统计学意义(P<0.05)。2组治疗1周后及1月后VAS评分比较差异不具有统计学意义。结论PVP/PKP术后联用仙灵骨葆胶囊治疗骨质疏松性椎体压缩性骨折具有良好的疗效,能够显著降低术后疼痛,提高腰椎骨密度,改善腰椎功能,恢复脊柱生理曲度且减少不良反应的发生,获得较好的安全性。

OBJECTIVE To systematically evaluate the efficacy and safety of percutaneous vertebroplasty(PVP)/percutaneous kyphoplasty(PKP)combined with Xianling Gubao capsule for osteoporotic vertebral compression fractures.METHODS Databases as CNKI,VIP,Wangfang,CBM,PubMed,Embase,and Cochrane Library were searched to collect randomized controlled trials(RCTs)about postoperative combined with Xianling Gubao capsule for osteoporotic vertebral compression from the establishment of the databases to December 31,2021.Cochrane Systematic Review Manual 5.1.0 was used for quality evaluation.Meta-analysis was performed with RevMan 5.3 software.RESULTS Nineteen RCTs were included,totaling 1715 patients.Meta-analysis results showed that compared with the control group,the experimental group had a higher clinical effect,which could better reduce the VAS score(after 3 months and 6 months of treatment),Oswestry dysfunction index,kyphotic Cobb angle and the incidence of adverse events.The experimental group could effectively improve lumbar spine BMD(after 3 months and 6 months of treatment),lumbar spine JOA score,lumbar kyphosis Cobb angle recovery rate.The differences in all of the above outcome indicators were statistically significant(P<0.05).There was no significant difference in VAS score between the two groups after 1 week and 1 month of treatment.CONCLUSION The combined use of Xianling Gubao Capsule for the treatment of osteoporotic vertebral compression fractures had good effect.It can significantly reduce postoperative pain,increase lumbar bone density,improve lumbar function,restore the physiological curvature of the spine and reduce the occurrence of adverse reactions,and obtain a better safety.