补肾健骨汤治疗骨质疏松症性椎体压缩性骨折的Meta分析

Vertebral Compression Fractures in Patients with Osteoporosis

目的:评价补肾健骨汤治疗骨质疏松性椎体压缩性骨折的疗效。方法:检索中国期刊全文数据库CNKI、万方、维普、Pubmed,以'补肾健骨汤''骨质疏松性椎体压缩性骨折'为关键词或主题,按照标准提取资料,筛选符合条件的补肾健骨汤辅助治疗骨质疏松性椎体压缩性骨折RCT,进行质量评估,确定终点指标为有效率、治疗后Cobb角和治疗后椎管侵占率,采用Review Manager 5.2行Meta分析。结果:共9篇随机对照临床试验纳入,对照组采用常规西医治疗,共338例;研究组采用西医治疗+补肾健骨汤,共387例,未提及盲法,研究质量为低质量。以有效率为指标,效应量OR=4.88,Z=5.83(P<0.000,01),95%CI(2.87,8.33),菱形图位于右侧,补肾健骨汤辅助治疗骨质疏松性椎体压缩性骨折,疗效明显,漏斗图显示文献位于虚线两侧周形对称,小部分倾斜,存在发表偏倚;以治疗后Cobb角为指标,效应量OR=-5.54,Z=35.99(P<0.000,01),95%CI(-5.84,-5.24),菱形图位于左侧,补肾健骨汤辅助治疗骨质疏松性椎体压缩性骨折治疗后Cobb角明显降低;以治疗后椎管侵占率为指标,效应量OR=-5.21,Z=6.84(P<0.000,01),95%CI(-6.70,-3.72),菱形图位于左侧,补肾健骨汤辅助治疗骨质疏松性椎体压缩性骨折治疗后椎管侵占率明显降低。结论:补肾健骨汤辅助治疗骨质疏松性椎体压缩性骨折有效率上有优势,尤其在提高椎体稳定性和缓解病情上,由于纳入文献较少、质量不高,致使结果的可信度不高,临床谨慎使用,有待于高质量RCT文献来证实。

Objective:To explore the Meta-analysis of Bushen Jiangu decoction in the treatment of vertebral compression fractures with osteoporosis.Methods:The Chinese journal full-text database CNKI,Wanfang,VIP,PubMed were searched for'Bushen Jiangu decoction'and'osteoporotic vertebral compression fracture'as the keywords or themes.According to the standard extraction data,the eligible kidneys were screened.Bushen Jiangu decoction was used to treated RCT in osteoporotic compression fractures.Quality assessment was performed.The endpoints were determined as effective rate,Cobb angle and spinal cord encrosis rate after treatment.Metaanalysis was performed using Review Manager 5.2.Results:A total of 9 randomized controlled clinical trials were included,338 cases were treated with routine western medicine in the control group,and 387 cases were treated with western medicine+Bushen Jiangu decoction in the study group,all trials without mentioned the blind method,and the quality of the studys was low.The effective rate was OR=4.88,Z=5.83(P<0.000,01),95%CI(2.87,8.33),the rhombogram was located on the right side,and the adjuvant treatment of osteoporotic vertebral compression fractures with Bushen Jiangu decoction was effective.The funnel plot showed that the literature was symmetrical on both sides of the dotted line,with a small part inclined,and had a publication bias.Taking the Cobb angle as the index after treatment,the effective dose OR=-5.54,Z=35.99(P<0.000,01),95%CI(-5.84,-5.24),the rhombogram was located on the left side,and the Cobb angle was significantly decreased after treatment with Bushen Jiangu decoction as an adjunct treatment for osteoporotic vertebral compression fractures.After treatment,the effective dose OR=-5.21,Z=6.84(P<0.000,01),95%CI(-6.70,-3.72),the rhombogram was located on the left side,and the invasive rate of spinal canal was significantly reduced after the treatment of osteoporotic vertebral compression fractures with Bushen Jiangu decoction.Conclusion:Bushen Jiangu decoction has an advantage in the treatment of osteoporotic vertebral compression fractures,especially in improving the stability of the vertebral body and alleviating the disease.Because of the lack of literature and poor quality,the credibility of the results was not high.It needed to be verified by high-quality RCT literature.