阿仑膦酸钠治疗糖尿病性骨质疏松症疗效及安全性Meta分析

Meta-analysis on Alendronate for Treatment of Diabetic Osteoporosis

目的 :评价阿仑膦酸钠治疗糖尿病性骨质疏松症(Diabetic Osteoporosis,DOP)的临床疗效及安全性。方法 :通过计算机检索和手工检索从建库至2018年8月期间,以阿仑膦酸钠为主要干预措施治疗糖尿病骨质疏松症的随机对照实验。按Cochrane系统评价方法,由两位研究者独立地对符合纳入标准的试验进行资料提取,若有分歧,则由第三方协助并解决;并利用Review Manager 5.3软件进行研究方法的质量评估,对提取的有效数据进行Meta分析。结果 :最终纳入12篇文献,受试者共1118例。Meta分析结果显示,治疗组对不同部位的视觉模拟评分(VAS)及血液中各项指标包括血清骨源性碱性磷酸酶(BAP)、抗酒石酸酸性磷酸酶5b(TRAP-5b)、血清骨钙素(BGP)显著优于对照组,差异具有统计意义;治疗组腰椎(整体、L2、L3、L4)、股骨颈、股骨粗隆、Wards三角的骨密度(BMD)值的改善情况显著优于对照组,差异具有统计意义;7篇文献发现阿仑膦酸钠引起的轻微不良反应,且对症治疗后症状均可消失。结论 :阿仑膦酸钠对治疗DOP有一定疗效,且具有一定安全性,但还需更多高质量的RCT进行分析才能对其疗效及安全性得出肯定性结论。

Objective:To evaluate the clinical efficacy and safety of alendronate in the treatment of diabetic osteoporosis(DOP).Methods:A randomized controlled trial of alendronate as the main intervention for the treatment of diabetic osteoporosis was conducted by computer retrieval and manual retrieval from the establishment of the library to August 2018.According to the Cochrane systematic review method,two researchers independently extracted data from the trials that met the inclusion criteria.If there were differences,they were assisted and solved by third parties;and using Review Manager 5.3 software to conduct quality assessment and extraction of the research methods.Meta-analysis of valid data.Results:A total of 13 articles were included,with a total of 1304 subjects.The results of the meta-analysis showed that the treatment group scored visual analogues(VAS)of different parts,blood indicators:serum bone-derived alkaline phosphatase(BAP),tartrate-resistant acid phosphatase 5 b(TRAP-5 b),serum bone calcium(BGP)was significantly better than the control group,and the difference was statistically significant.The improvement of bone mineral density(BMD)in the lumbar spine(integral,L2,L3,L4),femoral neck,femoral trochanter,and Wards triangle was excellent.In the control group,the difference was statistically significant;7 articles found adverse drug reactions caused by alendronate,and the symptoms disappeared after symptomatic treatment.Conclusion:Alendronate has certain curative effect on the treatment of DOP,and it has certain safety.However,more high-quality RCT is needed for analysis to obtain a positive conclusion on its efficacy and safety.