中西医结合治疗原发性骨质疏松症临床疗效的Meta分析

Meta-analysis on clinical efficacy of primary osteoporosis treated with integrated Chinese and Western medicine

目的系统评价中西医结合治疗原发性骨质疏松症的临床疗效。方法计算机检索The Cochrane Library、Embase、Pubmed、中国期刊全文数据库(China National Knowledge Infrastructure,CNKI)、中国生物医学文献数据库(China Biology Medicine disc,CBM)和万方数据库等中英文数据库,检索时间限定为建库至2018年1月30日,检索所有中西医结合治疗原发性骨质疏松症的随机对照试验,并追索纳入研究的参考文献。由两位研究者独立对符合纳入标准的研究进行严格质量评价和资料提取后,应用Rev Man5. 3软件进行Meta分析。结果纳入34项研究,共3263例患者。Meta分析结果显示:与常规单一西医治疗方案相比,中西医结合治疗原发性骨质疏松症能显著提高临床疗效[OR=4. 74,95%CI(3. 80,5. 91),P <0. 000 01],有效提高腰椎骨密度[MD=0. 06,95%CI(0. 03,0. 01),P <0. 000 01],有效提高股骨颈骨密度[MD=0. 10,95%CI(0. 05,0. 14),P <0. 000 01],其差异均具有统计学意义。发表性偏倚分析结果提示纳入研究可能存在发表性偏倚。结论与常规单一西医治疗方案相比,中西医结合治疗原发性骨质疏松症具有提高临床疗效,提高骨密度的优势。

Objective To systematically evaluate the clinical efficacy on primary osteoporosis treated with integrated Chinese and Western medicine.Method The databases such as the Cochrane Library,Embase,Pubmed,CNKI,CBM and Wanfang Data were searched.Search time was limited to 30 January,2018.All of randomized controlled trials on osteoporosis treated with integrated Chinese and Western medicine were searched,and research literatures included in the RCTs were also traced.Rev Man 5.3 was used for meta-analysis when the research materials which met the inclusion criteria were independently conducted and strictly evaluated for quality by two researchers.Result Totally 34 RCTs involving3 263 patients were included into the study.The Meta-analysis results showed that compared with western medicine,integrated Chinese and Western medicine could significantly improve the clinical effective rate[OR=4.74,95%CI(3.80,5.91),P<0.000 01],improve lumbar bone mineral density[MD=0.06,95%CI(0.03,0.01),P<0.000 01]and effectively improve femoral neck bone mineral density[MD=0.10,95%CI(0.05,0.14),P<0.000 01],with statistically significant difference in both groups.The results of publication bias analysis suggested that inclusion of research had the possibility of publication bias.Conclusion Compared with western medicine,integrated Chinese and Western medicine in treatment of osteoporosis has the advantage of improving clinical efficacy and increasing bone density.