中药治疗糖尿病性骨质疏松疗效与安全性的系统评价
Effects and safety of traditional Chinese medicine for treating diabetic osteoporosis : a systematic review
  
DOI:10.3969/j.issn.1006.7108.2016.03.001
中文关键词:  糖尿病性骨质疏松  中医药  系统评价  Meta分析  随机对照试验
英文关键词:Diabetic osteoporosis  Traditional Chinese medicine  Systematic review  Meta-analysis  Randomized controlled trial
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吴宏梓* 方洲 汪少波 克拉玛依市中心医院骨二科克拉玛依834000 
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中文摘要:
      目的 运用循证医学系统评价方法评价中药治疗糖尿病性骨质疏松的疗效与安全性,为临床实践和研究提供参考。方法 计算机检索PubMed、Web of science Cochrane图书馆、CNKI、VIP、CBM和万方数据库,查找中药治疗糖尿病性骨质疏松与单独应用西药(钙尔奇D片)比较、中西药结合与单独应用西药(钙尔奇D片)比较的随机对照试验,检索时限均从建库至2015年09月。由2名研究者按照纳人与排除标准独立进行文献筛选、资料提取和质量评价后,采用RevMan 5.2软件进行 Meta分析。结果 纳人8个RCT,共698例患者。Meta分析结果显示,与对照组比较,中西药联合治疗糖尿病性骨质疏松在增加患者骨钙素[MD= 0.90,95% CI(0. 22,1.57)]、腰椎骨密度[MD = 0. 02,95% CI(0. 02,0. 03 )]、股骨颈骨密度[MD = 0. 03,95% CI(0. 00,0. 06) ]、Ward’s三角骨密度[MD = 0. 03,95% CI( 0. 01,0. 05 )]方面均有统计学意义;但单纯中药组的腰椎骨密度与对照组相比无统计学意义。在不良反应方面,尚未见中医药的严重不良反应报告。结论 现有临床证据表明,中医药可以提高糖尿病性骨质疏松症患者骨密度、缓解骨痛。但其疗效优势值得进一步研究,特别需要高质量的多中心大样本 随机双盲对照试验来验证。
英文摘要:
      Objective To evaluate the effectiveness and safety of traditional Chinese medicine ( TCM) versus conventional treatment (CT) for diabetic osteoporosis ( Dop). Methods Systematic searches were conducted in PubMed,The Cochrane Library, SCI, CNKI, VIP,CBM and Wanfang database to collect randomized controlled trials (RCTs) on TCM treating Dop from inception to March 2013. Two reviewers independently screened articles according to the inclusion and exclusion criteria, extracted data and evaluated the quality of the included studies. Then meta-analysis was performed using RevMan5.2. Results A total of 8 RCTs involving 69B patients were included. Compared with the CT group, the influences on osteocolcin [ MD =0.90, 95% CI (0. 22,1. 57) ],BMD of the lumbar spine [ MD = 0. 02,95% CI (0. 02,0. 03 ) ] , femoml neck [ MD = 0. 03,95% CI (0. 00, 0.06) ] and ward’s triangle [ MD = 0.03,95% CI( 0.01,0.05) ] were showed by Meta-analysis, respectively. No study reported the quality of life and severe adverse reactions after TCM treatment. Conclusion Current clinical evidence indicates that TCM is efficient for increasing BMD in Diabetic osteoporosis and for alleviating bone pain. However, due to lack of enough high-quality studies, TCM has to be further studied by conducting more strictly-designed, multicenter, large-scale and double-blind RCTs.
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