中国骨质疏松杂志

骨碎补总黄酮治疗绝经后骨质疏松症的Meta分析

Meta analysis of total flavonoids from Rhizoma Drynariae(Gusuibu) in treatment of postmenopausal osteoporosis

DOI：10.3969/j.issn.1006-7108.2019.04.008

中文关键词: 骨碎补总黄酮强骨胶囊绝经后骨质疏松症 Meta分析系统评价

英文关键词:Total flavonoids Rhizoma Drynariae Qianggu Capsule postmenopausal osteoporosis Meta-analysis systematic review

基金项目:国家自然科学基金青年基金（81603517，81503601）；北京中医药科技发展资金项目(JJ2016-79)；中华中医药学会（2017-2019年度）青年人才托举工程项目（CACM-2017-QNRC2-A03）

作者	单位
王清滢1,2 章轶立1 谢雁鸣1 姜俊杰1* 魏戌3 王洋4 李晋玉5	1.中国中医科学院中医临床基础医学研究所，北京 100700； 2.中国中医科学院西苑医院，北京 100091； 3. 中国中医科学院望京医院，北京 100102 4.北京中医药大学，北京 100029 5.北京中医药大学东直门医院骨1科，北京100700

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中文摘要:

目的系统评价骨碎补总黄酮（强骨胶囊）治疗绝经后骨质疏松症(PMOP)的疗效及安全性。方法计算机检索CNKI、CBM、VIP、万方数据库、PubMed、Embase、Cochrane图书馆，检索时间是自建库以来至2017年11月3日，按照纳排标准，收集强骨胶囊治疗PMOP的临床对照试验，依据Cochrane Handbook for Systematic Reviews of Interventions（version 5.35）质量评估，并使用RevMan5.3软件进行Meta分析。结果纳入6篇文献，8个研究。在有效率[RR=1.50，95%CI（1.04~2.17），P=0.03]和提高股骨骨密度[MD=0.04，95% CI（0.02~0.06），P=0.0002]方面，强骨胶囊联合常规治疗可能优于单独常规治疗；在提高腰椎骨密度[MD=0.02，95% CI（–0.01~0.05），P=0.28]、髋骨骨密度[MD=–0.05，95% CI（–0.09~0.00），P=0.05]、改善血钙[MD=0.01，95% CI（–0.06~0.08），P=0.77]、血磷[MD=0.02，95% CI（–0.05~0.09），P=0.58]、血碱性磷酸酶[MD=4.28，95% CI（–6.98~15.54），P=0.46]等指标方面，与常规治疗组相比，差异无统计学意义。强骨胶囊的不良反应包括便秘、口干、恶心、胃肠道反应，经对症处理后缓解，不需停药。结论强骨胶囊在改善患者症状及股骨骨密度方面，可能有一定的辅助治疗作用。而在改善血钙、血磷、血碱性磷酸酶、血骨钙素等客观指标方面，可能无明显优势，但具有较好的安全性。

英文摘要:

Objective To provide evidence of the effects of total flavonoids from Rhizoma Drynariae(TFRD)on postmenopausal osteoporosis (PMOP)．Methods CNKI, China biomedical database , Chinese Science and Technique Journals Database, Wanfang database, the Cochrane Library, PubMed, and EMBASE had been retrieved by computer to collect data of randomized controlled clinical trials on the effects of Qianggu Capsule(the main component is TFRD) in treatment of PMOP．The retrieval time was from database establishment to November 2017．System evaluation and meta-analysis were performed by RevMan 5.3. Results Six references were included, including a total of 8 researches．In terms of clinical efficiency and improving bone mineral density of femur, Qianggu Capsule combined with conventional treatment was better than conventional treatment, the Meta results were RR=1.50，95% CI（1.04,2.17），P=0.03 and . Compared with the conventional treatment group, the difference was not statistically significant in improving bone mineral density of lumbar spine or hip and calcium, phosphorus, alkaline phosphatase, osteocalcin, and other biochemical indicators in blood. Its side effects included constipation, dry mouth, nausea and gastrointestinal reactions. But after treatment with symptomatic treatment, drug withdrawal was needless. Conclusion There is a lack of strong evidence to support that TFRD can play a fundamental role in PMOP．Although compare with conventional treatment, there is no obvious advantage in improving bone mineral density and calcium, phosphorus, alkaline phosphatase, osteocalcin, and other biochemical indicators in blood, but clinical research evidence shows that it has a certain effect in improving the patient's symptoms, and has good safety.

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