强骨胶囊联合降钙素治疗骨质疏松的系统评价
Qianggu capsules combined with calcitonin in the treatment of osteoporosis: a systematic review
  
DOI:10.3969/j.issn.1006.7108.2019.11.022
中文关键词:  强骨胶囊  降钙素  骨质疏松  系统评价  Meta分析
英文关键词:Qianggu capsules  calcitonin  osteoporosis  systematic review  meta-analysis
基金项目:国家自然科学基金(81302768)
作者单位
陈伦1 祁佳1 陶贤2* 1.上海交通大学医学院附属新华医院药剂科上海 200092 2.苏州市中西医结合医院苏州市木渎人民医院骨科江苏 苏州 215101 
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中文摘要:
      目的 评价强骨胶囊联合降钙素治疗骨质疏松的临床疗效。方法 检索主要数据库从建库至2017年4月1日强骨胶囊联合降钙素治疗骨质疏松随机对照试验研究,筛选合格研究。应用Cochrane评价员手册进行偏倚风险评价,Jadad评分法进行质量评价。应用RevMan5.3软件进行Meta分析。结果 符合纳入标准的文献共5篇。Meta分析结果显示,强骨胶囊联合降钙素试验组与对照组相比,临床疗效总有效率比值比(odds ratio,OR)为2.70,95%可信区间(confidence interval,CI)(1.13,6.44)差异有统计学意义(P=0.02);骨密度均数差(mean difference,MD)为0.11,95%CI(0.08,0.13)差异有统计学意义(P<0.0001);血磷指标MD为0.05,95%CI(0.01,0.09)差异有统计学意义(P=0.03);碱性磷酸酶MD为-7.40,95%CI (-11.15,-3.65)差异有统计学意义(P=0.0001);均无重大不良反应发生。结论 强骨胶囊联合降钙素治疗骨质疏松临床疗效显著,能有效增加骨密度,升高血磷指标,降低碱性磷酸酶指标,应用安全。但需要更多高质量、多中心严格设计的随机对照试验进一步验证。
英文摘要:
      Objective To evaluate the clinical efficacy of Qianggu capsules combined with calcitonin in the treatment of osteoporosis. Methods Main databases from the inception of each database up to 1 April 2017 were electronically searched. Randomized clinical trials (RCTs) of Qianggu capsules combined with calcitonin for osteoporosis treatment were included. The Cochrane risk of bias tool was used to assess the risk of bias. We assessed the quality of included studies using the Jadad rating scale. The Cochrane Collaboration’s RevMan5.3 software was used for meta-analysis. Results Fives studies met the inclusion criteria were included. The meta-analysis results showed that comparing Qianggu capsules combined with calcitonin experimental group with the control group, the total efficiency rate odds ratio (OR) was 2.70, 95% confidence interval (CI) [1.13,6.44], the difference was statistically significant (P=0.02); bone mineral density mean difference (MD) was 0.11, 95% CI [0.08, 0.13], the difference was statistically significant (P<0.00001); blood phosphorus MD was 0.05, 95% CI [0.01, 0.09], the difference was statistically significant (P=0.03). Alkaline phosphatase MD was -7.40, 95% CI [-11.15,-3.65], the difference was statistically significant (P=0.0001). All studies included did not report any adverse reactions. Conclusion Qianggu capsules combined with calcitonin in the treatment of osteoporosis showed significant clinical curative effect; could increase bone mineral density and blood phosphorus, reduce alkaline phosphatase and have good safety. However, the number and the study sample size were small and the methodological quality was low. To further evaluate the effect and safety of Qianggu capsules combined with calcitonin for treating osteoporosis, more rationally designed RCTs with large samples need to be carried out.
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