Objective To systematically evaluate the efficacy and safety of tonifying liver-kidney decoction in the treatment of postmenopausal osteoporosis (PMOP), providing a reference for clinical practice. Methods CNKI, Wanfang Database, VIP, Medline, PubMed, Web of Science, and Ovid were searched. The search deadline was May 2018. The clinical randomized controlled trial of treatment of postmenopausal osteoporosis with tonifying liver-kidney decoction (experimental group) was compared with other methods (Western medicine and non-tonifying liver-kidney decoction group, as control group). Data were extracted and scored with the modified Jadad rating scale for quality assessment. Meta-analysis was performed using the Rev Man 5.3 statistical software provided by International Cochrane Collaboration Network. Results A total of 19 RCTs were included, including 1480 patients. Meta-analysis showed that there was no significant difference in bone mineral density [MD=0.20, 95% CI (-0.16, 0.56), P=0.28], estradiol level [MD=9.53, 95% CI (-2.71, 21.78), P=0.13], and serum calcium [MD=0.07, 95% CI (-0.05, 0.19), P=0.23] levels between the experimental group and the control group. The pain was relieved [MD=-0.92, 95% CI (-1.03, -0.82), P<0.01], and osteocalcin level [MD=3.49, 95% CI (2.04, 4.93), P<0.01] and the clinical efficacy [OR=2.47, 95% CI (1.35, 4.50), P=0.003] in the experimental group were better than those in the control group. The effect of tonifying liver-kidney decoction combined with Western medicine was better than Western medicine or non-tonifying liver-kidney decoction alone in improving clinical efficacy [OR=4.47, 95% CI (3.09, 6.44), P<0.01], BMD of the lumbar spine [MD=0.10, 95% CI (0.06, 0.15), P<0.01], BGP [MD=1.51, 95% CI (0.77, 2.24), P<0.01], and E2 levels [MD=6.57, 95% CI (1.97, 11.23), P=0.006]. Conclusion Tonifying liver-kidney decoction effectively treats postmenopausal osteoporosis, synergizes with Western medicine, promotes bone formation, inhibits bone resorption, and relieves clinical symptoms. However, due to the limit of the quality and quantity of the literatures, further study is needed. |