| Objective To retrospective analyze the efficacy and safety of zoledronic acid in the treatment of postmenopausal osteoporosis. Methods The clinical randomized control studies (RCT) on the treatment of post-menopausal osteoporosis with pyrethroid acid were systematically retrieved from CNKI, CBM, PubMed, VIP, Embase, WanFang, and Cochrane Library. The study methodological quality assessment was conducted. The efficacy and safety were evaluated with software Stata16.0 and Review Manager 5.3. Results A total of 10 articles were included, involving 16 studies and 1277 patients. The results showed that zoledronic acid combined with calcium was effective in improving the bone mineral density (BMD) of the lumbar vertebrae in patients with post-menopausal osteoporosis (MD=0.021, 95%CI 0.009, 0.033, P>0.05). A subgroup analysis of lumbar spine BMD showed that in the subgroup analysis of treatment methods, zoledronic acid combined with calcium had the best effect (MD=0.037, 95%CI 0.009, 0.065, P=0.009). According to the grouping of treatment courses, the efficacy of treatment course less than 1 year is relatively low (MD=0.017, 95%CI -0.034, 0.069, P=0.506). When grouped by the country where the patients were located, China (MD=0.02, 95%CI 0.006, 0.035, P=0.005) and India (MD=0.03, 95%CI 0.002, 0.058, P=0.005) were the most effective. Network Meta results showed that zoledronic acid combined with calcium was the best for improving lumbar spine BMD. Zoledronic acid treatment rarely had serious adverse reactions, and the incidence of common adverse reactions (fever, myalgia, flu-like symptoms, headache, arthralgia, fractures, etc.) was low. Conclusion The combination of zoledronic acid has positive significance for the treatment of postmenopausal osteoporosis by significantly improving BMD of the patients and reducing serum biochemical markers. The incidence of adverse reactions is low and the safety is high. |