| Objective To systematically review the efficacy of traditional Chinese medicine (TCM) decoction or Chinese patent medicine for primary osteoporosis (POP) in Yang deficiency of the spleen and kidney, and to provide evidence for clinical decision-making. Methods Databases including China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), Wanfang data, China Biology Medicine disc (CBM), PubMed, and Embase were searched from the establishment to 1 March 2022. Randomized controlled trials with TCM treatment for POP in type of Yang deficiency of the spleen and kidney were identified. The quality assessment was conducted by using the Cochrane risk of bias tool. Meta-analysis was performed using RevMan version 5.3. Results Seventeen studies were included. Meta-analysis showed that in comparison with non-TCM treatment, TCM invigorating spleen and kidney showed a favorable effect in the total effective rate compared with Western medicine based on the change of bone mineral density (OR=3.22, 95%CI 2.07, 5.00, P<0.00001) and the total effective rate of TCM assessed by TCM syndrome score (OR=6.26, 95%CI 3.12, 12.58, P<0.00001). Compared with non-TCM, TCM showed a superior impact in improvement of lumbar bone mineral density (SMD=0.49, 95%CI 0.03, 0.95, P=0.03<0.05), reduction of TCM syndrome scores (SMD=?1.01, 95% CI ?1.29, ?0.73, P<0.00001) and visual analogue scale (VAS, SMD= ?1.58, 95% CI ?2.42,?0.74, P=0.0002<0.05). There were no significant side effect to the patients. Conclusion In the treatment of POP with Yang deficiency of the spleen and kidney, TCM treatment is more effective in improving the total clinical effective rate, lumbar bone mineral density, reducing TCM syndrome score, and VAS than conventional Western medicine treatment. Additionally, TCM has the advantage of high safety. |