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| 补益肝肾方治疗PMOP的Meta分析 |
| Meta-analysis of the Treatment of Tonifying Liver-Kidney Decoction in Postmenopausal Osteoporosis |
| 投稿时间：2018-12-25 修订日期：2019-03-17 |
| DOI： |
| 中文关键词: 补益肝肾方 绝经后骨质疏松症 Meta分析 疗效 |
| 英文关键词:Tonifying Liver-Kidney Decoction Postmenopausal Osteoporosis Meta-analysis Efficacy |
| 基金项目:国家自然科学基金(No.81774260) |
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| 中文摘要: |
| 目的 系统评估补益肝肾方治疗绝经后骨质疏松症(PMOP)的有效性和安全性,为临床治疗提供参考依据。方法 计算机检索中国知网(CNKI)、万方数据库、维普中文科技期刊数据库(VIP)、Medline、PubMed、Web of Science、Ovid,检索时限截至2018年05月。纳入补益肝肾方(试验组)对比其他方式(西药及非补益肝肾方,对照组)治疗绝经后骨质疏松症的临床随机对照试验,使用 Jadad评定量表提取数据并对相关数据进行评分,采用由国际 Cochrane协作网提供的 Rev Man5.3统计软件进行 Meta分析。结果 共纳入19项RCT,合计1480例患者。Meta分析显示,试验组在改善腰椎骨密度水平、雌二醇水平以及血清钙水平与对照组相比无明显差异,［MD=0.20,95%CI(-0.16,0.56),P=0.28］、［MD=9.53,95%CI(-2.71,21.78),P=0.13］、［MD＝0.07,95%CI(-0.05,0.19),P=0.23］；试验组在改善疼痛、骨钙素水平以及临床疗效方面优于对照组［MD＝-0.92,95%CI(-1.03,-0.82),P＜0.00001］、［MD=3.49,95%CI(2.04,4.93),P＜0.00001］、［OR=2.47,95%CI(1.35,4.50),P=0.003］。补益肝肾方配合西药在改善临床疗效、腰椎BMD、BGP以及E2水平等方面,疗效优于西药组或非补益肝肾方组［OR=4.47,95%CI(3.09,6.44),P＜0.00001］、［MD=0.10,95%CI(0.06,0.15),P＜0.00001］、［MD=1.51,95%CI(0.77,2.24),P＜0.0001］、［MD=6.57,95%CI(1.97,11.23),P=0.006］。结论 补益肝肾方能有效治疗 PMOP,并可与西药协同增效,促进机体骨质生成,降低骨质吸收,从而缓解临床症状,但因纳入文献质与量的限制,更深入的研究有待进行。 |
| 英文摘要: |
| 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 The computer search was conducted by CNKI, Wanfang Database, VIP, Medline, PubMed, Web of Science, Ovid. The search deadline was May 2018. Into a clinical randomized controlled trial of treatment of postmenopausal osteoporosis in the Tonifying Liver-Kidney Decoction (experimental group) versus other methods (Western medicine and non-Tonifying Liver-Kidney Decoction group , as control group), extracting data, and applying the modified Jadad rating scale for quality assessment. Using the Rev Man 5.3 statistical software provided by the International Cochrane Collaboration Network for meta-analysis. Results A total of 19 RCTs were included, totaling 1480 patients. Meta-analysis showed that there was no significant difference in bone mineral density, estradiol level, and serum calcium levels between the experimental group and the control group [MD=0.20,95%CI(-0.16,0.56),P=0.28],[MD=9.53,95%CI(-2.71, 21.78),P=0.13],[MD=0.07,95%CI(-0.05,0.19),P=0.23]; The experimental group improved pain and osteocalcin levels,and the clinical efficacy was better than that in the control group [MD=-0.92,95%CI(-1.03,-0.82),P<0.00001],[MD=3.49, 95%CI(2.04,4.93),P<0.00001],[OR=2.47,95%CI(1.35, 4.50),P=0.003]. The effect of Tonifying Kidney-Kidney Decoction Combined with Western Medicine was better than Western Medicine or non-Tonifying Liver-Kidney Decoction in improving clinical efficacy, lumbar spine BMD, BGP and E2 levels [OR=4.47,95%CI(3.09, 6.44),P<0.00001],[MD=0.10,95%CI(0.06,0.15),P<0.00001],[MD=1.51,95%CI(0.77, 2.24),P<0.0001],[MD=6.57,95%CI(1.97,11.23),P=0.006]. Conclusion Tonifying Liver-Kidney Decoction can effectively treat postmenopausal osteoporosis, and can synergize with Western medicine, promote bone formation, inhibit bone resorption, and thus relieve clinical symptoms, but due to the limit of the quality and quantity of the literatures, pending further study. |
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