中药治疗糖尿病性骨质疏松疗效与安全性的系统评价  

Effects and safety of traditional Chinese medicine for treating diabetic osteoporosis:a syste matic review

作　　者：吴宏梓 方洲[1] 汪少波[1] 

机构地区：[1]克拉玛依市中心医院骨二科,克拉玛依834000

出　　处：《中国骨质疏松杂志》2016年第3期251-256,270,共7页Chinese Journal of Osteoporosis

摘　　要：目的运用循证医学系统评价方法评价中药治疗糖尿病性骨质疏松的疗效与安全性,为临床实践和研究提供参考。方法计算机检索Pub Med、Web of science、Cochrane图书馆、CNKI、VIP、CBM和万方数据库,查找中药治疗糖尿病性骨质疏松与单独应用西药(钙尔奇D片)比较、中西药结合与单独应用西药(钙尔奇D片)比较的随机对照试验,检索时限均从建库至2015年09月。由2名研究者按照纳入与排除标准独立进行文献筛选、资料提取和质量评价后,采用Rev Man 5.2软件进行Meta分析。结果纳入8个RCT,共698例患者。Meta分析结果显示,与对照组比较,中西药联合治疗糖尿病性骨质疏松在增加患者骨钙素[MD=0.90,95%CI(0.22,1.57)]、腰椎骨密度[MD=0.02,95%CI(0.02,0.03)]、股骨颈骨密度[MD=0.03,95%CI(0.00,0.06)]、Ward’s三角骨密度[MD=0.03,95%CI(0.01,O.05)]方面均有统计学意义;但单纯中药组的腰椎骨密度与对照组相比无统计学意义。在不良反应方面,尚未见中医药的严重不良反应报告。结论现有临床证据表明,中医药可以提高糖尿病性骨质疏松症患者骨密度、缓解骨痛。但其疗效优势值得进一步研究,特别需要高质量的多中心大样本随机双盲对照试验来验证。Objective To evaluate the effectiveness and safety of traditional Chinese medicine（ TCM） versus conventional treatment（ CT） for diabetic osteoporosis（ Dop）.Me thods Systematic searches were conducted in Pub Med,The Cochrane Library,SCI,CNKI,VIP,CBMand Wanfang database to collect randomized controlled trials（ RCTs） on TCMtreating Dop from inception to March 2013.Two reviewers independently screened articles according to the inclusion and exclusion criteria,extracted data and evaluated the quality of the included studies.Then meta-analysis was performed using Rev Man5.2.Re sults A total of 8RCTs involving 698 patients were included.Compared with the CT group,the influences on osteocolcin [MD = 0.90,95% CI（ 0.22,1.57） ],BMD of the 1umbar spine [MD = 0.02,95% CI（ 0.02,0.03） ],femoml neck [MD = 0.03,95% CI（ 0.00,0.06） ] and ward＇s triangle [MD = 0.03,95% CI（ 0.01,0.05） ] were showed by Meta-analysis,respectively.No study reported the quality of life and severe adverse reactions after TCMtreatment.Conclusion Current clinical evidence indicates that TCMis efficient for increasing BMD in Diabetic osteoporosis and for alleviating bone pain.However,due to lack of enough high-quality studies,TCMhas to be further studied by conducting more strictly-designed,multicenter,large-scale and double-blind RCTs.

关 键 词：糖尿病性骨质疏松 中医药 系统评价 META分析 随机对照试验 

分 类 号：R683[医药卫生—骨科学]