右归丸联合西药治疗骨质疏松症的Meta分析  

Meta-analysis of Yougui Pill combined with Western medicine in the treatment of osteoporosis

作　　者：刘小沛 王相东[1] 邢文文 谭从娥[1] LIU Xiaopei;WANG Xiangdong;XING Wenwen;TAN Conge(Shaanxi University of Chinese Medicine, Xianyang 712046, China)

机构地区：[1]陕西中医药大学,陕西咸阳712046

出　　处：《中国骨质疏松杂志》2021年第6期781-787,共7页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金(81973754);陕西中医药大学创新团队项目(2019-QN06)。

摘　　要：目的系统评价右归丸联合西药治疗骨质疏松症的有效性和安全性,以期为临床决策提供参考。方法检索中国知识资源总库(CNKI)、中国学术期刊数据库(万方数据库)、中文科技期刊数据库(维普网)、中国生物医学文献数据库(CBM)、PubMed、Embase、Cochrance Library建库至2020年1月7日有关右归丸治疗骨质疏松症的随机对照试验文献,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,使用RevMan 5.3以及stata14.0进行Meta分析,发表偏倚采用Egger检验。结果共纳入11个研究,均为随机对照试验,包括1066例骨质疏松症患者。Meta分析结果显示,右归丸联合西药治疗骨质疏松症时,在提高总有效率(RR=1.29,95%CI:1.21~1.39,P<0.00001)、改善骨密度含量(SMD=-0.77,95%CI:0.28~1.25,P=0.002)、降低新发脆性骨折风险(RR=0.29,95%CI:0.11~0.51,P<0.0001)方面均优于西药对照组,右归丸联合西药组血钙浓度(MD=-0.09,95%CI:-0.16~-0.02,P=0.01)低于西药对照组,Egger检验(P=0.454>0.05)无明显发表偏倚。结论右归丸联合西药治疗骨质疏松症优于单纯使用西药治疗,但仍然有待高质量、大样本的随机对照试验予以进一步证实。Objective To systematically evaluate the clinical efficacy and safety of Yougui Pill combined with western medicine for Osteoporosis through Meta analysis.Methods All literatures published before January 7th,2020 on randomized controlled trails of Yougui Pill efficacy for Osteoporosis were retrieved from seven databases including China National Knowledge Infrastructure(CNKI),Wanfang Data,China Science and Technology Journal Database(CSTJ),China Biology Medicine disc(CBMdisc),PubMed,Embase,and Cochrance Library.Cochrane risk assessment tool was adopted to assess the quality of the retrieved literature;and Meta analysis was undertaken with RevMan5.3 and Stata14.0.Quality level for the primary outcome was analyzed with GRADE Profile 3.6.Results 260 studies were retrieved,among which only 11 studies with 1066 patients were included.Meta analysis result were as follows:total effective rate was higher in Yougui Pill combined with western medicine group than in western medicine group(RR=1.29,95%CI:1.21-1.39,P<0.00001);the effective rate in improving Bone Density was higher in Yougui Pill combined with western medicine group than in western medicine group(SMD=-0.77,95%CI:0.28-1.25,P=0.002);New fragility fractures was lower in Yougui Pill combined with western medicine group than in western medicine group(RR=0.29,95%CI:0.11-0.51,P<0.0001);Concentration of blood calcium was lower in Yougui Pill combined with western medicine group than in western medicine group(MD=-0.09,95%CI:-0.16--0.02,P=0.01).Egger test(P=0.454>0.05)finds no significant publication bias.Conclusion Yougui Pill combined with western medicine has higher clinical efficacy than western medicine alone in treating primary osteoporosis.But definite conclusion need to be drawn with higher level of evidence from multi-centre randomized controlled trails.

关 键 词：右归丸 骨质疏松症 META分析 

分 类 号：R259[医药卫生—中西医结合]