系统评价再评价在中药治疗绝经后骨质疏松症中的应用

目的运用AMSTAR 2方法质量评分和PRISMA报告质量评分定性定量再评价中药治疗绝经后骨质疏松症的系统评价/Meta分析,以期为临床决策者提供科学的参考证据。方法运用计算机检索国内外8大中英文数据库:中国知网(CNKI)、维普(VIP)、中国生物医学文献数据库(CBM)、万方数据库、The Cochrane Library、Embase、PubMed、Web of Science,收集中药治疗绝经后骨质疏松症的系统评价/Meta分析,检索时间从数据库建库至2020年2月。运用AMSTAR 2和PRISMA对中药治疗绝经后骨质疏松症系统评价/Meta分析的文献质量进行综合评估。运用GRADE对所有纳入文献的结局指标进行质量分级。采用多元线性回归分析法分析与纳入文献整体质量评分相关的因素及其效应量。结果共纳入12篇合格文献,运用Excel 2013进行数据提取并进行AMSTAR 2方法学质量评分和PRISMA报告学质量评分,结果显示所有纳入文献的质量偏低。主要存在项目注册、检索、方法学使用、质量报告影响、发表偏倚等方面的问题。GRADE证据质量评分偏低,以低质量为主。结论中药治疗绝经后骨质疏松症系统评价/Meta分析的文献质量不高。研究发现,文献质量受方法学使用和质量报告影响较大。研究者需按循证医学的要求和方法从方法学质量和报告学质量方面着手,不断加强以期进一步提高文献质量。今后的研究需要基于统一的标准与指标,采用科学的方法学进行统计分析,进一步提高中药临床治疗绝经后骨质疏松症的科学性、真实性与准确性。

Application of systematic evaluation and reevaluation in the treatment of postmenopausal osteoporosis with traditional Chinese medicine

Objective To qualitatively and quantitatively re-evaluate the systematic review/meta-analysis of Chinese medicine for postmenopausal osteoporosis using AMSTAR 2 and PRISMA quality score, in order to provide scientific reference evidence for clinical decision makers. Methods Systematic review/meta analysis of Chinese medicine for postmenopausal osteoporosis was collected from 8 Chinese and English databases, including China Knowledge Network (CNKI), VIP (VIP), China Biomedical Literature Database (CBM), and Wanfang Database. The retrieval time was from the database establishment to February 2020. The AMSTAR 2 and PRISMA quality score were used to comprehensively evaluate the literature quality of systematic reviews/meta analysis of Chinese medicine for postmenopausal osteoporosis. The quality of all included outcome indicators was graded using the GRADE evidence quality assessment tools. Multivariate linear regression analysis was used to analyze the factors related to the overall quality score of the included literature and the efficacy. Results A total of 12 qualified literature were included. Data were extracted using Excel 2013 and were scored with AMSTAR 2 and PRISMA quality score. The results showed that the quality of all the included literature was low. The main problems were project registration, retrieval, methodological use, quality report impact, and publication bias. GRADE evidence quality score was low, and mainly with low quality. Conclusion The systematic review/meta-analysis of traditional Chinese medicine for postmenopausal osteoporosis is of low quality. The study found that the quality of the literature was greatly affected by the use of methodology and quality reports. According to the requirements and methods of evidence-based medicine, researchers need to start from the quality of methodology and reporting, and constantly strengthen to further improve the quality of literature. Future research needs to unify standards and indicators and to use scientific methodology for statistical analysis. The scientific authenticity and accuracy of clinical treatment of postmenopausal osteoporosis with traditional Chinese medicine need to improve .