仙灵骨葆胶囊治疗绝经后骨质疏松症有效性的系统评价和Meta分析

目的评价仙灵骨葆胶囊治疗绝经后骨质疏松症的有效性和安全性。方法电子检索中、英文数据库共7个(自建库时间至2017年11月),按照纳入标准和排除标准筛选文献,依据Cochrane Handbook for Systematic Reviews of Interventions(version 5.35)质量评估,并用RevMan 5.3软件进行Meta分析。结果检索到文献共1 779篇,筛选后纳入文献16篇(19项原始研究),总样本量1 492例。Meta分析得出单用仙灵骨葆胶囊对于提高腰椎骨密度疗效优于常规治疗MD=0.08,95%CI(0.03,0.14),P=0.002];仙灵骨葆胶囊加常规干预对于提高临床有效率OR=3.35,95%CI(1.86,6.05),P<0.000 1]、改善疼痛MD=-1.71,95%CI(-2.39,-1.03),P<0.000 01]疗效优于常规治疗;在改善腰椎骨密度方面,仙灵骨葆胶囊+单一常规干预疗效明显优于单一常规干预MD=0.06,95%CI(0.04,0.07),P<0.000 01];仙灵骨葆胶囊联合常规干预在提高髋部骨密度疗效上可能优于常规干预MD=0.08,95%CI(0.03,0.14),P=0.001]。结论仙灵骨葆胶囊在改善腰椎骨密度、提高临床有效率及改善疼痛方面疗效确切;但在改善髋部骨密度方面证据不足,总疗程可能是其重要影响因素;仙灵骨葆胶囊联合单一抗骨质疏松药物具有增效作用,与两种或以上抗骨质疏松药物联用叠加增效作用尚待研究。

The effectiveness of Xianling Gubao capsule in the treatment of postmenopausal osteoporosis:a systematic review and meta-analysis

AN Yifang;ZHANG Yili;XIE Yanming;WEI Xu;JIANG Junjie(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700;Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053;College of Traditional Chinese Medicine,Beijing University of Chinese Medicine,Beijing 100029;Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102;Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091,China)