College of the First Clinical, Hubei University of Chinese Medicine, Wuhan, China.
Department of Rheumatism Immunology, Hubei Provincial Hospital of TCM, Wuhan, China.
Medicine (Baltimore). 2023 Mar 17;102(11):e33278. doi: 10.1097/MD.0000000000033278.
Glucocorticoid-induced osteoporosis (GIOP) is the most common secondary osteoporosis. Bushen Jiangu (BSJG), a classic traditional Chinese medicine (TCM) therapy, is widely used for treatment of GIOP. We conducted a meta-analysis to evaluate the effectiveness and safety of BSJG therapy on the treatment of GIOP.
We searched randomized controlled trials (RCTs) of BSJG therapy for GIOP in 10 databases. Methodological quality assessment was performed by using the Cochrane collaboration tool. RevMan v5.3 and Stata v14.0 software were used for performing data analysis. This study was conducted and reported following the PRISMA checklist.
Overall, 14 RCTs with 988 participants met the inclusion criteria. Pooled results indicated that BSJG therapy contributed to a betterment in improving the clinical efficacy rate of GIOP (risk ratio [RR] = 1.22, 95% confidence interval [CI]: 1.14, 1.30, P < .00001). The pooled results also indicated that BSJG therapy increased lumbar spine bone mineral density (LS-BMD) (weighted mean difference [WMD] = 0.21, 95% CI: 0.08, 0.33, P = .001), total hip bone mineral density (TH-BMD) (WMD = 0.16, 95% CI: 0.09, 0.24, P < .0001), and femoral neck bone mineral density (FN-BMD) (WMD = 0.07, 95% CI: 0.03, 0.10, P = .0001). Furthermore, our results indicated that BSJG therapy improved visual analogue scale (VAS) score (WMD = -0.60, 95% CI: -0.97, -0.23, P = .002), parathyroid hormone (PTH) (standardized mean difference [SMD] = -0.93, 95% CI: -1.58, -0.27, P = .006), and N-terminal propeptide of type I precollagen (PINP) (SMD = 0.69, 95% CI: 0.44, 0.95, P < .00001). In terms of safety, there was no significant difference in the adverse events (AEs) between the 2 groups (RR = 1.45, 95% CI: 0.63, 3.31, P = .38).
Our analysis indicates that BSJG therapy has a valid and safe effect on the treatment of GIOP in the clinic. However, the results need to be confirmed in more well-designed and large-scale RCTs.
糖皮质激素诱导的骨质疏松症（GIOP）是最常见的继发性骨质疏松症。补肾健骨（BSJG）是一种经典的中药（TCM）疗法，广泛用于治疗 GIOP。我们进行了一项荟萃分析，以评估 BSJG 疗法治疗 GIOP 的疗效和安全性。
我们在 10 个数据库中检索了 BSJG 治疗 GIOP 的随机对照试验（RCT）。使用 Cochrane 协作工具进行方法学质量评估。RevMan v5.3 和 Stata v14.0 软件用于数据分析。本研究按照 PRISMA 清单进行报告。
共有 14 项 RCT 纳入了 988 名患者，符合纳入标准。汇总结果表明，BSJG 疗法有助于提高 GIOP 的临床疗效（风险比 [RR] = 1.22，95%置信区间 [CI]：1.14，1.30，P <.00001）。汇总结果还表明，BSJG 疗法增加了腰椎骨密度（LS-BMD）（加权均数差 [WMD] = 0.21，95%CI：0.08，0.33，P =.001）、全髋关节骨密度（TH-BMD）（WMD = 0.16，95%CI：0.09，0.24，P <.0001）和股骨颈骨密度（FN-BMD）（WMD = 0.07，95%CI：0.03，0.10，P =.0001）。此外，我们的结果表明，BSJG 疗法改善了视觉模拟评分（VAS）（WMD = -0.60，95%CI：-0.97，-0.23，P =.002）、甲状旁腺激素（PTH）（标准化均数差 [SMD] = -0.93，95%CI：-1.58，-0.27，P =.006）和 I 型前胶原氨基端肽（PINP）（SMD = 0.69，95%CI：0.44，0.95，P <.00001）。安全性方面，两组间不良事件（AE）无显著差异（RR = 1.45，95%CI：0.63，3.31，P =.38）。
我们的分析表明，BSJG 疗法对 GIOP 的临床治疗具有有效且安全的作用。然而，这些结果需要在更多设计良好和大规模的 RCT 中得到证实。
