Department One of Spine Surgery, Zhongshan Hospital of Traditional Chinese Medicine, Zhong Shan, Guangdong Province, China.
Department of Geriatric Medicine, Zhongshan Hospital of Traditional Chinese Medicine, Zhong Shan, Guangdong Province, China.
Medicine (Baltimore). 2023 Dec 22;102(51):e36634. doi: 10.1097/MD.0000000000036634.
To evaluate the efficacy and safety of oral traditional Chinese medicine combined with conventional anti-osteoporosis drugs in the treatment of osteoporosis and fractures.
The database of China national knowledge infrastructure, China Science and Technology Journal Database, Wangfang (WANGFANG DATA), ChineseBioMedicalLiteratureDatabase, PubMed, Embase, and Cochrane Library databases were searched from inception to June 1st, 2023 for randomized controlled trials on oral Chinese medicine combined with conventional anti-osteoporosis drugs for the treatment of osteoporosis and fractures. Quality assessment was performed using the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. STATA 15.0 software was used for meta-analysis. Outcome measures included overall response rate, adverse events, T-score, bone mineral density, Oswestry Disability Index score, fracture healing time, and visual analog scale score.
A total of 72 studies were included, involving 7847 participants. Different treatment options showed different advantages in the adjuvant treatment of osteoporosis and fractures. The total response rate, complication reduction, Oswestry Disability Index and visual analog scale score reduction, bone mineral density improvement and fracture healing time were all superior to drug therapy alone. The differences were statistically significant, but the improvement in T-score was not significant.
The combination of oral traditional Chinese medicine and conventional anti-osteoporosis drugs is more effective and safer than Western medicine alone in the treatment of osteoporosis and fractures, which indicated that the treatment of integrated Chinese and western medicine can promote the healing of osteoporosis and fracture. This approach had a promising clinical application prospect. Due to the limitations of included studies, the ranking results should be interpreted with caution. In the next step, we will further conduct subgroup data based on factors, such as conventional Western medicine treatment regimens, whether surgical treatment was performed, fracture locations.
评价口服中药联合常规抗骨质疏松药物治疗骨质疏松症及骨折的疗效和安全性。
计算机检索中国知网、中国科技期刊数据库、万方（WANFANG DATA）、中国生物医学文献数据库、PubMed、Embase 和 Cochrane 图书馆数据库，搜集口服中药联合常规抗骨质疏松药物治疗骨质疏松症及骨折的随机对照试验，检索时限均为建库至 2023 年 6 月 1 日。采用 Cochrane 干预措施系统评价手册 5.1.0 评价纳入研究的偏倚风险，采用 STATA 15.0 软件进行 Meta 分析。结局指标包括总有效率、不良反应、T 值、骨密度、Oswestry 功能障碍指数评分、骨折愈合时间、视觉模拟评分。
共纳入 72 项研究，涉及 7847 名参与者。不同的治疗方案在骨质疏松症及骨折的辅助治疗中表现出不同的优势，总有效率、不良反应减少、Oswestry 功能障碍指数评分和视觉模拟评分降低、骨密度改善、骨折愈合时间均优于单纯药物治疗，差异均有统计学意义，但 T 值改善差异无统计学意义。
口服中药联合常规抗骨质疏松药物治疗骨质疏松症及骨折的疗效优于单纯西药，安全性更高，表明中西药结合治疗可促进骨质疏松及骨折愈合，具有较好的临床应用前景。鉴于纳入研究的局限性，对排序结果的解释应谨慎。下一步我们将进一步开展基于常规西药治疗方案、是否手术治疗、骨折部位等因素的亚组数据挖掘。
