经典中医古方治疗骨质疏松症的系统评价

背景：经典中医古方在针对骨质疏松症的治疗中有着较好的疗效，但以系统科学方法进行Meta分析以明确其总体疗效的报道不多。 目的：系统评价中医经典古方在治疗骨质疏松症的疗效性和安全性，为经典古方在骨质疏松症中的应用提供依据。 方法：计算机检索中国期刊全文数据库(2001/2010)、中国重要会议论文全文数据库(2001/2010)、维普数据库(2001/2010)等国内各大数据库，手工检索所有纳入文献的参考文献。纳入经典中医古方治疗骨质疏松症的随机对照试验(RCT)。评价纳入研究的方法学质量并进行资料提取后，采用RevMan4.2软件进行Meta分析。 结果与结论：共纳入包括1 235例受试者在内的随机对照试验17个，Jadad评分4个2分，其余均为1分，且所有研究均处于C级，质量不高。经典古方与单纯西药治疗相比，总体疗效合并OR=3.82, 95%CI2.70~5.41]；症状积分WMD=-1.95，95%CI-2.19~1.72]；腰椎骨密度WMD=0.04，95%CI0.03~0.06]，其他部分骨密度WMD=0.04，95%CI0.03~0.06]。经典古方加西药对比西药，总有效率OR=3.09，95%CI1.58~6.07]。提示现有临床研究证据表明中医经典古方在治疗骨质疏松症方面存在一定的优势，未见明显不良反应的报道。

Classical ancient recipe for patients with osteoporosis: A systematic review

BACKGROUND:Classical ancient recipe shows satisfactory therapeutic effects in treatment of osteoporosis, but there are few reports describing systemic scientific methods for meta analysis to identify the general curative effects of classical ancient recipe. OBJECTIVE:To evaluate the clinical curative effects and safety of classical ancient recipe in treatment of osteoporosis. METHODS:A computer-based retrieval was performed in China National Knowledge Infrastructure, CPCD and Weipu databases for searcing papers addressing randomized controlled trials (RCTs) involving classical ancient recipe for treatment of osteoporosis published between 2001 and 2010. The Cochrane collaboration’s RevMan 4.2.2 software was used for data analyses. RESULTS AND CONCLUSION:A total of 17 trials involving 1 235 patients were included. According to the Jadad scoring method, of the 17 RCTs, 4 studies scored 2 points, and the remaining studies each scored 1 point. According to the allocation concealment, all the 17 RCTs got C. In the meta-analysis, the classical ancient recipe treatment was significantly superior to western medicine treatment in total effective rate OR=3.82, 95%CI (2.70-5.41), symptom score WMD=-1.95, 95%CI (-2.19-1.72), lumbar vertebra bone minearal density WMD=0.04, 95%CI(0.03-0.06), and the other parts bone minearal density WMD=0.04, 95%CI (0.03-0.06). Classical ancient recipe plus western medicine treatment were significantly superior to western medicine treatment in total effective rate OR=3.09, 95%CI (1.58-6.07). The current clinical evidence shows that the classical ancient recipe treatment is superior in treatment of osteoporosis with no obvious adverse reactions.