摘要
目的系统评价雌激素类药物治疗绝经后骨质疏松的疗效及安全性。方法检索PubMed、EMbase、Cochrane Library、中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、维普中文期刊全文数据库(VIP)和万方数据库中关于雌激素治疗绝经后骨质疏松的临床随机对照研究(RCT),依据纳排标准纳入文献,运用软件Review Manager 5.0和Stata 14.0进行疗效和安全性的系统评价。结果共纳入15篇RCTs,包括13 280例患者。结果表明雌激素类药物对改变绝经后骨质疏松患者的腰椎骨密度[MD=1.08,95%CI(0.75,1.40),P<0.001]、椎体骨折发生率[OR=0.61,95%CI(0.52,0.71),P<0.001]、血清骨钙素[MD=-16.03,95%CI(-18.68,-13.67),P<0.001]等指标具有特异性。网状Meta-结果表明雌激素中巴多昔芬对于提高腰椎BMD的效果最好。雌激素治疗极少发生严重不良反应,普通不良反应发生率(潮热、肌肉痉挛等)较低。结论雌激素类药物对绝经后骨质疏松的治疗具有积极意义,显著减低了椎体骨折发生率并改善了患者的骨密度;雌激素类药物治疗的不良反应发生率较低,安全性高。
Objective To systematically evaluate the efficacy and safety of estrogen drugs in the treatment of postmenopausal osteoporosis. Methods Search PubMed, EMbase, Cochrane Library CBM, CNKI, VIP, and Wanfang Data on estrogen treatment of postmenopausal osteoporosis in clinical case-control study. Determine the search formula and included literature in the exclusion criteria included in the literature followed by data extraction. Review Manager 5.0 and Stata 14.0 were used to evaluate the efficacy and safety of the system. Results A total of 15 RCTs articles were included, including 13 280 patients. The results showed that estrogen drugs had specific effects on lumbar vertebra bone density [MD=1.08, 95%CI(0.75, 1.40), P < 0.001], vertebra fracture incidence [OR=0.61, 95%CI(0.52, 0.71), P < 0.001], osteocalcin [MD=-16.03, 95%CI(-18.68,-13.67), P < 0.001] and other indicators of post-menopausal osteoporosis. Network meta results showed that the effect of the estrogen bazedoxifene on the improvement of lumbar BMD was the best. Serious adverse reactions rarely occur in estrogen therapy, and the incidence of common adverse reactions(hot flashes, muscle spasms, etc.) is low. Conclusion Estrogen drugs have positive effects on the treatment of postmenopausal osteoporosis, significantly reduce the incidence of vertebral fractures and improve the patient’s bone mineral density. The incidence of adverse reactions of estrogen drugs was lower, and the safety is higher than control drugs.
作者
陈维媛
赵春阳
蔡佳怡
姜明燕
CHEN Weiyuan;ZHAO Chunyang;CAI Jiayi;JIANG Mingyan(Department of Pharmacy,The First Affiliated Hospital of China Medical University,Shenyang 110001,China;College of Pharmaceutical Science,China Medical University,Shenyang 110122,China)
出处
《药物评价研究》
CAS
2019年第12期2451-2458,共8页
Drug Evaluation Research
