摘要
目的系统评价中药复方治疗糖尿病性骨质疏松(Diabetic Osteoporosis,DO)的有效性及安全性并对其用药规律进行分析。方法系统检索中国生物医学文献数据库(Sino Med)、中国期刊全文数据库(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库、PubMed、Springer、Embase databases、Cochrane Library等电子数据库,纳入以中药复方作为主要干预措施治疗糖尿病性骨质疏松症临床试验的研究文献,文献的检索年限均为从建库至2018年08月,检索资料由两名研究人员独立进行提取,若有分歧,则由第三方协助并解决。采用Review Manager 5.3对中药复方治疗糖尿病性骨质疏松症的有效性、血糖、骨代谢等结局指标进行Meta分析。结果最终纳入18篇文献,受试者共1127人,其中12篇为在西药基础上联合应用中药。Meta分析结果显示,中药复方无论是否联合西药治疗糖尿病性骨质疏松在有效率上均优于对照组,合并效应值RR=1.39,95%CI=[1.29,1.50],差异具有统计学意义(P<0.000 01);中药复方联合西药与西药对比,可明显降低空腹血糖(RR=-0.32,95%CI=[-0.51,-0.12],P=0.002)、餐后血糖(RR=-0.33,95%CI=[-0.62,-0.04],P=0.03)、糖化血红蛋白(RR=-0.31,95%CI=[-0.46,-0.16],P<0.000 01),且对股骨颈骨密度(RR=0.07,95%CI=[0.02,0.12],P=0.005)、腰椎骨密度(RR=0.07,95%CI=[0.01,0.13],P=0.02)作用明显,但对血清钙、磷、碱性磷酸激酶(ALP)、I型原胶原N端前肽(P1NP)的作用不明显(P>0.05);中药复方与西药对比,可明显降低餐后血糖(RR=-0.37,95%CI=[-0.69,-0.05],P=0.02)、糖化血红蛋白(RR=-0.40,95%CI=[-0.60,-0.20],P<0.000 01),但对空腹血糖、血清钙、磷、ALP作用不明显(P>0.05)。所用的中药中以熟地黄为主的补益药使用频次最高。结论中药复方对治疗DO有一定疗效,能够改善血糖和骨质疏松症状,且以补益肝肾的中药为主。
Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of diabetic osteoporosis(DO) and analyze its medication rules. Methods According to the requirements of Meta-analysis, the Chinese Biomedical Literature Database(Sino Med), China Journal Full-text Database(CNKI), VIP Chinese Science and Technology Periodical Database(VIP), Wanfang Database, PubMed, Springer, Embase databases and Cochrane Library were searched. The randomized controlled trials of traditional Chinese medicine as the main intervention for the treatment of diabetic osteoporosis were included. The search period of the literature was from inception to August 2018. The data was independently extracted by two researchers. If there was any disagreement, it would be assisted and solved by a third party. Review Manager 5.3 was used to do the Meta-analysis in order to systematically evaluate the effect of Chinese herbal medicine in the treatment of diabetic osteoporosis, blood glucose and bone metabolism. Results A total of 18 RCTs were included in the literature. A total of 1127 patients were included, 12 RCTs of which were combined with traditional Chinese medicine based on western medicine. The results of Meta-analysis showed that the traditional Chinese medicine with or without western medicine was superior to the control group in the treatment of diabetic osteoporosis. The combined effect value was statistically significant,RR=1.39, 95%CI=[1.29, 1.50](P<0.000 01). Chinese herbal compound combined with western medicine can significantly reduce fasting blood glucose(RR=-0.32, 95%CI=[-0.51,-0.12], P=0.002),postprandial blood glucose(RR=-0.33,95%CI=[-0.62,-0.04], P=0.03), glycosylated hemoglobin(RR=-0.31, 95%CI=[-0.46,-0.16], P<0.000 01), the femoral neck bone density(RR=0.07, 95%CI=[0.02,0.12], P=0.005), and lumbar spine bone mineral density(RR=0.07, 95% CI=[0.01,0.13], P=0.02), but the effect on serum calcium, phosphorus, alkaline phosphokinase(ALP), type I procollagen N-terminal propeptide(P1 NP)
作者
李嘉鑫
杨宇峰
曲超
石岩
LI Jiaxin;YANG Yufeng;QU Chao;SHI Yan(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China)
出处
《中华中医药学刊》
CAS
北大核心
2020年第4期173-180,I0031,共9页
Chinese Archives of Traditional Chinese Medicine
基金
辽宁省高等学校创新团队基金(LT2014020)。
关键词
中药
糖尿病性骨质疏松
系统评价
用药规律
Chinese medicine
diabetic osteoporosis
systematic evaluation
medication rule
