[1]匡浩铭,杨张琪,彭志飞,等.六味地黄丸治疗绝经后骨质疏松症疗效和安全性的Meta分析[J].中医正骨,2022,34(08):31-35,58.
 KUANG Haoming,YANG Zhangqi,PENG Zhifei,et al.Clinical efficacy and safety of Liuwei Dihuang Wan(六味地黄丸)for treatment of postmenopausal osteoporosis:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(08):31-35,58.
点击复制

六味地黄丸治疗绝经后骨质疏松症疗效和安全性的Meta分析()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年08期
页码:
31-35,58
栏目:
文献研究
出版日期:
2022-08-20

文章信息/Info

Title:
Clinical efficacy and safety of Liuwei Dihuang Wan(六味地黄丸)for treatment of postmenopausal osteoporosis:a meta-analysis
作者:
匡浩铭1杨张琪1彭志飞2戎宽2匡建军2
(1.湖南中医药大学,湖南 长沙 410208; 2.湖南省中医药研究院,湖南 长沙 410006)
Author(s):
KUANG Haoming1YANG Zhangqi1PENG Zhifei2RONG Kuan2KUANG Jianjun2
1.Hunan University of Chinese Medicine,Changsha 410208,Hunan,China 2.Hunan Academy of Chinese Medicine,Changsha 410006,Hunan,China
关键词:
骨质疏松绝经后 六味地黄丸 专题Meta分析
Keywords:
osteoporosispostmenopausal Liuwei Dihuang Wan meta-analysis as topic
摘要:
目的:系统评价六味地黄丸治疗绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)的疗效和安全性。方法:应用计算机检索中国知网、万方数据库、维普网、Cochrane Library、PubMed中有关六味地黄丸治疗PMOP的随机对照试验文献,检索时限均为2012年5月31日至2022年2月31日。治疗组干预措施为口服六味地黄丸(或以六味地黄丸为基础适当加减),对照组干预措施为口服西药,2组均可联合其他相同的治疗措施。经文献检索、文献筛选、数据提取及偏倚风险评价后,采用RevMan5.3软件对治疗后疼痛视觉模拟量表(visual analogue scale,VAS)评分、治疗后L2~L4骨密度、治疗后血清碱性磷酸酶(alkaline phosphatase,ALP)含量及并发症发生率进行Meta分析,并采用漏斗图进行发表偏倚分析。结果:共纳入10项随机对照试验,涉及1102例患者,治疗组和对照组各551例。Meta分析结果显示,治疗组治疗后疼痛VAS评分、血清ALP含量和并发症发生率均低于对照组[MD=-1.03,95%CI(-1.29,-0.77),P=0.000; MD=-18.02,95%CI(-32.61,-3.43),P=0.020; OR=0.45,95%CI(0.23,0.90),P=0.020],治疗后L2~L4骨密度高于对照组[MD=0.06,95%CI(0.02,0.09),P=0.003]。基于治疗后L2~L4骨密度的发表偏倚分析结果显示,5项研究的分布不完全对称,不排除存在发表偏倚的可能。结论:现有的证据表明,六味地黄丸治疗PMOP的疗效和安全性均优于西药治疗。
Abstract:
Objective:To systematically review the clinical outcomes and safety of oral application of Liuwei Dihuang Wan(六味地黄丸,LWDHW)for treatment of postmenopausal osteoporosis(PMOP).Methods:All the randomized controlled trial(RCT)articles about oral application of LWDHW for treatment of PMOP included from May 31,2012 to February 31,2022 were retrieved from the China National Knowledge Internet,Wanfang Database,Vip Database,Cochrane Library and PubMed through computer.The patients in treatment group were treated with oral application of LWDHW or modified LWDHW,while the ones in control group with oral application of Western medicines.Other same therapies could be used in patients of the 2 groups.The articles were retrieved and screened and the information was extracted independently by two researchers according to the inclusion and exclusion criteria,and if any disagreement was found between them,discussion was conducted with another researcher for making a final decision.The bias risk of research in the articles was evaluated by using Cochrane bias risk assessment tools,and then a Meta-analysis on posttreatment pain visual analogue scale(VAS)score,posttreatment bone mineral density(BMD)of lumbar vertebrae from L2 to L4,posttreatment serum level of alkaline phosphatase(ALP)and complication incidence was conducted by using RevMan5.3 software,furthermore,the publication bias was analyzed by using funnel plot.Results:Ten articles(1102 patients)were included in the final analysis,551 patients in each group.The results of Meta-analysis revealed that the posttreatment pain VAS score,posttreatment serum level of ALP and complication incidence were lower,while the posttreatment BMD of lumbar vertebrae from L2 to L4 was higher in treatment group compared to control group(MD=-1.03,95%CI(-1.29,-0.77),P=0.000; MD=-18.02,95%CI(-32.61,-3.43),P=0.020; OR=0.45,95%CI(0.23,0.90),P=0.020; MD=0.06,95%CI(0.02,0.09),P=0.003).Publication bias was analyzed according to funnel plot drawned based on posttreatment BMD of lumbar vertebrae from L2 to L4,and the asymmetrical funnel plot demonstrated that there might be publication bias.Conclusion:Available evidences suggest that the clinical curative effects and safety of LWDHW are better than that of Western medicines in treatment of PMOP.

参考文献/References:

[1] 王奔,林乾,韩栋,等.绝经后女性骨质疏松危险因素分析[J].中国慢性病预防与控制,2021,29(7):510-513.
[2] 梁文娜,李西海,李灿东.绝经后骨质疏松的核心病机——骨痿[J].中国老年学杂志,2015,35(18):5333-5335.
[3] 卢严方,林贯川,刘倩倩,等.六味地黄丸对绝经期肾阴虚骨质疏松症的基因表达调控数据分析[J].中国骨质疏松杂志,2017,23(3):350-356.
[4] 房谋昊,周航,陈天鹏,等.从“治痿独取阳明”论治绝经后骨质疏松症[J].中医正骨,2021,33(8):49-50.
[5] 王鹏,翁凤泉,陈述祥.翁凤泉教授治疗绝经后骨质疏松症临证经验[J].中国民族民间医药,2021,30(24):84-86.
[6] 郝霞,黄竞威,吴沛冉,等.浅析周蜻从阴论治绝经后骨质疏松症的临床经验[J].辽宁中医杂志,2020,47(5):62-64.
[7] 王嘉俊,刘浩,张彦卿.刘浩从肝、脾、肾论治绝经后骨质疏松经验[J].湖南中医杂志,2021,37(1):34-35.
[8] LIMOPASMANEE W,CHANSAKAOW S,ROJANASTHIEN N,et al.Effects of the Chinese herbal formulation(Liu Wei Di Huang Wan)on the pharmacokinetics of isoflavones in postmenopausal women[J/OL].Biomed Res Int,2015[2022-03-10].https://pubmed.ncbi.nlm.nih.gov/26146635.
[9] 兰挨元,王中元,刘彦平.六味地黄丸改善绝经后骨质疏松症的临床观察[J].中国民间疗法,2021,29(21):56-58.
[10] 王文君.六味地黄丸治疗绝经后骨质疏松症的研究进展[J].内蒙古中医药,2021,40(12):146-147.
[11] CUMPSTON M,LI T,PAGE M J,et al.Updated guidance for trusted systematic reviews:a new edition of the cochrane handbook for systematic reviews of interventions[J].Cochrane Database Syst Rev,2019,10:142.
[12] 方虹,鲁林,陈炜.经皮雌二醇联合六味地黄丸治疗绝经期妇女骨质疏松症临床研究[J].湖北中医药大学学报,2019,21(5):28-31.
[13] 李涛.六味地黄丸加味治疗肝肾阴虚证绝经后骨质疏松症临床研究[J].医药论坛杂志,2014,35(8):160-162.
[14] 王玺,罗志秀.六味地黄丸联合鲑鱼降钙素对改善绝经后骨质疏松性疼痛症状的临床研究[J].中国骨质疏松杂志,2018,24(11):1485-1488.
[15] 宋博.阿仑膦酸钠联合六味地黄丸口服治疗女性绝经后骨质疏松症的临床研究[J].北方药学,2019,16(2):125-126.
[16] 王久清,张显,郭庆功,等.阿仑膦酸钠片联合六味地黄丸治疗女性绝经后骨质疏松症40例临床观察[J].中国民族民间医药,2018,27(20):74-76.
[17] 兰洪文,李红英.六味地黄丸联合钙尔奇D治疗绝经后骨质疏松的疗效分析[J].中外女性健康研究,2016(7):84-85.
[18] 卫丽娟.六味地黄丸联合钙尔奇D治疗绝经后骨质疏松症对照观察[J].实用中医内科杂志,2012,26(9):54-55.
[19] 李冠仪.六味地黄丸联合葡萄糖酸钙治疗原发性骨质疏松症的临床研究[D].广州:广州中医药大学,2012.
[20] 陈思圆,冯柏淋,郭伟雄,等.六味地黄丸联合唑来膦酸治疗妇女绝经后骨质疏松的临床研究[J]. 现代药物与临床,2018,33(5):1140-1144.
[21] 郭小双,郑剑南,曹俊青,等.六味地黄丸配合阿仑膦酸钠治疗肝肾阴虚型绝经后骨质疏松症的临床研究[J].湖北中医药大学学报,2018,20(2):82-84.
[22] 王雷,李盛华.六味地黄丸治疗绝经后骨质疏松症作用机制[J].中国骨质疏松杂志,2021,27(7):1042-1049.
[23] 易生辉,招文华,任辉,等.中西医治疗绝经后骨质疏松症的研究进展[J].中国实验方剂学杂志,2022,28(5):274-282.
[24] 温明韬,梁学振,李嘉程,等.基于网络药理学与分子对接技术探讨六味地黄丸抗骨质疏松症的机制研究[J].中国骨质疏松杂志,2021,27(8):1129-1134.
(收稿日期:2022-03-16 本文编辑:李晓乐)

相似文献/References:

[1]李林军.应用膨胀式椎弓根螺钉内固定治疗合并骨质疏松的 胸腰椎退行性疾病[J].中医正骨,2015,27(08):49.
[2]李学朋,朱立国.骨疏康胶囊对去卵巢大鼠骨小梁的影响[J].中医正骨,2015,27(12):12.
 LI Xuepeng,ZHU Liguo.Effect of Gushukang Jiaonang(骨疏康胶囊)on bone trabecula in the ovariectomized rats[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):12.
[3]陈冠军,陈扬,庄汝杰.可灌注骨水泥椎弓根螺钉系统 在老年腰椎疾患手术中的应用[J].中医正骨,2015,27(02):40.
[4]王丹辉,贲越,韩梅.林蛙油治疗绝经后骨质疏松症的临床研究[J].中医正骨,2014,26(01):27.
 Wang Danhui*,Ben Yue,Han Mei..Clinical study of Rana temporaria oil in the treatment of postmenopausal osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(08):27.
[5]黄建华,黄建武,李慧辉,等.加味左归丸对绝经后骨质疏松症肝肾不足证 患者骨密度的影响[J].中医正骨,2013,25(11):19.
 Huang Jianhua*,Huang Jianwu,Li Huihui,et al.Effect of JIAWEI ZUOGUI pill on bone mineral density in postmenopausal osteoporosis patients with deficiency of liver and kidney[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(08):19.
[6]项旻,杨虹,林爱菊,等.绝经后2型糖尿病患者骨质疏松与血微量元素的关系研究[J].中医正骨,2013,25(12):20.
 Xiang Min*,Yang Hong,Lin Aiju,et al.Clinical study on the relationship between osteoporosis and serum trace elements levels in postmenopausal women with type 2 diabetes[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2013,25(08):20.
[7]史晓林,李春雯,张志强.弱阳离子磁珠分离技术和基质辅助激光解吸电离飞行时间质谱技术在原发性Ⅰ型骨质疏松症血清标志蛋白筛选中的应用[J].中医正骨,2014,26(03):5.
 Shi Xiaolin*,Li Chunwen,Zhang Zhiqiang..Application of magnetic beads based weak cation exchange separation technology and matrix-assisted laser desorption-ionization time of flight mass spectrometry technology in screening serum protein markers of primary type-Ⅰ osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(08):5.
[8]李明,徐明雄,冯左基,等.自拟壮骨方治疗绝经后骨质疏松症的疗效及作用机制研究[J].中医正骨,2014,26(09):21.
 Li Ming*,Xu Mingxiong,Feng Zuoji,et al.Study on the curative effect and mechanism of action of self-made ZHUANGGU decoction in treatment of postmenopausal osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2014,26(08):21.
[9]陈俊杰,李晴晴,夏瑢.脂代谢及血清内脂素水平与绝经后骨质疏松症的 相关性研究[J].中医正骨,2012,24(04):16.
 CHEN Jun-jie*,LI Qing-qing,XIA Rong.*.Study on the correlations between the levels of lipid metabolism and serum visfatin and postmenopausal osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2012,24(08):16.
[10]许超,肖鲁伟,吴承亮.绝经后女性骨质疏松症辨证分型与抑郁焦虑的关系研究[J].中医正骨,2011,23(12):3.
 XU Chao*,XIAO Lu-wei,WU Cheng-liang.*.Study on the relationship between the syndrome differ classification and the depression and anxiety for the postmenopausal women with osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2011,23(08):3.
[11]韩艳,温利平,刘娜,等.补肾活血方对去卵巢大鼠骨代谢及骨密度的影响[J].中医正骨,2015,27(12):7.
 HAN Yan,WEN Liping,LIU Na,et al.Effect of Bushen Huoxue Fang(补肾活血方)on bone metabolism and bone mineral density in the ovariectomized rats[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2015,27(08):7.
[12]欧国峰,刘鑫,董博,等.绝经后骨质疏松症的免疫学研究进展[J].中医正骨,2016,28(08):70.
[13]施振宇,刘钟,陈文亮,等.中医综合疗法防治绝经后骨量减少的多中心临床研究[J].中医正骨,2017,29(04):1.
 SHI Zhenyu,LIU Zhong,CHEN Wenliang,et al.A multicenter clinical study of complex therapy of traditional Chinese medicine for prevention and treatment of postmenopausal osteopenia[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(08):1.
[14]梁文娜,李西海,李灿东.血清microRNA与绝经后骨质疏松症肾虚证的关系[J].中医正骨,2017,29(10):53.
[15]梁文娜,李西海,胡柳,等.二至丸抑制绝经后骨质疏松大鼠骨代谢紊乱的作用机制研究[J].中医正骨,2017,29(11):1.
 LIANG Wenna,LI Xihai,HU Liu,et al.Study on mechanism of action of Erzhi Wan(二至丸)in inhibiting bone metabolism disorder in rats with postmenopausal osteoporosis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2017,29(08):1.
[16]刘晨,李兴勇,姚兴璋,等.绝经后骨质疏松症的流行病学概况及发病机制研究进展[J].中医正骨,2018,30(03):52.
[17]杨依然,刘钟,毛一凡,等.酪蛋白激酶-2相互作用蛋白1基于磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白通路参与绝经后骨质疏松症发生发展过程中细胞自噬的机制[J].中医正骨,2018,30(04):59.
[18]曹俊青,郑剑南,张麟.右归丸联合阿仑膦酸钠口服治疗绝经后骨质疏松症肾阳虚证的临床研究[J].中医正骨,2018,30(05):20.
 CAO Junqing,ZHENG Jiannan,ZHANG Lin.A clinical study of oral application of Yougui Wan(右归丸)and alendronate sodium for treatment of postmenopausal osteoporosis with kidney-yang deficiency syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(08):20.
[19]李中万,徐绍俊,杨广钢,等.健肾方联合碳酸钙D3咀嚼片(Ⅱ) 治疗绝经后骨质疏松症肾阳虚证[J].中医正骨,2018,30(08):11.
 LI Zhongwan,XU Shaojun,YANG Guanggang,et al.Oral application of Jianshen Fang(健肾方)and calcium carbonate and Vitamin D3 chewable tablets(Ⅱ)for treatment of postmenopausal osteoporosis with kidney-yang deficiency syndrome[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(08):11.
[20]赵凡,刘全,吴连国.口服强骨饮联合碳酸钙D3片治疗绝经后骨质疏松症的临床研究[J].中医正骨,2019,31(04):26.
 ZHAO Fan,LIU Quan,WU Lianguo.Oral applications of Qianggu Yin(强骨饮)and calcium carbonate and Vitamin D3 tablets for treatment of postmenopausal osteoporosis:a clinical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(08):26.

备注/Memo

备注/Memo:
基金项目:长沙市科技计划项目(kh2201063) 通讯作者:匡建军 E-mail:13786165656@163.com
更新日期/Last Update: 1900-01-01