Meta-analysis of Efficacy and Safety of TCM Compound Preparation for Tonifying Kidney and Activating Blood Circulation in the Treatment of Postmenopausal Osteoporosis
- VernacularTitle:补肾活血类中药复方制剂治疗绝经后骨质疏松症有效性和安全性的Meta分析
- Author:
Siyi ZHAO
1
;
Fan HUANG
1
;
Zitong FENG
1
;
Wanyi FANG
1
;
Weipeng SUN
2
;
Guizhen CHEN
3
;
Yunxiang XU
1
Author Information
1. Acupuncture and Rehabilitation Clinical Medical College,Guangzhou University of TCM,Guangzhou 510405,China
2. The First Clinical College,Guangzhou University of TCM,Guangzhou 510405,China
3. Dept. of Rehabilitation,Bao’an TCM Hospital of Guangzhou University of TCM,Guangdong Shenzhen 518133,China
- Publication Type:Journal Article
- Keywords:
Postmenopausal osteoporosis;
TCM compound preparation for tonifying kidney and activating blood circulation;
Therapeutic efficacy;
Safety;
Meta-analysis;
Trial sequential analysis
- From:
China Pharmacy
2019;30(8):1105-1111
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE: To systematically evaluate the efficacy and safety of TCM compound preparation for tonifying kidney and activating blood circulation, and to provide evidence-based reference for rational drug use in the clinic. METHODS: By retrieving Cochrane library, PubMed, Embase, CBM, CNKI, VIP and Wanfang database, randomized controlled trials (RCTs) about TCM compound preparation for tonifying kidney and activating blood circulation (trial group) versus calcium or non-calcium agents (control group) in the treatment of postmenopausal osteoporosis were included. After literature screening, data extraction and quality evaluation with bias risk evaluation tool and Jadad scale of Cochrane system evaluator manual 5.1.0, Meta-analysis was conducted by using Stata 12.0 software, and trial sequential analysis (TSA) was conducted by using TSA 0.9 software. RESULTS: Totally 18 RCTs were included, involving 1 408 patients. The results of Meta-analysis showed that total response rate [RR=1.35,95%CI(1.17,1.54),P<0.000 1] and bone density[SMD=0.24,95%CI(0.16,0.32),P<0.000 1] of trial group were significantly higher than those of control group; blood calcium [SMD=-0.05,95%CI(-0.09,0.00), P=0.033] of trial group was significantly lower than that of control group. There was no statistical significance in the levels of urine creatinine [SMD=-1.60,95%CI(-5.94,2.74),P=0.470], urinary calcium/urine creatinine ratio [SMD=-0.05,95%CI(-0.14,0.04),P=0.295], urinary hydroxyproline/urine creatinine ratio [SMD=-0.16,95%CI(-1.04,0.72),P=0.726], ALT [SMD=0.51,95%CI(-3.26,4.28),P=0.790], AST [SMD=0.23,95%CI(-5.22,4.77),P=0.929], serum alkaline phosphatase [SMD=-0.22,95%CI(-0.68,0.25),P=0.361], serum phosphate [SMD=-0.02,95%CI(-0.11,0.07),P=0.639], urea nitrogen [SMD=-0.19,95%CI(-0.70,0.31),P=0.453], estradiol [SMD=0.62,95%CI(-0.28,1.52),P=0.177], IL-6 [SMD=-1.78,95%CI(-4.86,1.30),P=0.258] or VAS [SMD=0.55,95%CI(-1.03,2.13),P=0.496] between 2 groups. No server ADR was found in 2 groups. TSA showed that there were extract evidences for total response rate of TCM compound preparation in the treatment postmenopausal osteoporosis. CONCLUSIONS: TCM compound preparation for tonifying kidney and activating blood circulation shows significant therapeutic efficacy for postmenopausal osteoporosis, and can improve serum calcium and bone density with good safety.