| Objective:To evaluate the curative effect and safety of Erxian Decoction in the treatment of osteoporosis, and look for the support from the evidence-based medicine.Methods:All satisfactory literature were searched according to the search strategy (including exclusion criteria and inclusion criteria)from the date of founding of database to December,2015. All data were mata-analyzed by RevMan5.1, Cochrane, after the quality assessment.Results:9 randomized controlled trials were ultimately meet the standards, all of them are published in Chinese.1.Meta-analysis of curative effect of Erxian Decoction in the treatment of osteoporosisErxian Decoction & western medicine 8 randomized controlled trials involved 633 cases were ultimately meet the standards. The fixed effect model was used for data analysis according to the homogeneity of the results (P=0.98, 12=0%). The results suggest that the clinical efficacy rate of Erxian Decoction is significantly better than that of western medicine.Erxian Decoction & hormone therapy 2 randomized controlled trials involved 148 cases were ultimately meet the standards. The fixed effect model was used for data analysis according to the homogeneity of the results(P=0.89, 12=0%). The results suggest that the clinical efficacy rate of Erxian Decoction is significantly better than that of hormone therapy.Erxian Decoction & calcium carbonate 2 randomized controlled trials involved 122 cases were ultimately meet the standards.The fixed effect model was used for data analysis according to the homogeneity of the results(P=0.75,12=0%). The results suggest that the clinical efficacy rate of Erxian Decoction is significantly better than that of calcium carbonate.Erxian Decoction & calcium carbonate and calcitriol 2 randomized controlled trials involved 208 cases were ultimately meet the standards. The fixed effect model was used for data analysis according to the homogeneity of the results(P=0.66,12=0%). The results suggest that the clinical efficacy rate of Erxian Decoction is significantly better than that of calcium carbonate and calcitriol.2. Meta-analysis of the improvement of BMD of Erxian Decoction in the treatment of osteoporosisBMD of L2-46 randomized controlled trials involved 499 cases were ultimately meet the standards. The random-effect model was used for data analysis according to the heterogeneity of the results(P=0.01,12=65%). The results suggest that BMD of L2-4 is significantly increased after the treatment of Erxian Decoction.BMD of Ward’s triangle 2 randomized controlled trials involved 148 cases were ultimately meet the standards. The fixed effect model was used for data analysis according to the homogeneity of the results (P=0.88,12=0%). The results suggest that BMD of Ward’s triangle is significantly increased after the treatment of Erxian Decoction.BMD of femoral neck 4 randomized controlled trials involved 344 cases were ultimately meet the standards. The random-effect model was used for data analysis according to the heterogeneity of the results (P=0.03, 12=67%). The results suggest that BMD of femoral neck is significantly increased after the treatment of Erxian Decoction.BMD of proximal femur 3 randomized controlled trials involved 206 cases were ultimately meet the standards. The fixed effect model was used for data analysis according to the homogeneity of the results(P=0.19, 12=40%). The results suggest that BMD of proximal femur is significantly increased after the treatment of Erxian Decoction.3. Meta-analysis of the concentration of serum ALP, Ca and P of Erxian Decoction in the treatment of osteoporosis serum ALP 5 randomized controlled trials involved 406 cases were ultimately meet the standards. The random-effect model was used for data analysis according to the heterogeneity of the results (P<0.0001,12=84%). The results suggest that there is no significance on the concentration of serum ALP between the treatment of Erxian Decoction and western medicine,serum Ca 4 randomized controlled trials involved 336 cases were ultimately meet the standards. The random-effect model was used for data analysis according to the heterogeneity of the results (P<0.00001,12=94%). The results suggest that there is no significance on the concentration of serum Ca between the treatment of Erxian Decoction and western medicine.serum P 4 randomized controlled trials involved 277 cases were ultimately meet the standards. The random-effect model was used for data analysis according to the heterogeneity of the results (P<0.00001,12=97%). The results suggest that there is no significance on the concentration of serum P between the treatment of Erxian Decoction and western medicine.4. Adverse eventsAdverse events were reported in 2 randomized controlled trials. There were no obvious adverse events occurred during the 12 weeks of treatment of Erxian Decoction, calcium carbonate and calcitriol, according to the research of Jiang Hui(35 cases).1 case of abdominal distention,3 cases of constipation and 2 cases of stomach disorder occurred in the treatment group with Erxian Decoction, calcium carbonate and calcitriol; 5 case of abdominal distention, 7 cases of constipation and 6 cases of stomach disorder occurred in the control group with calcium carbonate and calcitriol, according to the research of Liu Yu-ning(69 cases). Adverse events occurred significantly less in the treatment group.Conclusion:1. The clinical efficacy rate of Erxian Decoction is significantly better than that of common anti-osteoporosis therapy, including hormone therapy, suggesting that Erxian Decoction is effective in hormone-deficient osteoporosis and may play hormone-like function.2. There is no significance on the concentration of serum ALP, Ca and P between the treatment of Erxian Decoction and western medicine. Because some biases might alter the results of meta-analysis, it should be further explored when new eligible study appears.3. Adverse events occurred significantly less in the group of Erxian Decoction.4. Methods of the evidence-based medicine.Objective:To analyze the pathogenic related factors and distribution of TCM syndromes of postmenopausal osteoporosis, research the correlation among biochemical marks of bone turnover, levels of sexual hormone and the distribution of TCM syndromes.Methods:63 postmenopausal women with osteoporosis were collected from July,2014 to February,2015 in outpatient department of Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA.These patients were divided into 4 groups:Kidney Yin-Deficiency Group(19 cases), Kidney Yang-Deficiency Group(18 cases), Kidney Yin and Yang-Deficiency Group (9 cases) and Control Group (17 cases). Age,height, weight, BMI and menopausal years were recorded;BMD, levels of sexual hormone and biochemical marks of bone turnover were measured. All data were analyzed by SPSS19.0.Results:63 postmenopausal women with osteoporosis were collected, including 4 groups:Kidney Yin-Deficiency Group(19 cases),Kidney Yang-Deficiency Group(18 cases), Kidney Yin and Yang-Deficiency Group(9 cases) and Control Group(17 cases).1.There is no significant difference in age,height, weight, BMI and menopausal years of each group (P>0.05).2. Lumbar vertebrae BMD is related to TCM syndromes. BMD in Kidney Yin-Deficiency Group, Kidney Yang-Deficiency Group and Kidney Yin and Yang-Deficiency Group were significantly lower than that in Control Group(P <0.05). BMD in Kidney Yang-Deficiency Group was significantly lower than that in Kidney Yin-Deficiency Group and Kidney Yin and Yang-Deficiency Group (P <0.05). Sexual hormone level is also related to TCM syndromes. E2, FSH, LH and T gradually declined in order of Kidney Yin-Deficiency, Kidney Yin and Yang-Deficiency and Kidney Yang-Deficiency (P<0.05). PRL and P are not related to TCM syndromes (P>0.05).3. The concentration of serum PINP and β-Cos are significantly lower in Kidney Yang-Deficiency (P<0.05).4. Lumbar vertebrae BMD is positively correlated with E2 and negatively correlated with FSH, LH and T(P<0.01).5. The concentration of serum PINP and β-Cos is negatively correlated with E2(P<0.05).Conclusions:l.BMD of POP patients with obvious TCM syndromes is lower than that with no obvious symptoms. BMD in POP patients with Kidney Yang-Deficiency is lowest. The concentration of serum PINP and β-Cos of POP patients with Kidney Yang-Deficiency is lower than that with other TCM syndromes. 2. E2, T, FSH and LH are main effective factors in TC syndrome differentiation. E2 and T of POP patients with Kidney Yang-Deficiency is lower than that with other TCM syndromes;FSH of POP patients with Kidney Yang-Deficiency is higher than that with other TCM syndromes. The results suggest that ovarian failure occurrs most obviously in patients with Kidney Yang-Deficiency.3. The formation of POP is closed related with imbalance of sexual hormone caused by ovarian failure. E2 is the most important sexual hormone.Objective:To evaluate the possible estrogen-like function of Erxian Decoction and its function on osteoblast cells of rats.Methods:CCG, the main component of the principal drug of Erxian Decoction, was used to affect the osteoblast cell culture. Proliferation and osteogenic differentiation were observed by methods of MTT and PNPP.Results:1. Compared with the control group, E2 and different concentration of CCG significantly improved the proliferation of UMR-106 cells and OB cells. High concentration of CCG significantly improved the proliferation than that of E2.2. Compared with the control group, E2 and different concentration of CCG significantly improved the ALP activity of UMR-106 cells and OB cells. High concentration of CCG significantly improved the ALP activity than that of E2.Conclusion:CCG strengthened the proliferation ability and osteogenic differentiation of cultured UMR-106 cells and OB cells. CCG may functioned like estrogen, which suggested that Erxian Decoction may be applicated in the treatment of postmenopausal osteoporosis. |
PDF Full Text Request