Meta-Analysis Of Traditional Chinese Medicine For The Treatment Of Glucocorticoid-Induced Osteoporosis

Objective:To evaluate the clinical effect of traditional Chinese medicine therapy for glucocorticoid-induced osteoporosis by using the method of evidence-based medicine,and provide evidence-baced medical science for the clinical application of traditional Chinese medicine therapy for glucocorticoid-induced osteoporosis.Methods:Searching the literature related to traditional Chinese medicine for the treatment of glucocorticoid-induced osteoporosis in CNKI,CBM,Wan-Fang,VIP,PubMed and The Cochrane Library according to the wellestablished search strategy,limited time from the data of founding of database to December 31,2018.Screening of the literature according to inclusion and exclusion criteria,and evaluating the quality of the literature based on the Cochrane systerm evaluation methods.Taking the clinical efficacy rate,bone mineral density,bone metabolite correlation index level,main clinical symption score,safety index as evaluation index and making Meta-analysis by using RevMan5.3 Meta analysis software.Results:A total of 11 articles including 766 patients with glucocorticoidinduced osteoporosis were included.There were 388 patients in the experimental group and 378 patients in the control group.The results of meta-analysis showed that compared with the treatment group of western medicine,the treatment group of traditional Chinese medicine bears significant advantage in many aspects such as clinical efficacy rate[P<0.00001,OR=3.32,95%CI:(1.99,5.53)];bone mineral density of each part(lumbar spine,proximal femur,hip)[P=0.004,MD=0.06,95% CI:(0.02,0.09)],[P=0.03,MD=0.05,95%CI:(0.01,0.09)],[P<0.0001,MD=0.16,95%CI:(0.08,0.23)],main clinical symptoms(waist and knee pain,back pain,lower limb weakness,lower limb pain)score[P<0.00001,MD=-0.62,95%CI:(-0.72,-0.51)],[P<0.00001,MD=-0.63,95%CI:(-0.87,-0.40)],[P=0.003,MD=-0.24,95%CI:(-0.39,-0.08)],[P=0.0009,MD=-0.85,95% CI:(-1.35,-0.35)],the difference was statistically significant.The treatment effect of traditional Chinese medicine group was the same as that of western medicine group in aspects such as bone metabolite correlation index(Blood calcium,blood phosphorus,serum alkaline phosphatase)[P=0.09,MD=0.13,95%CI:(-0.02,0.28)],[P=0.54,MD=0.04,95%CI:(-0.10,0.18)],[P=0.67,MD= 1.27,95%CI:(-4.63,7.17)] level and safety index[P=0.06,OR=0.37,95%CI:(0.13,1.05)],the difference was not statistically significant.Conclusions: The research results shows that traditional Chinese medicine has positive effects on glucocorticoid-induced osteoporosis.Comparing with the control group,the traditional Chinese medicine group bears significant advantage in many aspects such as clinical efficacy rate,bone mineral density of each part(lumbar spine,proximal femur,hip),main clinical symptoms(waist and knee pain,back pain,lower limb weakness,lower limb pain)score.But it works the same in aspects such as bone metabolite correlation index(Blood calcium,blood phosphorus,serum alkaline phosphatase)level and safety index.A small number of articles were included in this study and articles quality is generally low,so the methodology and sample size of this study have some limitations.It needs going on to be evaluated with more large sample and high quality researches in the future.