雷洛昔芬治疗绝经后妇女骨质疏松症的系统评价.doc

雷洛昔芬治疗绝经后妇女骨质疏松症的系统评价
黄涛刘世清张春廖琦赵奇
【摘要】目的评价雷洛昔芬治疗绝经后骨质疏松症的疗效和安全性。方法计算机检索MEDLINE、EMBASE、Cochrane图书馆临床对照试验注册中心、中国生物医学文献数据库、中国期刊全文数据库、数字化期刊全文数据库,并手工检索相关领域其他杂志。检索不受语种限制,时间截止至2012年11月。以患绝经后骨质疏松症的女性为研究对象、比较雷洛昔芬与安慰剂的随机对照试验,评价纳入研究的质量,,并采用GRADE系统评价证据质量评价。结果纳入11个随机对照试验,包括21028例患者。%,且60mg/d剂量提高腰椎BMD强于30mg/d组,但60mg/d与120mg/d以上剂量组间效果无差别,能有效降低椎体骨折发生率,降低幅度达40%。基于上述系统评价结果,采用GRADE系统评价证据质量及推荐等级,证据总体质量评级为低质量,推荐强度为弱推荐。结论雷洛昔芬治疗绝经后骨质疏松症疗效肯定,能提高腰椎骨密度,降低椎体骨折的风险,但尚无证据支持其能降低非椎体骨折发生率。
【关键词】雷洛昔芬;绝经;骨质疏松;系统评价
Raloxifene Treatment in Postmenopausal Women With Osteoporosis: A Systematic Reviews HUANG Tao, LIU shiqing , ZHANG Chun ,LIAO Qi, ZHAO Qi,. Department of Orthopedics, Renmin Hospital of Wuhan University. Wuhan 430060, China
[Abstract] Objective Evaluation of raloxifene treatment efficacy and safety of postmenopausal osteoporosis. Methods We searched MEDLINE, EMBASE, Cochrane Library Controlled Clinical Trial Register, the Chinese Biomedical Literature Database, China Academic Journal, digitized journals full-text databases and hand searching of relevant areas of other magazines. Retrieved without language restrictions, and ended in November 2012. Suffering from osteoporosis in postmenopausal women as the object of study, randomized controlled paring raloxifene and placebo, the evaluation of the quality of the included studies, and software Meta-analysis and quality evaluation of the the GRADE system evaluation evidence . Results Include the results of 11 randomized controlled trials, including 21,028 cases of patients. Patients with lumbar spine BMD increased by %, and 60mg / d dose raise the lumbar BMD strong at 30mg / d group, but the effect is no difference between the more than 60mg / d and 120mg / d dose group, can effectively reduce the incidence of vertebral fractures, the reduction ranges up to 40%. System Evaluation Based on the above results, the GRADE evaluation of the quality of evidence and the mended level, the the evidenc