雷洛昔芬治疗绝经后妇女骨质疏松症的系统评价

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1、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MEDLINEsEMBASE、Cochrane图书馆临床对照试验注册屮心、屮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丿J。以患绝经后骨质疏松症的女性为研究对象、比较雷洛昔芬与女慰剂的随机对照试验，评价纳入研究的质量，并用RcvMan5.l软件进行Meta分析，并采用GRADE系统评价证据质量评价。结果纳入11

2、个随机对照试验，包括21028例患者。患者腰椎BMD升高达2.39%,H60mg/d剂暈提高腰椎BMD强于3()mg/d组，但60mg/d与12()mg/d以上剂暈组间效果无差别，能冇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RaloxifeneTreatmentinPo

3、stmenopausalWomenWithOsteoporosis:ASystematicReviewsHUANGTao,LIUshiqing,ZHANGChun.LIAOQi.ZHAODepartmentofOrthopedics,RenminHospitalofWuhanUniversity.Wuhan4300609China[AbstractlObjectiveEvaluationofraloxifenetreatmentefficacyandsafetyofpostmenopausalosteoporosis.MethodsWe

4、searchedMEDLINE,EMBASE,CochraneLibraiyControlledClinicalTrialRegister,theChineseBiomedicalLiteratureDatabase,ChinaAcademicJournal,digitizedjournalsfull-textdatabasesandhandsearchingofrelevantareasofothermagazines・Retrievedwithoutlanguagerestrictions,andendedinNovember201

5、2・Sufferingfromosteoporosisinpostmenopausalwomenastheobjectofstudy,randomizedcontrolledtrialscomparingraloxifeneandplacebo,theevaluationofthequalityoftheincludedstudies,andRcvMan5.1softwareMcta-analysisandqualityevaluationofthetheGRADEsystemevaluationevidence・ResultsInel

6、udetheresultsof11「andomizedcontrolledtrials,including21,028casesofpaticnts.PatientswithlumbarspineBMDincreasedby2.39%,and60mg/ddoseraisethelumbarBMDstrongat30mg/dgroup,buttheeffectisnodifferencebetweenthemorelhan60mg/dand120mg/ddosegroup,caneffectivelyreducetheincidenceo

7、fvertebralfractures,thereductionrangesupto40%・SystemEvaluationBasedontheaboveresults,theGRADEevaluationofthequalityofevidenceandtherecommendedlevel,thetheevidenceoverallqualityratingforthelowqualityandstrengthofrecommendationforaweakrecommendation.ConclusionRaloxifenetre

8、atmentofpostmenopausalosteoporosisefficacycertainlycanincreasespinalbonemineraldensityandreducetherisko