目的 系統(tǒng)評價雌激素類藥物治療絕經(jīng)后骨質(zhì)疏松的療效及安全性。方法 檢索PubMed、EMbase、CochraneLibrary、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫（CBM）、中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫中關(guān)于雌激素治療絕經(jīng)后骨質(zhì)疏松的臨床隨機對照研究（RCT），依據(jù)納排標(biāo)準(zhǔn)納入文獻，運用軟件ReviewManager 5.0和Stata 14.0進行療效和安全性的系統(tǒng)評價。結(jié)果 共納入15篇RCTs，包括13 280例患者。結(jié)果表明雌激素類藥物對改變絕經(jīng)后骨質(zhì)疏松患者的腰椎骨密度［MD=1.08，95% CI（0.75，1.40），P<0.001］、椎體骨折發(fā)生率［OR=0.61，95% CI（0.52，0.71），P<0.001］、血清骨鈣素［MD=-16.03，95% CI（-18.68，-13.67），P<0.001］等指標(biāo)具有特異性。網(wǎng)狀Meta-結(jié)果表明雌激素中巴多昔芬對于提高腰椎BMD的效果最好。雌激素治療極少發(fā)生嚴(yán)重不良反應(yīng)，普通不良反應(yīng)發(fā)生率（潮熱、肌肉痙攣等）較低。結(jié)論 雌激素類藥物對絕經(jīng)后骨質(zhì)疏松的治療具有積極意義，顯著減低了椎體骨折發(fā)生率并改善了患者的骨密度；雌激素類藥物治療的不良反應(yīng)發(fā)生率較低，安全性高。

Objective To systematically evaluate the efficacy and safety of estrogen drugs in the treatment of postmenopausal osteoporosis. Methods Search PubMed, EMbase, Cochrane Library CBM, CNKI, VIP, and Wanfang Data on estrogen treatment of postmenopausal osteoporosis in clinical case-control study. Determine the search formula and included literature in the exclusion criteria included in the literature followed by data extraction. Review Manager 5.0 and Stata 14.0 were used to evaluate the efficacy and safety of the system. Results A total of 15 RCTs articles were included, including 13 280 patients. The results showed that estrogen drugs had specific effects on lumbar vertebra bone density[MD=1.08, 95%CI (0.75, 1.40), P<0.001], vertebra fracture incidence[OR=0.61, 95%CI (0.52, 0.71), P<0.001], osteocalcin[MD=-16.03, 95%CI (-18.68,-13.67), P<0.001] and other indicators of post-menopausal osteoporosis. Network meta results showed that the effect of the estrogen bazedoxifene on the improvement of lumbar BMD was the best. Serious adverse reactions rarely occur in estrogen therapy, and the incidence of common adverse reactions (hot flashes, muscle spasms, etc.) is low. Conclusion Estrogen drugs have positive effects on the treatment of postmenopausal osteoporosis, significantly reduce the incidence of vertebral fractures and improve the patient's bone mineral density. The incidence of adverse reactions of estrogen drugs was lower, and the safety is higher than control drugs.