目的 系統(tǒng)評價雙膦酸鹽類藥物用于治療糖皮質(zhì)激素性骨質(zhì)疏松的療效及安全性。方法 計算機檢索自建庫至2018年12月中國學(xué)術(shù)期刊全文數(shù)據(jù)庫（CNKI）、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫（CBM）、維普中文期刊全文數(shù)據(jù)庫（VIP）和萬方數(shù)據(jù)庫、Pubmed、Embase、Medline、Web of Science、Cochrane Library等中英文數(shù)據(jù)庫，篩選符合納入排除標(biāo)準(zhǔn)的隨機對照試驗（RCT）。提取資料，評價質(zhì)量，采用RevMan 5.0版和Stata 12.0統(tǒng)計軟件進行分析。結(jié)果 共納入25項RCTs，包括2857例患者。結(jié)果顯示，兩組患者腰椎骨密度［SMD=1.01，95% CI（0.83，1.20），P=0.000］、髖骨骨密度［SMD=0.87，95% CI（0.57，1.17），P=0.000］等指標(biāo)比較具有統(tǒng)計學(xué)意義。兩組患者椎骨骨折發(fā)生率［OR=0.63，95% CI（0.34，1.15），P=0.131］、不良反應(yīng)發(fā)生率［OR=1.04，95% CI（0.82，1.33），P=0.725］等比較無統(tǒng)計學(xué)意義。結(jié)論 雙磷酸鹽可有效改善糖皮質(zhì)激素性骨質(zhì)疏松患者的骨質(zhì)流失，具有降低骨折發(fā)生率的趨勢，并且與對照組相比具有較好的安全性。

Objective To systematically analyze the efficacy and safety of bisphosphonates in the treatment of the glucocorticoidinduced osteoporosis. Methods Randomized controlled trials of related articles from inception to December 2018 were searched from CNKI, WanFang, Pubmed, Embase, Medline, Web of Science and Cochrane Library by computer. Meta-analysis were performed using RevMan 5.0 and Stata 12.0 software after data extraction and quality evaluation. Results A total of 25 RCTs were included,involving 2857 patients. The results of Meta-analysis showed that lumbar spine density[SMD=1.01, 95%CI(0.83, 1.20), P=0.000], hip bone density[SMD=0.87, 95%CI(0.57, 1.17), P=0.000] and other indicators were statistically significant between the two groups of patients. There were no significant differences in the incidence of vertebral fractures[OR=0.63, 95%CI(0.34, 1.15), P=0.131] and incidence of adverse reactions[OR=1.04, 95%CI(0.82, 1.33), P=0.725]. Conclusion Bisphosphonates can effectively improve bone loss in patients with glucocorticoid osteoporosis, have the tendency to reduce the incidence of fractures and good security compared with the control group.

中國健康促進基金會醫(yī)藥知識管理專項基金（JJYX-ZX-1800）