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Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis

OBJECTIVE: To systematically evaluate the efficacy and safety of Gushukang (GSK) capsules in the treatment of primary osteoporosis. METHODS: Randomized controlled trials related to the treatment of primary osteoporosis were collected through online retrieval of the China National Knowledge Infrastru...

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Autores principales: Liu, Tianpeng, Yao, Menglin, Zhao, Yifan, Zhao, Shaochuan, Rui, Chen, Yang, Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631217/
https://www.ncbi.nlm.nih.gov/pubmed/37940992
http://dx.doi.org/10.1186/s13018-023-04264-9
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author Liu, Tianpeng
Yao, Menglin
Zhao, Yifan
Zhao, Shaochuan
Rui, Chen
Yang, Feng
author_facet Liu, Tianpeng
Yao, Menglin
Zhao, Yifan
Zhao, Shaochuan
Rui, Chen
Yang, Feng
author_sort Liu, Tianpeng
collection PubMed
description OBJECTIVE: To systematically evaluate the efficacy and safety of Gushukang (GSK) capsules in the treatment of primary osteoporosis. METHODS: Randomized controlled trials related to the treatment of primary osteoporosis were collected through online retrieval of the China National Knowledge Infrastructure (CNKI), Wanfang database, Chinese Biomedical Literature Database (Sino-Med), VIP, US National Library of Medicine (PubMed), Web of Science and Cochrane library. The literature was searched from January 1, 2000, to March 17, 2022. The risk bias and quality of the trials included in the meta-analysis were evaluated with the Cochrane Collaboration's risk assessment tool. The effect size was expressed as risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: A total of 24 randomized controlled clinical trials (RCTs) were incorporated into this systematic review. The 2363 patients were all primary osteoporosis patients, of whom 1197 were in the observation group and 1166 were in the control group. GSK capsule group was superior to conventional medication group in improving beta type I collagen carboxy-terminal peptide (β-CTX) (MD − 0.28, 95% CI [− 0.31, − 0.25]), while in improving prepeptide of type I procollagen (PINP), conventional medications group was superior to GSK capsule group (MD − 1.37, 95% CI [− 1.92, − 0.82]), and there were no significant differences between the two groups in overall efficacy (OE) (OR 1.62, 95% CI [0.89, 2.98]), increase of bone mineral density (BMD) (lumbar spine: MD − 0.02, 95% CI [− 0.08, 0.04]; femoral neck: MD − 0.01, 95% CI [− 0.07, 0.05]; hip: MD 0.01, 95% CI [− 0.02, 0.02]), enhancement of alkaline phosphatase (ALP) (MD − 1.37, 95% CI [− 13.29, 10.55]), serum calcium (S-Ca) (MD 0.02, 95% CI [− 0.13, 0.17]), bone glutamyl protein (BGP) (MD 3.75, 95% CI [− 12.26, 19.76]), safety (OR 0.37, 95% CI [0.07, 2.02]) and pain relief (MD 0.32, 95% CI [− 0.59, 1.22]). GSK capsule combined with conventional medications group was superior to conventional medications group in improvement of OE (OR 3.19, 95% CI [2.20, 4.63]), BMD (lumbar spine (MD 0.06, 95% CI [0.02, 0.10]), femoral neck (MD 0.08, 95% CI [0.03, 0.13]), hip (MD 0.14, 95% CI [0.08, 0.21]) and other parts (MD 0.04, 95% CI [0.03, 0.05]), ALP (MD − 5.56, 95% CI [− 10.08, − 1.04]), β-CTX (MD − 0.15, 95% CI [− 0.18, − 0.12]) and pain relief (MD − 1.25, 95% CI [− 1.83, − 0.68]), but there was no difference in S-Ca (MD 0.02, 95% CI [− 0.13, 0.17]), BGP (MD 1.30, 95% CI [− 0.29, 2.89]), PINP (MD 1.30, 95% CI [− 0.29, 2.89]), serum phosphorus (S-P) (MD 0.01, 95% CI [− 0.09, 0.12]) and safety (OR 0.71, 95% CI [0.38, 1.35]). CONCLUSION: GSK capsules can effectively treat primary osteoporosis, and when combined with conventional medications, the drug significantly increased bone mineral density, relieved pain and improved bone metabolism-related indicators in primary osteoporosis patients with better efficacy. However, due to the inclusion of Chinese literature and possible publication bias, the reliability of conclusions still requires more high-quality RCTs to enhance. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13018-023-04264-9.
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spelling pubmed-106312172023-11-08 Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis Liu, Tianpeng Yao, Menglin Zhao, Yifan Zhao, Shaochuan Rui, Chen Yang, Feng J Orthop Surg Res Systematic Review OBJECTIVE: To systematically evaluate the efficacy and safety of Gushukang (GSK) capsules in the treatment of primary osteoporosis. METHODS: Randomized controlled trials related to the treatment of primary osteoporosis were collected through online retrieval of the China National Knowledge Infrastructure (CNKI), Wanfang database, Chinese Biomedical Literature Database (Sino-Med), VIP, US National Library of Medicine (PubMed), Web of Science and Cochrane library. The literature was searched from January 1, 2000, to March 17, 2022. The risk bias and quality of the trials included in the meta-analysis were evaluated with the Cochrane Collaboration's risk assessment tool. The effect size was expressed as risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs). RESULTS: A total of 24 randomized controlled clinical trials (RCTs) were incorporated into this systematic review. The 2363 patients were all primary osteoporosis patients, of whom 1197 were in the observation group and 1166 were in the control group. GSK capsule group was superior to conventional medication group in improving beta type I collagen carboxy-terminal peptide (β-CTX) (MD − 0.28, 95% CI [− 0.31, − 0.25]), while in improving prepeptide of type I procollagen (PINP), conventional medications group was superior to GSK capsule group (MD − 1.37, 95% CI [− 1.92, − 0.82]), and there were no significant differences between the two groups in overall efficacy (OE) (OR 1.62, 95% CI [0.89, 2.98]), increase of bone mineral density (BMD) (lumbar spine: MD − 0.02, 95% CI [− 0.08, 0.04]; femoral neck: MD − 0.01, 95% CI [− 0.07, 0.05]; hip: MD 0.01, 95% CI [− 0.02, 0.02]), enhancement of alkaline phosphatase (ALP) (MD − 1.37, 95% CI [− 13.29, 10.55]), serum calcium (S-Ca) (MD 0.02, 95% CI [− 0.13, 0.17]), bone glutamyl protein (BGP) (MD 3.75, 95% CI [− 12.26, 19.76]), safety (OR 0.37, 95% CI [0.07, 2.02]) and pain relief (MD 0.32, 95% CI [− 0.59, 1.22]). GSK capsule combined with conventional medications group was superior to conventional medications group in improvement of OE (OR 3.19, 95% CI [2.20, 4.63]), BMD (lumbar spine (MD 0.06, 95% CI [0.02, 0.10]), femoral neck (MD 0.08, 95% CI [0.03, 0.13]), hip (MD 0.14, 95% CI [0.08, 0.21]) and other parts (MD 0.04, 95% CI [0.03, 0.05]), ALP (MD − 5.56, 95% CI [− 10.08, − 1.04]), β-CTX (MD − 0.15, 95% CI [− 0.18, − 0.12]) and pain relief (MD − 1.25, 95% CI [− 1.83, − 0.68]), but there was no difference in S-Ca (MD 0.02, 95% CI [− 0.13, 0.17]), BGP (MD 1.30, 95% CI [− 0.29, 2.89]), PINP (MD 1.30, 95% CI [− 0.29, 2.89]), serum phosphorus (S-P) (MD 0.01, 95% CI [− 0.09, 0.12]) and safety (OR 0.71, 95% CI [0.38, 1.35]). CONCLUSION: GSK capsules can effectively treat primary osteoporosis, and when combined with conventional medications, the drug significantly increased bone mineral density, relieved pain and improved bone metabolism-related indicators in primary osteoporosis patients with better efficacy. However, due to the inclusion of Chinese literature and possible publication bias, the reliability of conclusions still requires more high-quality RCTs to enhance. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13018-023-04264-9. BioMed Central 2023-11-08 /pmc/articles/PMC10631217/ /pubmed/37940992 http://dx.doi.org/10.1186/s13018-023-04264-9 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Systematic Review
Liu, Tianpeng
Yao, Menglin
Zhao, Yifan
Zhao, Shaochuan
Rui, Chen
Yang, Feng
Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis
title Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis
title_full Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis
title_fullStr Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis
title_full_unstemmed Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis
title_short Chinese medicine Gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis
title_sort chinese medicine gushukang capsule for treating primary osteoporosis: a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10631217/
https://www.ncbi.nlm.nih.gov/pubmed/37940992
http://dx.doi.org/10.1186/s13018-023-04264-9
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