目的 系统评价双膦酸盐类药物用于治疗糖皮质激素性骨质疏松的疗效及安全性。方法 计算机检索自建库至2018年12月中国学术期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、维普中文期刊全文数据库（VIP）和万方数据库、Pubmed、Embase、Medline、Web of Science、Cochrane Library等中英文数据库，筛选符合纳入排除标准的随机对照试验（RCT）。提取资料，评价质量，采用RevMan 5.0版和Stata 12.0统计软件进行分析。结果 共纳入25项RCTs，包括2857例患者。结果显示，两组患者腰椎骨密度［SMD=1.01，95% CI（0.83，1.20），P=0.000］、髋骨骨密度［SMD=0.87，95% CI（0.57，1.17），P=0.000］等指标比较具有统计学意义。两组患者椎骨骨折发生率［OR=0.63，95% CI（0.34，1.15），P=0.131］、不良反应发生率［OR=1.04，95% CI（0.82，1.33），P=0.725］等比较无统计学意义。结论 双磷酸盐可有效改善糖皮质激素性骨质疏松患者的骨质流失，具有降低骨折发生率的趋势，并且与对照组相比具有较好的安全性。

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.

中国健康促进基金会医药知识管理专项基金（JJYX-ZX-1800）