本文選題：骨質(zhì)疏松性骨折 + 維生素D�。� 參考：《廣西醫(yī)科大學》2015年碩士論文

【摘要】：目的：對單獨補充維生素D與結(jié)合補充維生素D和鈣與安慰劑和鈣劑對比預防中老年骨質(zhì)疏松性骨折的療效進行系統(tǒng)評價。方法：計算機檢索Cochrane協(xié)作網(wǎng)數(shù)據(jù)庫(1992-2014年12月份),MEDLINE(1992-2014年12月份),EMBASE(1992-2014年12月份)、中國生物醫(yī)學文獻數(shù)據(jù)庫(CBM,1992-2014年12月份)、中文期刊全文數(shù)據(jù)庫(CNKI,1992-2014年12月份)。手工檢索國內(nèi)期刊已發(fā)表的論文和會議資料,收集所有相關(guān)隨機對照試驗,并評價納入研究的方法學質(zhì)量。統(tǒng)計軟件使用Cochrane協(xié)作網(wǎng)提供的RevMan5.3結(jié)果：計算機檢索到相關(guān)文獻81篇,最終納入24個隨機對照試驗(RCT),包括141047例患者。Meta分析結(jié)果：1、關(guān)于死亡率治療組與對照組對比的死亡率無統(tǒng)計學意義,其中維生素D結(jié)合鈣組與對照組分析結(jié)果：RR=1.24(95%CI=0.91-1.70,P=0.18)；維生素D組與對照組分析結(jié)果：RR=1.05(95%CI=0.97-1.13,P=0.27)；2、關(guān)于骨折發(fā)生率單純維生素D組與對照組的發(fā)生率無明顯優(yōu)勢：RR=0.97(95%CI=0.89-1.04,P=0.38)；維生素D結(jié)合鈣組與對照組的發(fā)生率有統(tǒng)計學差異：RR=0.90(95%CI=0.82-0.98,P=0.02)；3、關(guān)于血清25羥基維生素D濃度治療組的血清25羥基維生素D濃度明顯比對照組提高。結(jié)論：單獨補充維生素D和結(jié)合維生素D和鈣與對照組對比的死亡率沒有區(qū)別；血清25羥基維生素D濃度通過治療雖然改善但還沒達到骨健康狀態(tài)；單獨補充維生素D預防骨質(zhì)疏松性骨折無明顯優(yōu)勢；維生素D結(jié)合鈣可降低骨質(zhì)疏松性骨折的發(fā)生率。
[Abstract]:Aim: to evaluate the efficacy of vitamin D alone and calcium supplementation with placebo and calcium in the prevention of osteoporotic fractures in middle-aged and old people. Methods: a computer search was conducted on the Cochrane collaborative network database in December 1992 to December 2014, and the Chinese Biomedical Literature Database (CBM) in December 1992 to December 2014, and the full text Database of Chinese Journals from 1992 to December 2014. Manual retrieval of published papers and conference materials in domestic journals, collection of all relevant randomized controlled trials, and evaluation of methodological quality included in the study. The statistical software uses the RevMan5.3 results provided by the Cochrane Cooperative Network: 81 related papers were retrieved by computer. Finally, 24 randomized controlled trials were conducted, including 141047 patients. Meta-analysis results showed that there was no significant difference in mortality rate between the treatment group and the control group. The results of vitamin D combined calcium group and control group were 0.91-1.70 P0. 18; vitamin D group and control group showed 0. 97-1. 13 pectin 0.270.The incidence of fracture in vitamin D alone group and control group were not significantly superior to that in control group. There was no significant difference between vitamin D group and control group in the incidence of bone fracture; vitamin D combined calcium group and the control group. The incidence rate of the control group was significantly different. The serum 25 hydroxyvitamin D concentration in the treatment group was significantly higher than that in the control group. Conclusion: there is no difference between the mortality of vitamin D supplementation alone and combined vitamin D and calcium compared with the control group, the concentration of 25 hydroxyvitamin D in serum has not reached the state of bone health although it has been improved by treatment. Vitamin D supplementation alone has no significant advantage in preventing osteoporotic fractures, but vitamin D combined calcium can reduce the incidence of osteoporotic fractures.
【學位授予單位】：廣西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R580;R687.3

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