title: Phytotherapy versus hormonal therapy for postmenopausal bone loss: a meta-analysis.
abstract: This meta-analysis included 14 randomized controlled trials involving 780 patients to compare phytotherapy with hormonal therapy in the treatment of postmenopausal bone loss. Current evidence suggests that phytotherapy may possess a similar effect on bone mineral density (BMD) values but clinically is not associated with a high incidence of uterine bleeding and breast pain as is hormonal therapy. Clinical trials indicate that phytotherapy may be a potential treatment for postmenopausal osteoporosis. The objective of this meta-analysis was to compare the efficacy and safety of phytotherapy with that of hormonal therapy, to assess the quality of phytotherapy trials, and to identify herbs used commonly in the treatment of postmenopausal bone loss. A total of 43 electronic databases were searched. The quality of eligible trials was assessed using Jadad's scale. Outcome measures were BMD values and adverse events. Revman 5.0 software was used for data syntheses and meta-analyses. The database search revealed 14 randomized controlled trials involving 780 patients that met the inclusion criteria, and four trials were graded as high quality (score 3-5). There was no significant difference in lumbar, femoral or forearm BMD values between subjects treated with phytotherapy and those treated with hormonal therapy (P>0.05), but the incidence of uterine bleeding and breast pain was significantly lower in those treated with phytotherapy than in those treated with hormonal therapy (P = 0.002 and P = 0.01). The six most commonly used herbs in the included trials were identified. Phytotherapy may not show effects beyond hormonal therapy, but may be safer than hormonal therapy in the treatment of postmenopausal bone loss. Further trials with high-quality study designs should be conducted in this field.
authors.affiliation: School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, China. xumin@hkbu.edu.hk
authors.forename: M
authors.initials: M
authors.lastname: Xu
authors.forename: C
authors.initials: C
authors.lastname: Qi
authors.forename: B
authors.initials: B
authors.lastname: Deng
authors.forename: P X
authors.initials: PX
authors.lastname: Deng
authors.forename: C W
authors.initials: CW
authors.lastname: Mo
mesh_terms: D000368:Aged; D015914:Estrogen Replacement Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy*; D008517:Phytotherapy / Q000009:adverse effects / Q000379:methods*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome
references.citation: J Clin Endocrinol Metab. 2004 Mar;89(3):1207-12
references.pmid: 15001611
references.citation: Maturitas. 2003 Mar 14;44 Suppl 1:S67-77
references.pmid: 12609561
references.citation: Control Clin Trials. 1996 Feb;17(1):1-12
references.pmid: 8721797
references.citation: Menopause. 2004 May-Jun;11(3):337-42
references.pmid: 15167314
references.citation: Addiction. 2007 Feb;102(2):282-8
references.pmid: 17222283
references.citation: Osteoporos Int. 1998;8(3):274-81
references.pmid: 9797913
references.citation: Zhongguo Zhong Xi Yi Jie He Za Zhi. 1998 Oct;18(10):620-2
references.pmid: 11477849
references.citation: Climacteric. 2004 Mar;7(1):103-11
references.pmid: 15259289
references.citation: Biol Pharm Bull. 1998 Jan;21(1):62-6
references.pmid: 9477170
references.citation: Acta Med Port. 1997 Oct;10(10):689-95
references.pmid: 9477594
references.citation: Am J Chin Med. 1997;25(3-4):351-6
references.pmid: 9358909
references.citation: Cochrane Database Syst Rev. 2004 Oct 18;(4):CD002291
references.pmid: 15495031
references.citation: Nutr Rev. 2003 Oct;61(10):346-51
references.pmid: 14604267
references.citation: Am J Clin Nutr. 2003 Sep;78(3 Suppl):593S-609S
references.pmid: 12936954
references.citation: Am J Clin Nutr. 2004 Feb;79(2):326-33
references.pmid: 14749241
references.citation: JAMA. 2002 Jul 17;288(3):321-33
references.pmid: 12117397
references.citation: Int J Fertil Menopausal Stud. 1993;38 Suppl 1:45-54
references.pmid: 8499959
references.citation: Osteoporos Int. 1999;9(5):379-93
references.pmid: 10550456
references.citation: Nurs Res. 2005 Mar-Apr;54(2):128-32
references.pmid: 15778654
references.citation: Lupus. 2000;9(5):322-7
references.pmid: 10878722
references.citation: J Clin Endocrinol Metab. 2003 Oct;88(10):4740-7
references.pmid: 14557449
references.citation: Menopause. 2004 May-Jun;11(3):246-54
references.pmid: 15167303
references.citation: Am J Chin Med. 2003;31(1):87-101
references.pmid: 12723758