Traditional Chinese Medicine Applications in Osteoporosis Management
Summary
Traditional Chinese Medicine (TCM) has been applied for millennia in China to preserve bone health and to manage osteoporosis, a systemic skeletal disorder characterised by reduced bone mass and deteriorated microarchitecture. TCM conceptualises osteoporosis as a manifestation of kidney and liver deficiency leading to impaired qi and blood circulation in bone. Clinical regimens rely predominantly on multi-herb formulas, such as Epimedii Folium derivatives, Ligustri Lucidi Fructus, Erxian Decoction and Zuogui pill, which are tailored to restore internal balance, strengthen vital essence and nourish the marrow. Active constituents, including flavonoids, iridoids, phenylethanoid glycosides and triterpenoids, have demonstrated osteogenic, anti-resorptive and immunomodulatory properties. Mechanistic studies have elucidated modulation of the RANKL/OPG axis, PI3K-Akt signalling, antioxidant pathways and osteoblast–osteoclast crosstalk, as well as regulation of calcium and hormonal homeostasis. Beyond herbal preparations, TCM integrates acupuncture, massage (tui na) and qigong to enhance bone regeneration and alleviate pain. Recent advances in network pharmacology and systems biology have begun to dissect the multi-target interactions of TCM formulas, facilitating formula optimisation and quality control. Globally, the adoption of TCM approaches reflects a growing demand for complementary therapies with favourable safety profiles. Nonetheless, well-designed clinical trials and standardised manufacturing are essential to validate efficacy, ensure reproducibility and integrate TCM into comprehensive osteoporosis management.
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Technical terms
Osteoblastogenesis: the differentiation process by which precursor cells become osteoblasts, the bone-forming cells.
Osteoclastogenesis: the differentiation process by which precursor cells become osteoclasts, the bone-resorbing cells.
RANKL/OPG ratio: the relative abundance of receptor activator of nuclear factor kappa-B ligand to osteoprotegerin, a key regulator of bone remodelling.
Network pharmacology: an interdisciplinary method combining bioinformatics and systems biology to analyse interactions between multiple compounds and biological targets.
References
- Epimedii Folium and Ligustri Lucidi Fructus Promote Osteoblastogenesis and Inhibit Osteoclastogenesis against Osteoporosis via Acting on Osteoblast‐Osteoclast Communication. Oxidative Medicine and Cellular Longevity (2023).
- Role of Traditional Chinese Medicine in Bone Regeneration and Osteoporosis. Frontiers in Bioengineering and Biotechnology (2022).
- Analysis of Molecular Mechanism of Erxian Decoction in Treating Osteoporosis Based on Formula Optimization Model. Oxidative Medicine and Cellular Longevity (2021).
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