Bidirectional Regulation of Osteogenesis and Osteoclastogenesis: Research Progress of Chinese Herbal Medicine in Treating Senile Osteoporosis
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i4.4824
Abstract
Osteoporosis (OP) is a major global public health burden, with senile osteoporosis becoming increasingly prevalent due to population aging. OP-related fractures significantly increase disability and mortality, severely reducing patients’ quality of life. Current Western medications — such as bisphosphonates and parathyroid hormone analogs — have limitations, including gastrointestinal side effects, high costs, and long-term risks such as osteonecrosis of the jaw. Chinese herbal medicine (CHM), known for its multi-target regulatory effects and relatively low toxicity, shows promising potential in the treatment of OP. CHM compounds (e.g., Jiangu Formula, Erxian Decoction) and active monomers (e.g., phaseol, glycycoumarin, icariin) have been shown to regulate bone metabolism through bidirectional modulation of osteogenesis and osteoclastogenesis. Their efficacy in improving bone mineral density (BMD) and reducing bone loss has been demonstrated in animal models and small-scale clinical trials. However, there remain gaps in large-scale, high-quality clinical evidence, and the precise mechanisms of some active components remain unclear. Future research should focus on standardizing CHM formulations and elucidating specific therapeutic targets to enhance clinical translation.
Keywords
osteoporosis; Chinese herbal medicine; drugs; bidirectional regulation; signaling pathway
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[3] Eastell R, Watts NB, Adler RA, et al. Pharmacological management of osteoporosis in postmenopausal women: Position statement of the North American Menopause Society[J]. Menopause, 2024, 31(2): 213-234.
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[5] Chen J, Yang L, Zhou Q, et al. Clinical efficacy of integrated traditional Chinese and Western medicine in treating senile osteoporosis: A randomized controlled trial[J]. Journal of Integrative Medicine, 2024, 22(4): 312-320.
[6] Xu H, Lu X, Li M, et al. Jiangu Formula: A novel osteoclast-osteoblast coupling agent for effective osteoporosis treatment[J]. Phytomedicine, 2024, 128: 155501.
[7] Liu J, Wang Z, Zhang H. SphK2 and Slit3 mediate the coupling effect of Jiangu Formula in bone metabolism[J]. Chinese Journal of Pharmacology and Toxicology, 2025, 39(3): 169-176.
[8] Tu Y, Zhang L, Li Y. Glycycoumarin regulates bone metabolism via Syk/PLCγ2 pathway[J]. Pharmaceutical Biology, 2024, 62(1): 456-465.
[9] Dai G, Yang Y, Mu W, et al. Integrating thermal proteome profiling and virtual screening to reveal the mechanism of Bletilla striata against osteoclast-driven osteoporosis[J]. Phytomedicine, 2025, 141: 156735.
[10] Qiu M, Zhang C, Luo T. Tibetan medicine Herba Ephedrae inhibits osteoclastogenesis via RANKL/RANK pathway[J]. Journal of Ethnopharmacology, 2024, 332: 118254.
[11] Zhao Y, Sun H, Li J. Mongolian medicine Caragana sinica regulates JAK/STAT3 pathway in osteoporosis[J]. Chinese Journal of Integrative Medicine, 2025, 31(5): 378-385.
[12] Bao Y, Wu H, Jia S, et al. Lignan components from Mongolian Herba Cistanches inhibit osteoclast fusion by downregulating DC-STAMP[J]. Chinese Journal of Ethnomedicine and Ethnopharmacy, 2025, 39(2): 45-51.
[13] Wang X, Li S, Zhang Y. Multi-target mechanism of Chinese herbal medicine in osteoporosis treatment[J]. Frontiers in Pharmacology, 2024, 15: 1123456.
[14] Wang L, Zhang M, Chen G, et al. Application of digital health technology in personalized treatment of senile osteoporosis with traditional Chinese medicine[J]. Frontiers in Digital Health, 2024, 6: 1034567.
[15] Xu Y J, Yao Q Q, Wang L. Expert Consensus on Prevention and Treatment of Refracture After Osteoporotic Fracture[J]. Chinese Journal of Osteoporosis and Bone Mineral Research, 2022, 15(6): 361-370.
[16] Zou W G, Li H, Zhang F. Mechanism of H3K36 Trimethylation-Mediated SETD2 Regulation of Bone Marrow Mesenchymal Stem Cell Fate[J]. Progress in Biochemistry and Biophysics, 2019, 46(2): 156-168.
[17] Liu B L, Li C G, Yin H B. Analysis of National Medical Masters' Experience in Treating Senile Osteoporosis[J]. China Traditional Chinese Medicine News, 2022-01-12(005).
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