The Efficacy and Safety of Traditional Chinese Medicine Tonifying‐Shen (Kidney) Principle for Primary Osteoporosis: A Systematic Review and Meta‐Analysis of Randomized Controlled Trials

Abstract

Objective. This study aimed to appraise the efficacy and safety of the tonifying-Shen (kidney) principle (TS (TK) principle) for primary osteoporosis (POP). Methods. Randomized controlled clinical trials (RCTs) using the TS (TK) principle for POP were searched from eight electronic databases to search for relevant literature that was published from the initiation to September 2019. Two reviewers performed study selection, data extraction, data synthesis, and quality assessment independently. Review Manager 5.3 software was used to assess the risk of bias and conduct the data synthesis. We assessed the quality of evidence for outcomes by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results. Thirty-six studies with 3617 participants were included. Meta-analysis showed a consistently superior effect of the TS (TK) principle combined with conventional Western medicine (CWM) in terms of total effectiveness rates (RR = 1.28; 95% CI (1.23, 1.33); P < 0.00001 ), BMD of the lumbar spine (SMD = 0.71; 95% CI (0.47, 0.95); P < 0.00001 ) and proximal femur (SMD = 0.94; 95% CI (0.49, 1.38); P < 0.00001 ), TCM symptom integral (SMD = −1.23; 95% CI (−1.43, −1.02); P < 0.00001 ), and VAS scores (SMD = −3.88; 95% CI (−5.29, −2.46); P < 0.00001 ), when compared to using CWM alone and with significant differences. Besides, in respect of adverse effects, it showed no significant statistical difference between the experimental and control groups, RR = 0.99 and 95% CI (0.65, 1.51), P = 0.97 . Conclusion. Our meta-analysis provides promising evidence to suggest that using the TS (TK) principle combined with CWM for POP is more effective than using CWM alone. Also, both of them are safe and reliable for POP.

Comparative Efficacy of Xianling Gubao Capsules in Improving Bone Mineral Density in Postmenopausal Osteoporosis: A Network Meta-Analysis

“…In traditional Chinese medicine, orthopedic diseases such as osteoporosis are believed to be the manifestation of kidney deficiency. The kidney governs bone and generates marrow, which should be used to tonify the kidney and strengthen Yang (38,39). Deficiency of the kidney and spleen is the root cause of the disease, and blood stasis is the promoting factor.…”

“…Deficiency of the kidney and spleen is the root cause of the disease, and blood stasis is the promoting factor. Blood stasis further aggravates injury to the spleen and kidney and then accelerates the occurrence of osteoporosis (39). XLGB, which is mainly composed of Epimedium supplemented with Dipsacus, Salvia miltiorrhiza, Rehmannia glutinosa and Anemarrhena asphodeloides, has the effects of nourishing the liver and kidney, activating blood circulation and dredging collaterals, and strengthening tendons and bones (40).…”

Role of Traditional Chinese Medicine in Bone Regeneration and Osteoporosis

“…In Chinese medicine, “yang-tonifying” medications are common and traditional type of natural remedies used to prevent osteoporosis ( Ju et al, 2014 ; Li et al, 2015 ). Several clinical trials have demonstrated the antiosteoporosis actions of well substances, such as Epimedium derived phytoestrogen flavonoids, which were employed in a clinical study to cure and suppress osteoporosis and bone resorption in older women ( Zhang et al, 2007 ; Zhu et al, 2012 ; Wang et al, 2013 ; Shi et al, 2017 ; Liang et al, 2020 ). TCM formulations offer less adverse effects, have become less expensive, and may be used for a prolonged time.…”

Metabolomics analysis of the potential mechanism of Yi-Guan-Jian decoction to reverse bone loss in glucocorticoid-induced osteoporosis

“…In the knowledge system of Chinese traditional medicine (TCM), GIOP is in accordance with the characteristics of TCM that "medicine causes disease". Exogenous glucocorticoids are pungent and warm medicines, and long-term use will deplete qi and harm yin, resulting in deficiency of kidney essence and inability to nourish liver yin and blood, so in the treatment of GIOP, TCM considers it very important and effective to nourish liver and kidney [ 6 ]. Yi-Guan-Jian decoction (YGJ)comes from Xu Mingyi Lei'an, is mainly for the treatment of liver and kidney yin deficiency, which fits well with the TCM etiology of GIOP.…”