Research on Chinese medicine and osteoporosis

Chinese Herbal Medicine for Osteoporosis: A Systematic Review of Randomized Controlled Trials

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“Conclusions: Our results demonstrated that Chinese herbs significantly increased lumbar spine Bone Mineral Density as compared to the placebo or other standard anti-osteoporotic drugs.”

Evid Based Complement Alternat Med. 2013; 2013: 356260.

Published online 2013 Jan 30.

Authors: Zhi-qian Wang, Jin-long Li, Yue-li Sun, Min Yao, Jie Gao, Zhu Yang, Qi Shi, Xue-jun Cui,* and Yong-jun Wang*

This article has been cited by other articles in PMC.

Background. Osteoporosis is a major health problem for the elderly population. Chinese herbs may be beneficial to osteoporosis due to its capability. Objectives. This study was designed to evaluate the effectiveness of Chinese medicine treatment on the patients with osteoporosis. Search Methods. Randomized controlled trials were retrieved from different 9 databases. Results. This meta analysis included 12 RCTs involving 1816 patients to compare Chinese herbs with placebo or standard anti-osteoporotic therapy in the treatment of bone loss. The pooled data showed that the percent change of increased BMD in the spine is higher with Chinese herb compared to placebo (lumber spine: WMD = 0.07, 95% CI: 0.01–0.04). In the femoral, Chinese herb showed significantly higher increments of BMD compared to placebo (femoral neck: WMD = 0.06, 95% CI: −0.02–0.13). Compared to the other standard anti-osteoporotic drugs, Chinese herbs also show advantage in BMD change (lumber spine: WMD = 0.03, 95% CI: −0.01–0.08; femoral: WMD = 0.01, 95% CI: −0.01–0.02). Conclusions. Our results demonstrated that Chinese herb significantly increased lumbar spine BMD as compared to the placebo or other standard anti-osteoporotic drugs.


Osteoporosis: a possible mechanism of how Chinese herbal treatment might work as viewed through animal studies

Effect of Buguzhi (Psoralea corylifolia fruit) extract on bone formation

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J Orthop Res. 2010 Mar 1

Extracts of Bu Gu Zhi (Psoralea corylifolia fructus), a plant known as a Kidney yang tonic in Chinese medicine, can increase bone growth in vivo. The plant, whose Chinese name means ‘tonify bone resin’ is considered a common weed in Asia and is known colloquially as ‘scruffy pea’. Studies in rabbits showed that a total of 275% more new bone was present in bone defects grafted with Bu Gu Zhi extract mixed with collagen matrix than those grafted with collagen matrix alone. In a similar study, the same Hong Kong researchers showed that psoralen, an active ingredient extracted from Bu Gu Zhi, produced 454% more new bone compared with collagen matrix alone. Psoralen is already widely used in combination with UV light as a treatment for skin conditions such as psoriasis, eczema and vitiligo, and also shows promise as an anti-tumour agent. (Effect of Buguzhi (Psoralea corylifolia fruit) extract on bone formation. Phytother Res. 2009 Dec 1. [Epub ahead of print]. Effect of psoralen on bone formation. J Orthop Res. 2010 Mar 1. [Epub ahead of print]).


Bone mass improved effect of icariin (Yin Yang Huo Extract) for postmenopausal osteoporosis in ovariectomy-induced rats: a meta-analysis and systematic review.

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“Bone mass improved effect of ICA [an extract of the Chinese herb Epimedium- Xian Ling Pifor postmenopausal osteoporosis was observed in OVX-induced rats.”

Xu JH1, Yao M, Ye J, Wang GD, Wang J, Cui XJ, Mo W.

OBJECTIVE: Ovariectomy (OVX)-induced rats are the most frequently used animal model to research postmenopausal osteoporosis. Our objective was to summarize and critically assess the bone mass improved effect of icariin (ICA) for treatment of postmenopausal osteoporosis in an OVX-induced rat model.

METHODS: The PUBMED, EMBASE, and Chinese databases were searched from their inception date to February 2015. Two reviewers independently selected animal studies that evaluated the bone mass improved effect of ICA compared with control in OVX-induced rats. Extracted data were analyzed by RevMan statistical software, and the methodological quality of each study was assessed.

RESULTS: Seven studies with adequate randomization were included in the systematic review. Overall, ICA seemed to significantly improve bone mass as assessed using the bone mineral density (seven studies, n = 169; weighted mean difference, 0.02; 95% CI, 0.01-0.02, I = 77%, P < 0.00001) using a random-effects model. There is no significant difference between ICA and estrogen (E) (six studies, n = 128; weighted mean difference, 0.00; 95% CI, -0.00 to 0.01, I = 54%, P = 0.01).

CONCLUSIONS: Bone mass improved effect of ICA for postmenopausal osteoporosis was observed in OVX-induced rats. Assessment of the methodological quality of studies involving OVX-induced animal models is required, and good methodological quality should be valued in systematic reviews of animal studies.

Effect of Morinda officinalis capsule on osteoporosis in ovariectomized rats.

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Morinda officinalis capsules possess potent anti-osteoporotic activity in OVX rats which could be an effective treatment for postmenopausal osteoporosis.”

Chin J Nat Med. 2014 Mar;12(3):204-12. doi: 10.1016/S1875-5364(14)60034-0.

Li Y1, Lü SS2, Tang GY2, Hou M1, Tang Q1, Zhang XN1, Chen WH3, Chen G4, Xue Q1, Zhang CC1, Zhang JF1, Chen Y1, Xu XY5.

AIM: To explore the therapeutic effects of Morinda officinalis capsules (MOP) on osteoporosis in ovariectomized rats.

METHODS: Six-month-old female Sprague-Dawley rats were induced for postmenopausal osteoporosis (PMOP) by bilateral ovariectomy and divided into seven groups as follows: sham-operated group, ovariectomized (OVX) control group, OVX treated with xianlinggubao (XLGB) (270 mg·kg⁻¹·d⁻¹), OVX treated with alendronate sodium (ALN) (3 mg·kg⁻¹·d⁻¹), and OVX treated with Morinda officinalis capsule (MOP) of graded doses (90, 270 and 810 mg·kg⁻¹·d⁻¹) groups. Oral treatments were administered daily on the 4(th) week after ovariectomy and lasted for 12 weeks. The bone mineral density was evaluated by dual-energy X-ray absorptiometry. The tartrate-resistant acid phosphatase (TRAP), alkaline phosphatase (AKP), and osteocalcin (OC) levels in the serum and plasma were determined by standard colorimetric and enzyme immunoassays methods. Bone biomechanical properties and morphological parameters were analyzed by three-point bending test and histomorphometry respectively.

RESULTS: Morinda officinalis capsules at all doses were able to significantly prevent the OVX-induced loss of bone mass due to diminishing serum AKP and TRAP levels while elevating OC level in the plasma. Morinda officinalis capsules also enhanced the bone strength and prevented the deterioration of trabecular microarchitecture.

CONCLUSION: Morinda officinalis capsules possess potent anti-osteoporotic activity in OVX rats which could be an effective treatment for postmenopausal osteoporosis.


A traditional Chinese herbal preparation, Er-Zhi-Wan, prevent ovariectomy-induced osteoporosis in rats.

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“The present study indicated that EZW had a definite antiosteoporotic effect without hyperplastic effect on uterus, and it might be a potential alternative medicine for treatment of postmenopausal osteoporosis.”

J Ethnopharmacol. 2011 Nov 18;138(2):279-85. doi: 10.1016/j.jep.2011.09.030. Epub 2011 Oct 5.

Cheng M1, Wang Q, Fan Y, Liu X, Wang L, Xie R, Ho CC, Sun W.

ETHNOPHARMACOLOGICAL RELEVANCE: Er-Zhi-Wan (EZW), a classic Chinese formulation, which contains Fructus Ligustri Lucidi (FLL) and Herba Ecliptae (HE). EZW is widely used to prevent and treat various kidney diseases for its actions of nourishing the kidney and strengthening tendon and bone. Although recent reports indicate that EZW restrains osteoclastic bone resorption, its effects on the protection against define OVX-induced bone loss in mature rats have not been systematically investigated.

MATERIALS AND METHODS: Sixty 3-month-old female Sprague-Dawley rats were randomly assigned into sham-operated group (Sham) and five OVX subgroups, OVX with vehicle (OVX); OVX with Estradiol Valerate (EV, 0.4 mg/kg body weight/day); OVX with EZW of graded doses (9.0, 4.5, or 2.25 g/kg/day). Daily oral administration of EV and EZW on 5th week for 26 weeks. Bone turnover markers (Serum alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), osteocalcin (OCN), deoxypyridinoline (DPD)), other parameters, including serum calcium (S-Ca), serum phosphorus (S-P), urine calcium (U-Ca), phosphorus (U-P), and bone mineral density (BMD) of the femur, 4th lumbar vertebra and tibia, bone biomechanical properties and trabecular microarchitecture parameters were measured.

RESULTS: Administration of EZW could significantly prevent ovariectomy-induced bone loss, biomechanical reduction, deterioration of trabecular microarchitecture and the body weight gain without affecting the weight of the uterus, and increased S-Ca, S-P levels, decreased level of bone turnover markers and U-Ca, U-P levels in ovariectomized rats.

CONCLUSION: The present study indicated that EZW had a definite antiosteoporotic effect without hyperplastic effect on uterus, and it might be a potential alternative medicine for treatment of postmenopausal osteoporosis.