Clinical Medications and Safety of Traditional Chinese Medicine for Osteoporosis Complicated with Lumbar Disc Herniation

doi:10.19803/j.1672-8629.20250476

Abstract

Abstract: Objective To analyze the clinical medications and safety of oral traditional Chinese medicine (TCM) in the treatment of osteoporosis (OP) combined with lumbar disc herniation (LDH). Methods Medical records of outpatients diagnosed with OP combined with LDH and treated with oral administration of TCM in Wangjing Hospital between January 2023 and April 2025 were collected. Data on their medications was statistically analyzed via the Ancient and Modern Medical Cases Cloud Platform (V2.3.9), including high-frequency herbs, compatibility of herb pairs, and core prescriptions for OP complicated with LDH. The safety of these medications was assessed based on clinical data and literature review. Results A total of 250 cases were included. Most of the patients were middle-aged or elderly, accounting for 87.2%. 236 types of TCM herbs were used, with a total frequency of medication use of 3,378. High-frequency herbs included Ligusticum chuanxiong Hort., Achyranthes bidentata Bl., and Paeonia lactiflora Pall. The properties of these herbs were predominantly warm, neutral or slightly warm and the flavors were mainly sweet, bitter or pungent. The meridian tropisms involved the liver, spleen, and kidney. The efficacies included tonifying the liver and kidney, strengthening tendons and bones, and dispelling wind-dampness. Association analysis showed that high-frequency herb pairs were Ligusticum chuanxiong Hort.- Achyranthes bidentata Bl., Ligusticum chuanxiong-Paeonia lactiflora Pall., and Paeonia lactiflora Pall.- Achyranthes bidentata Bl. The core prescriptions for OP combined with LDH consisted of 15 types of herbs. The most commonly used Western medicines were calcium carbonate D3 tablets, mecobalamin tablets and calcitriol soft capsules, and the Chinese patent medicines included Danlu Tongdu tablets, Gutong plaster and Jintiange capsules. Safety assessment indicated that TCM was safe in treating OP combined with LDH. Conclusion The basic principle by which TCM treats OP combined with LDH is to regulate the liver, spleen, and kidney in order to tonify the liver and kidney, strengthen tendons and bones, and dispel wind-dampness. These medications have proved to be safe clinically.

Key words: Osteoporosis, Lumbar Disc Herniation, Comorbidity, Medication Patterns, Core Prescription, Safety Analysis, Data Mining

CLC Number:

R927.1

KANG Jiaqi, BAI Jianqi, CAI Mingyang, WANG Yuan, ZHANG Ping. Clinical Medications and Safety of Traditional Chinese Medicine for Osteoporosis Complicated with Lumbar Disc Herniation[J]. Chinese Journal of Pharmacovigilance, 2025, 22(10): 1120-1126.

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References

[1] HAN T, SUN K, SUN CR, et al.Prevalence and Associated Factors of Lumbar Disc Herniation in Osteoporosis: a Cross-Sectional Survey[J]. Chinese General Practice(中国全科医学), 2022, 25(35): 4375-4380.
[2] ZHANG YY, ZHANG YK, TIAN H, et al.The Relationship between Lumbar Disc Herniation and Osteoporosis and the Analysis of Infl-uencing Factors of Osteoporosis[J]. Chinese Journal of Osteoporosis(中国骨质疏松杂志), 2024, 30(11): 1633-1636.
[3] LING ZF, ZENG XL, LUO QY, et al.Co-Morbid Mechanisms of Intervertebral Disc Degeneration and Osteoporosis: Biomechanical Coupling and Molecular Pathways Synergistically Driving Degenerative Lesions[J]. J Orthop Surg Res, 2025, 20(1): 652.
[4] Chinese Society of Osteoporosis and Bone Mineral Research. Guidelines for the Diagnosis and Treatment of Primary Osteoporosis (2022)[J]. Chinese General Practice(中国全科医学), 2023, 26(14): 1671-1691.
[5] KANG S, PARK C, JUNG H, et al.Analysis of the Physiological Load on Lumbar Vertebrae in Patients with Osteoporosis: a Finite-Element Study[J]. Sci Rep, 2022, 12(1): 11001.
[6] Basic Research and Transformation Society, Professional Committee of Spine and Spinal Cord, Chinese Association of Rehabilitation Medicine. Guideline for Diagnosis, Treatment and Rehabilitation of Lumbar Disc Herniation[J]. Chinese Journal of Surgery(中华外科杂志), 2022, 60(5): 401-408.
[7] BOWDEN D, PICKLES S, SPRUNG VS, et al.Reduced Physical Activity in Young and Older Adults: Metabolic and Musculoskeletal Implications[J]. Ther Adv Endocrinol Metab, 2019, 10: 1906157896.
[8] SABO A, HATGIS J, GRANVILLE M, et al.Multilevel Contiguous Osteoporotic Lumbar Compression Fractures: the Relationship of Scoliosis to the Development of Cascading Fractures[J]. Cureus, 2017, 9(12): e1962.
[9] WANG JX, KONG XH, GUO DH, et al.Analysis of 5597 Reports of Adverse Reactions to NSAIDs[J]. Chinese Journal of Pharmacoe-pidemiology(药物流行病学杂志), 2021, 30(7): 457-461.
[10] ZHENG B.Effect of Calcium Combined with Calcitriol on Bone Mineral Density and Vascular Calcification in Senile Osteoporosis Patients with Kidney Deficiency and Blood Stasis[D]. Fuzhou: Fujian University of Traditional Chinese Medicine, 2023.
[11] FENG CZ, LI JW, LI YH.Progress in the Efficacy and Safety of Calcium and Vitamin D in the Treatment of Primary Osteoporosis[J]. Chinese Journal of General Practice(中华全科医学), 2020, 18(4): 642-645.
[12] LI X, LI ZG, SHEN YW, et al.Clinical Efficacy of Yihe Decoction in Treating Osteoporosis and Its Impact on Bone Remodeling Markers Based on the Concept of Kidney Governing Bone and Generating Marrow[J]. China Journal of Traditional Chinese Medicine and Pharmacy(中华中医药杂志), 2024, 39(11): 6270-6274.
[13] TAN HS, WANG YB, HUANG Y, et al.Therapeutic Effect and Mechanism of Shentong Zhuyutang Combined with Dilongtang in Treatment of Lumbar Disc Herniation with Qi Stagnation and Blood Stasis Syndrome[J]. Chinese Journal of Experimental Traditional Medical Formulae(中国实验方剂学杂志), 2025, 31(1): 47-54.
[14] Commission Chinese Pharmacopoeia.Pharmacopoeia of the People's Republic of China Volume I(中华人民共和国药典一部)[M]. Beijing: China Medical Science Press, 2020.
[15] ZHONG GS, YANG BC. Traditional Chinese Pharmacy(中药学)[M]. Beijing: China Press of Chinese Medicine, 2021.
[16] GE JR, WANG HM, ZHENG HX, et al.Chinese Journal of Experimental Traditional Medical Formulae[J]. Chinese Journal of Osteoporosis(中国骨质疏松杂志), 2020, 26(12): 1717-1725.
[17] XU ZH, JIN LF, QI PK, et al. Discuss the Medication Rule of Traditional Chinese Medicine Prescription for Primary Osteoporosis Based on the Real World[J/OL]. Journal of Practical Traditional Chinese Internal Medicine(实用中医内科杂志), (2025-07-16)[2025-07-28]. http://kns.cnki.net/kcms/detail/21.1187.R.20250328.1807.008.html.
[18] ZHANG ZL, QU W, MA X, et al.Experience of TCM National Master Liu Bailing in Treating Osteoporosis from the Perspective of "Tonifying the Kidney and Strengthening Bones"[J]. Journal of Li-shizhen Traditional Chinese Medicine(时珍国医国药), 2023, 34(3): 720-722.
[19] HAN J, WEN SB, XU ZW, et al.Data Mining-Based Exploration into the Medication Rules of TCM National Master Wei Guikang in the Treatment of Lumbar Disc Herniation[J]. Western Journal of Traditional Chinese Medicine(西部中医药), 2024, 37(5): 66-71.
[20] ZENG Q, LI N, WANG QQ, et al.The Prevalence of Osteoporosis in China, a Nationwide, Multicenter DXA Survey[J]. J Bone Miner Res, 2019, 34(10): 1789-1797.
[21] QI L, LUO LJ, MENG XR, et al.Risk Factors for Lumbar Disc Herniation in Adolescents and Young Adults: a Case-Control Study[J]. Front Surg, 2022, 9: 1009568.
[22] ZILELI M, OERTEL J, SHARIF S, et al.Lumbar Disc Herniation: Prevention and Treatment of Recurrence: WFNS Spine Committee Recommendations[J]. World Neurosurg X, 2024, 22: 100275.
[23] XU B, HUANG ZL, ZHANG L, et al.Prevalence Rate of Lumbar Disc Herniation in the Chinese Population: a Meta-Analysis[J]. The Journal of Traditional Chinese Orthopedics and Traumatology(中医正骨), 2023, 35(9): 17-23.
[24] YAO Y, CAI X, CHEN Y, et al.Estrogen Deficiency-Mediated Osteoimmunity in Postmenopausal Osteoporosis[J]. Med Res Rev, 2025, 45(2): 561-575.
[25] SHENG B, YUAN Y, LIU XY, et al.Protective Effect of Estrogen against Intervertebral Disc Degeneration is Attenuated by miR-221 through Targeting Estrogen Receptor Alpha[J]. Acta Biochim Biophys Sin (Shanghai), 2018, 50(4): 345-354.
[26] LOU C, CHEN MH, MEI L, et al.Association between Menopause and Lumbar Disc Degeneration: an MRI Study of 1,566 Women and 1,382 Men[J]. Menopause, 2017, 24(10): 1136-1144.
[27] CUI EZ, FANG JJ, WANG J, et al.Mechanism of Classical Famous Formula Shaoyao Gancaotang in Alleviating Spasm and Pain: a Review[J]. Chinese Journal of Experimental Traditional Medical Formulae(中国实验方剂学杂志), 2025, 31(14): 267-278.
[28] YANG F, LIN ZW, HUANG TY, et al.Ligustilide, a Major Bioactive Component of Angelica Sinensis, Promotes Bone Formation via the GPR30/EGFR Pathway[J]. Sci Rep, 2019, 9(1): 6991.
[29] CUI J, LI MY, LIU YT, et al.Ligustilide Inhibits RANKL-Induced Osteoclast Differentiation in RAW264.7 Cells and Its Mechanism Related by GPER[J]. Journal of Nanjing University of Traditional Chinese Medicine(南京中医药大学学报), 2021, 37(4): 514-520.
[30] SHI L, DUAN L, DONG XH.The Effect of Ligustrazine on Dege-neration of Nucleus Pulposus Cells in Intervertebral Disc and Its Possible Mechanisms[J]. Clinical Misdiagnosis & Mistherapy(临床误诊误治), 2018, 31(12): 87-93.
[31] YANG H, ZENG FH.Study on Achyranthes Bidentata Polysaccharides Improving Bone Metabolism in Osteoporotic Fracture Rats by Regulating Wnt/Β-Catenin Pathway[J]. Acta Chinese Medicine(中医学报), 2021, 36(10): 2188-2194.
[32] WANG XL, LIU RY, WANG XB, et al.Effects of Achyranthes Bidentata Saponins on Extracellular Matrix Synthesis in Rat Nucleus Pulposus[J]. Chinese Traditional Patent Medicine(中成药), 2020, 42(1): 69-74.
[33] ZHAO XR, WNG HF, LIU Y, et al.Proliferation, Differentiation, and Mineralization of MC3T3-E1 Osteoblastic Cells[J]. Chinese Journal of Integrated Traditional and Western Medicine(中国中西医结合杂志), 2019, 39(10): 1230-1233.
[34] HE MD, HU ZP, YANG MY.Effects of Total Glucosides of Paeony on Serum Inflammatory Cytokines in Animal Models of Rheumatoid Arthritis: a Systematic Review and Meta-Analysis[J]. Front Pharmacol, 2024, 15: 1349259.
[35] HUANG CS, CHEN J, WU XJ, et al.Effect of Pachymoic Acid on Osteoporosis in Ovariectomized Mice Based on STING/NF-κB Signaling Pathway[J]. Journal of Guangdong Pharmaceutical University(广东药科大学学报), 2024, 40(2): 119-123.
[36] KONG QX, XU WP, FAN C, et al. Investigation of the Mechanism of Pachyman against Gout Arthritis with Network Pharmacology Analysis and Verification in vivo[J/OL]. Comb Chem High Throughput Screen, (2025-07-16)[2025-07-28]. http://doi:10.2174/0113862073330896241211155436.
[37] LI QC.Isoliquiritin Suppresses Osteoclastogenesis and Treats Osteoporosis Through Suppressing Glycolysis and Inflammation Activation[D]. Shanghai: Naval Medical University, 2023.
[38] YAN ZJ, QI WH, ZHAN JD, et al.Activating Nrf2 Signalling Alleviates Osteoarthritis Development by Inhibiting Inflammasome Activation[J]. J Cell Mol Med, 2020, 24(22): 13046-13057.
[39] CHEN ZM.Meta-Analysis of Tonifying Kidney and Promoting Blood Circulation in the Treatment of Lumbar Disc Herniation[D]. Fuzhou: Fujian University of Traditional Chinese Medicine, 2021.
[40] XIONG L, TANG F, MA WK, et al.The Meta-Analysis of the Therapeutic Effects of Tonifying the Kidney and Promoting Blood Circulation Method on Bone Density and Bone Metabolism in the Treatment of Osteoporosis[J]. Chinese Journal of Osteoporosis(中国骨质疏松杂志), 2024, 30(7): 1013-1020.
[41] CHENG ZL.Clinical Observation of Modified DangguiShaoyao Powder in the Treatment of Swelling and Related Factors (Syndrome of Qi Deficiency with Blood Stasis) after Total Knee Arthroplasty[D]. Jinan: Shandong University of Traditional Chinese Medicine, 2024.
[42] ZHOU DH, LU YH, WANG L, et al.Observation on the Clinical Efficacy of Danggui Shaoyao Powder on the Treatment of Knee Osteo-arthritis with Dampness-Stasis Obstruction[J]. Chinese Journal of Traditional Medical Traumatology & Orthopedics(中国中医骨伤科杂志), 2024, 32(5): 36-40.
[43] YE PY.Clinical Observation of Jiawei Shiquan Dabu Decoction on Fracture Healing after Minimally Invasive Orthopedic Surgery (Qi and Blood Deficiency Syndrome) [D]. Changsha:Hunan University of Chinese Medicine, 2024.
[44] LIU JS, WANG CL, XIONG W, et al.Effect of Duhuo Jisheng Decoction and Mecobalamin on Postoperative Pain and Functional Recovery in Patients with Lumbar Disc Herniation[J]. Drug Evaluation(药品评价), 2023, 20(2): 253-256.
[45] CHEN JF, YU LD, LOU Q.Clinical Effect of Daqinjiao Decoction Combined with Butyphthalide in the Treatment of Acute Cerebral Infarction of Wind Phlegm Blocking Collaterals[J]. China Modern Medicine(中国当代医药), 2021, 28(22): 205-207.
[46] LUO KL, WU ZF, TANG Y, et al.Effect of Bushen Jianpi Prescription on Serum Osteoclast, Osteogenesis Related Factors and Intestinal Flora in Postmenopausal Osteoporosis Patients[J]. Chinese Journal of Clinical Research(中国临床研究), 2023, 36(12): 1866-1870.
[47] LIANG CH, GUO Y, LU Y.Clinical Study on Danlu Tongdu Tablets Combined with Mecobalamin in Treatment of Lumbar Disc Herniation[J]. Drugs & Clinic(现代药物与临床), 2023, 38(9): 2218-2222.
[48] LI L, ZHOU ZX, LIU AP, et al.Clinical Study on the Treatment of Early and Middle Knee Osteoarthritis with Gutong Paste[J]. World Latest Medicine Information(世界最新医学信息文摘), 2019, 19(69): 166-167.
[49] HUANG BL, WANG QY, HUANG HW.Clinical Effect of Self-Made Yishen Bugan Jiangu Decoction Combined with Calcitriol Soft Capsule in the Treatment of Postmenopausal Osteoporosis[J]. Chinese Journal of Clinical Rational Drug Use(临床合理用药), 2025, 18(17): 120-123.
[50] YANG HH, LI SJ.The Effect of Jintiange Capsule Combined with Calcitriol in the Treatment of Osteoporosis[J]. Systems Medicine(系统医学), 2021, 6(7): 54-56.
[51] ZHU MS.Observation on the Efficacy of Jintiange Capsules in the Treatment of Lumbar Intervertebral Disc Herniation and Preliminary Investigation on the Mechanism[D]. Hefei: Anhui University of Chinese Medicine, 2024.
[52] WANG ZM, XIAO HB, NIU WY, et al.Effects of Platelets Treated by Blood-Ativating and Stasis-Resolving Chinese Drugs[J]. Chinese Archives of Traditional Chinese Medicine(中华中医药学刊), 2021, 39(2): 78-81.
[53] LIU W, CHEN H.Application of drugs for Promoting Blood Circulation and Removing Blood Stasis during Pregnancy: a Brief Analysis[J]. Journal of Modern Clinical Medicine(现代临床医学), 2020, 46(2): 122-125.
[54] WANG CT, WEN W.Reports and Influencing Factors of Drug-Induced Hypokalemia Induced by Diammonium Glycyrrhizinate[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2022, 19(5): 532-536.
[55] WANG Q, HUO YM.Mechanism and Application Precautions of Glycyrrhiza Uralensis Increasing Blood Pressure[J]. Medical Recapitulate(医学综述), 2020, 26(12): 2402-2405.