Diabetic Osteoporosis: A Review of Its Traditional Chinese Medicinal Use and Clinical and Preclinical Research

Table 1

Clinical used TCM prescriptions for treatment of patients with DOP.

Compound prescription name	Treatment aim and biomarker examination	Results (# of patients)	References
Tanggukang decoction; 7	Fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C), bone mineral density (BMD), superoxide dismutase (SOD), malondialdehyde (MDA), bone gla-protein (BGP), Ca and P in serum, and urine	FBG and HbA1C levels decreased; BMD, BGP, and serum SOD levels increased; serum MDA decreased; urine Ca and P decreased.; Control treatment using oyster shell calcium chewable tablet	[5, 6]
Bushen Huoxue decoction; 11	Significant effect: BMD increased; clinical symptoms and pains disappeared.; Effective: clinical symptoms alleviated; BMD remained the same.; Ineffective: BMD and clinical symptoms remained the same	Markedly improved (24); Moderately improved (4); Ineffective (2); Overall efficacy: 93.3%; Control treatment: Qianggu capsule	[7]
Bushen Tongluo decoction; 9	Broadband ultrasound attenuation (BUA), sound of speed (SOS), Ca and P in serum, alkaline phosphatase (ALP), FBG, and HbA1C	BUA and SOS significantly increased; FBG and HbA1C levels reduced.; Control treatment using caltrate D	[8, 9]
Jiawei Qing’e Pill; 9	Ca, P/creatinine (Cr) ratios in blood and urine	Markedly improved (25); Moderately improved (11); Ineffective (4); Overall efficacy: 90%; Serum Ca decreased by 0.48 mM/L; serum P increased by 0.44 mM/L; urine Ca/Cr ratio decreased by 0.29.; Control treatment using alfacalcidol and caltrate D	[10]
Xihongkang; 7	Significant effect: clinical symptoms disappeared; FBG < 7.2 mM; two-hour postprandial blood glucose (2 hPG) < 8.3 mM; HbA1C < 6% or HbA1C decreased by ⩾30%; BMD increased by ⩾20%.; Effective: clinical symptoms alleviated; FBG < 8.3 mM/L; 2 hPG < 10.0 mM/L; HbA1C < 8% or HbA1C decreased by ⩾10%; BMD increased by ⩾10%.; Ineffective: no significant improvement in symptoms; HbA1C and BMD remained the same	Markedly improved (56); Moderately improved (68); Ineffective (16); Overall efficacy: 88.6%; Control treatment using alfacalcidol, glipizide, and caltrate D	[11]
Yishen Zhuanggu compound; 9	Significant effect: pain disappeared; BMD increased by 0.05 g/cm^2.; Effective: pain significantly alleviated; BMD remained the same or decreased by <0.05 g/cm^2.; Ineffective: no improvement in symptoms	Markedly improved (14); Moderately improved (17); Ineffective (1); Overall efficacy: 96.8%; Control treatment using alfacalcidol and caltrate D	[12]
Huqian pill; 8	Significant effect: symptom and physical sign disappeared; 23 mM/d ⩽ urine P ⩽ 48 mM/d; 2.5 mM/d ⩽ urine Ca ⩽ 7.5 mM/d; 16.7 mM/d ⩽ urine Mg^2+ ⩽ 100 mM/d; 0.96 mM/L ⩽ serum P ⩽ 1.45 mM/L; 0.8 mM ⩽ serum Mg^2+ ⩽ 1.2 mM. X-ray appeared normal.; Effective: clinical symptoms alleviated; urine Ca remained 6.5 ± 2.5 mmol/d; urine P remained 38 ± 15 mmol/d; urine Mg^2+ remained 80 ± 40 mmol/d; X-ray without obviously abnormal.; Ineffective: no improvement in symptoms and signs as well as other biomarkers	Markedly improved (23); Moderately improved (28); Ineffective (5); Overall efficacy: 91.07%; No controls	[13]
Gusong decoction; 13	Significant effect: symptoms and physical signs score decreased by ⩾70%; BMD increased by ⩾2%; significant improvement in bone metabolism index; FPG and 2 hPG returned to the normal or decreased by ⩾40%; HbA1C ⩽ 6.2% or decreased by ⩾30%.; Effective: symptoms and physical signs score decreased between 30% and 70%; BMD increased between 1% and 2%; bone metabolism index improved; FPG and 2 hPG decreased by ⩾20%; HbA1C decreased between 10% and 30%.; Ineffective: no significant change in clinical symptoms; symptoms and physical signs score decreased by <30%; BMD increased by <1%; no improvement in bone metabolism index, FPG and 2 hPG, and HbA1C	Markedly improved (15); Moderately improved (22); Ineffective (3); Overall efficacy: 92.5%; Control treatment using vitamin D3 calcium carbonate tablets and alendronate sodium tablets	[14]
Gusong decoction; 4	Significant effect: lumbar vertebra pain and other clinical symptoms disappeared or total scores decreased by more than 2/3.; Effective: lumbar vertebra pain and other clinical symptoms markedly alleviated or total scores decreased by more than 1/3.; Ineffective: no improvement in clinical symptoms; total scores did not reach the effective value	Markedly improved (21); Moderately improved (14); Ineffective (3); Overall efficacy: 92.11%; Control treatment using glipizide and alendronate sodium tablets	[15]
Tangmaikang granules combined with alendronate sodium tablets; 9	Significant effect: lumbar vertebra pain disappeared; significant increase in BMD.; Effective: lumbar vertebra pain alleviated with no significant increase in BMD.; Ineffective: lumbar vertebra pain still existed; BMD remained the same	Markedly improved (24); Moderately improved (21); Ineffective (3); Overall efficacy: 93.75%; Control treatment using alendronate sodium tablets	[16]
Bushen Huoxue decoction; 0	Significant effect: back pain disappeared; symptoms and physical signs score decreased by 2/3; significant improvement in bone metabolism index; BMD increased by more than 0.06 g/cm^2.; Effective: back pain obviously alleviated; symptoms and physical signs scores decreased by 1/3; no change or aggravation was found in the biomarkers and BMD.; Ineffective: no improvement in all the aspects	Markedly improved (3); Moderately improved (26); Ineffective (1); Overall efficacy: 96.7%; Control treatment using caltrate D	[17]
Jiawei Gutongxian capsule; 14	Cure: lumbar vertebra pain disappeared; X-ray appeared normal.; Significant effect: lumbar vertebra pain obviously alleviated; significant improvement in X-ray.; Effective: lumbar vertebra pain alleviated; improvement in X-ray.; Ineffective: lumbar vertebra pain and X-ray remained the same	Cure (1); Markedly improved (8); Moderately improved (27); Ineffective (4); Overall efficacy: 90.0%; Control treatment using osteoform capsule	[18]
Qianggubao capsule; 8	Back pain; BMD	Markedly improved (24); Moderately improved (13); Ineffective (3); Overall efficacy: 92.5%	[19]
Jiangu formula; 12	Clinical symptomatic scales	Markedly improved (18); Moderately improved (28); Ineffective (4); Overall efficacy: 92.0%; Control treatment using osteoform capsule	[20]
Jiangtang Bushen formula; 10	BMD, serum C-reactive protein (CRP)	BMD and serum CRP significantly increased.; Control treatment using caltrate D	[21]
Huolisu oral liquid; 5	Significant effect: clinical symptoms markedly improved; BMD significantly increased.; Effective: clinical symptoms alleviated; BMD slightly increased.; Ineffective: clinical symptoms and BMD remained the same	Markedly improved (12); Moderately improved (86); Ineffective (14); Overall efficacy: 79.1%; Control treatment using salmon calcitonin	[22]
Migu decoction; 7	Visual analogue scale (VAS) pain score, BMD	VAS pain score significantly improved; BMD significantly increased.; Control treatment using calcium carbonate	[23]
Xianling Gubao; 6	Clinical symptom scales and BMD	Clinical symptom scales and BMD significantly improved.; Control treatment using caltrate D	[24]

Radix Rehmanniae Preparata, Fructus Corni, Rhizoma Dioscoreae, Herba Cynomorii, Carapax et Plastrum Testudinis, Rhizoma Chuanxiong, and Radix et Rhizoma Salviae Miltiorrhizae (dosage information is not available).
Radix Astragali 30 g, Herba Epimedii 12 g, Rhizoma Polygonati 12 g, Colla Cornus Cervi (melting in boiled water) 15 g, Rhizoma Dioscoreae 30 g, Semen Astragali Complanati 15 g, Radix Puerariae Lobatae 30 g, Radix Polygoni Multiflori 15 g, Radix et Rhizoma Salviae Miltiorrhizae 30 g, Radix et Rhizoma Rhei 10 g, and Sanguis Draconis 10 g.
Radix Astragali, Colla Cervi Cornus, Radix Rehmanniae, Fructus Psoraleae, Herba Epimedii, Fructus Ligustri Lucidi, Radix Notoginseng, Radix et Rhizoma Salviae Miltiorrhizae, and Pheretima (dosage information is not available).
Cortex Eucommiae 12 g, Fructus Psoraleae 12 g, Radix Astragali 30 g, Radix Notoginseng 15 g, Rhizoma Dioscoreae 15 g, Colla Cornus Cervi (melting in boiled water) 6 g, Radix et Rhizoma Salviae Miltiorrhizae 12 g, Os Draconis 30 g, and Concha Ostreae 30 g.
Radix Astragali, Radix et Rhizoma Rhei, Fructus Ligustri Lucidi, Fructus Lycii, Hirudo, Flos Carthami, and Radix et Rhizoma Rhodiolae Crenulatae (dosage information is not available).
Radix Rehmanniae Preparata 15 g, Fructus Corni 10 g, Rhizoma Chuanxiong 15 g, Rhizoma Drynariae 15 g, Fructus Psoraleae 15 g, Herba Epimedii 12 g, Radix et Rhizoma Salviae Miltiorrhizae 15 g, Radix Cyathulae 15 g, and Fructus Lycii 20 g.
Cortex Phellodendri Chinensis 10 g, Radix Rehmanniae Preparata 15 g, Carapax et Plastrum Testudinis 15 g, Radix Paeoniae Alba 12 g, Rhizoma Anemarrhenae 9 g, Pericarpium Citri Reticulatae 10 g, Herba Cynomorii 10 g, and Rhizoma Zingiberis 4 g.
Radix Astragali, Radix Codonopsis, Radix Polygoni Multiflori, Radix Angelicae Sinensis, Rhizoma Atractylodis Macrocephalae, Poria, Carapax et Plastrum Testudinis, Carapax Trionycis, Herba Taxilli, Herba Epimedii, Radix Dipsaci, Cortex Eucommiae, and Fructus Aurantii (dosage information is not available).
Rhizoma Drynariae 20 g, Herba Epimedii 20 g, Rhizoma Atractylodis Macrocephalae 15 g, and Cortex Eucommiae 15 g.
Radix Astragali, Radix Rehmanniae, Radix Paeoniae Rubra, Radix et Rhizoma Salviae Miltiorrhizae, Radix Cyathulae, Radix Ophiopogonis, Rhizoma Polygonati, Herba Epimedii, and Radix Puerariae Lobatae (dosage information is not available).
Prescription constituents and dosage information are not available.
Radix Rehmanniae Preparata, Radix Morindae Officinalis, Herba Cistanches, Rhizoma Drynariae, Pyritum, Rhizoma Curculiginis, Herba Epimedii, Radix Angelicae Sinensis, Rhizoma Anemarrhenae, Radix Notoginseng, Carapax et Plastrum Testudinis, Placenta Hominis, Radix Astragali, and Endothelium Corneum Gigeriae Galli (dosage information is not available).
Radix Astragali, Fructus Corni, Herba Dendrobii, Rhizoma Dioscoreae, Rhizoma Drynariae, Colla Cornus Cervi (melting in boiled water), Radix et Rhizoma Salviae Miltiorrhizae, and Concha Ostreae (dosage information is not available).
Herba Epimedii 10 g, Herba Cistanches 10 g, Cortex Eucommiae 18 g, Radix Dipsaci 12 g, Radix Polygoni Multiflori 10 g, Radix Rehmanniae Preparata 12 g, Rhizoma Dioscoreae 15 g, Fructus Corni 10 g, Fructus Lycii 12 g, Radix Angelicae Sinensis 10 g, Radix Cyathulae 18 g, and Poria 12 g.
Radix Astragali 30 g, Radix Paeoniae Rubra 20 g, Radix et Rhizoma Salviae Miltiorrhizae 20 g, Cortex Mori 10 g, Radix Trichosanthis 20 g, Fructus Lycii 15 g, Radix Scrophulariae 20 g, Radix Rehmanniae 20 g, Semen Cuscutae 15 g, and Rhizoma Drynariae 15 g (modification according to symptoms. If diagnosed as Qi deficiency, Radix Pseudostellariae (30 g) is added to the above prescription and the dosage of Radix Astragali is modified from 30 g to 50 g. If diagnosed as Yin deficiency, Herba Dendrobii (15 g) is added to the above prescription. If diagnosed as blood deficiency, Radix Paeoniae Alba (20 g) is added to the above prescription. If diagnosed as blood stasis, Rhizoma Chuanxiong (20 g) is added to the above prescription. If diagnosed as phlegm-heat, Fructus Trichosanthis (15 g) and Caulis Bambusae in Taenia (10 g) are added to the above prescription).
Herba Epimedii, Radix et Rhizoma Salviae Miltiorrhizae, Radix Astragali, Radix Ophiopogonis, and Fructus Lycii (dosage information is not available).
Radix Rehmanniae Preparata 15 g, Herba Epimedii 10 g, Fructus Psoraleae 15 g, Radix Notoginseng 15 g, Rhizoma Drynariae 15 g, Semen Cuscutae 15 g, and Rhizoma Dioscoreae 12 g.
Herba Epimedii, Radix Dipsaci, Fructus Psoraleae, Radix Rehmanniae, Radix et Rhizoma Salviae Miltiorrhizae, and Rhizoma Anemarrhenae (dosage information is not available).