Exploration of the Prevention and Treatment Strategies of Traditional Chinese Medicine for Osteosarcopenia Based on the Theory of “Bone-Muscle Disharmony”

Authors

  • Xiaoyao Xu Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi, China; Xi’an Hospital of Traditional Chinese Medicine Affiliated to Shaanxi University of Chinese Medicine, Xi’an 710021, Shaanxi, China
  • Yanhong Li Xi’an Hospital of Traditional Chinese Medicine Affiliated to Shaanxi University of Chinese Medicine, Xi’an 710021, Shaanxi, China

DOI:

https://doi.org/10.53469/jcmp.2025.07(03).20

Keywords:

Bone-Muscle Disharmony, Osteosarcopenia, Traditional Chinese Medicine, Spleen-Kidney Deficiency, Prevention and Treatment Strategies

Abstract

Osteosarcopenia(OS) , a degenerative disease of the musculoskeletal system, shares similarities with the concepts of “bone atrophy” and “muscle atrophy” in Traditional Chinese Medicine (TCM). Its pathological mechanism is succinctly summarized as the “Bone-Muscle Disharmony.” With the accelerating aging of society, the incidence of OS continues to rise, imposing substantial economic burdens on families and society. However, there remains no definitive single therapeutic agent for OS in clinical practice, and treatment efficacy remains uncertain. Given the necessity for long-term or even lifelong management, the development of highly effective, safe, and cost-effective therapeutic strategies is imperative. As a traditional medical system, TCM offers unique advantages in treating musculoskeletal disorders. Based on the theory of “Bone-Muscle Disharmony,” this study explores the overlapping etiological and pathological mechanisms of OS from both TCM and modern medical perspectives. It posits that the core pathology of OS lies in the musculoskeletal system, rooted in the deficiency of the spleen and kidneys. Dysfunction of these two organs leads to “Bone-Muscle Disharmony,” resulting in musculoskeletal imbalance and disease onset. The therapeutic approach emphasizes replenishing deficiencies, harmonizing the spleen and kidneys, and concurrently treating bone and muscle to nourish both the innate (kidney) and acquired (spleen) foundations. This strategy aims to restore flexibility to tendons and bones, reestablishing harmony between bone and muscle, thereby offering novel insights for the prevention and treatment of OS in clinical TCM practice.

References

Yuan Jiayao, Lin Yanping, Huang Jiachun, et al. Study on Influencing Factors of muscle mass in postmenopausal women [J]. Chinese Journal of osteoporosis, 2022,28 (03): 359-363.

The working group of the Chinese guidelines for the diagnosis and treatment of osteoporosis in the elderly (2023), the osteoporosis branch of the Chinese society of Gerontology and geriatrics, and the osteoporosis branch of the China Association for the promotion of international exchanges in health care, etc Chinese guidelines for the diagnosis and treatment of osteoporosis in the elderly (2023) [J]. Chinese Journal of bone and joint surgery, 2023,16 (10): 865-885.

Fangyu P, Fang X, Otto M. Alteration of Copper Fluxes in Brain Aging: A Longitudinal Study in Rodent Using sup64/supCuClsub2/sub-PET/CT. [J]. Aging and disease, 2018, 9(1):109-118.

Huanghongxing, shixiaolin, lishenghua, etc OS expert consensus [J]. Chinese Journal of osteoporosis, 2022,28 (11): 1561-1570.

Huo R Y, Suriyaarachchi P, Gomez F, et al. Phenotype of Osteosarcopenia in Older Individuals With a History of Falling [J]. Journal of the American Medical Directors Association,2015,16(4):290-295.

Bruyère O, Beaudart C, Ethgen O, et al. The health economics burden of sarcopenia: a systematic review [J]. Maturitas, 2018,11961-69.

Song Yun Clinical observation of Bushen Huoxue Jianpi Decoction on sarcopenia osteoporosis [d]. Shandong University of traditional Chinese medicine, 2023. 000677.

Lishuangliai, jiangyunxia Discussion on the relationship between oligomyosis and osteoporosis from the perspective of “no affinity between flesh and bone” theory [J]. Beijing Journal of traditional Chinese medicine, 2016,35 (06): 526-528.

Yang YJ, Kim DJ. An Overview of the molecular mechanisms contributing to musculoskeletal disorders in chronic liver disease: osteoporosis, sarcopenia, and osteoporotic sarcopenia [J]. Int JMol Sci, 2021, 22(5): 2604.

Einar E, MIE, GIL, et al. Increased hypertrophic response with increased mechanical load in skeletal muscles receiving identical activity patterns. [J]. American journal of physiology. Cell physiology, 2016, 311(4): C616-C629.

L. V G, L. C P. Impact of Intrinsic Muscle Weakness on Muscle–Bone Crosstalk in Osteogenesis Imperfecta [J]. International Journal of Molecular Sciences, 2021, 22(9): 4963-4963.

Chenmingxian, Zuo Qun Research progress of iridin and bone metabolism [J]. Chinese Journal of osteoporosis, 2024,30 (05): 739-744.

Liu Yandong, Deng Qiang, pengrandong, et al Research progress of metabonomics on muscle bone attenuation diseases [J]. Chinese Journal of osteoporosis, 2023,29 (10): 1513-1518+1560.

G C, T M, S C, et al. Crosstalk Between Muscle and Bone Via the Muscle-Myokine Irisin. [J]. Current osteoporosis reports, 2016, 14(4):132-7.

Lu Zhen, qixiaonan, Zhenghao, et al Construction of kidney yang deficiency type OS rat model by castration and its mechanism [J]. Chinese Journal of traditional Chinese medicine, 2024,42 (10): 1673-7717.

Salech F, Marquez C, Lera L, et al. Osteosarcopenia Predicts Falls, Fractures, and Mortality in Chilean Community-Dwelling Older Adults [J]. Journal of the American Medical Directors Association, 2020, (prepublish):

Craig M, Zi G H, Wei Z W A, et al. Human myostatin negatively regulates human myoblast growth and differentiation. [J]. American journal of physiology. Cell physiology,2011,301(1):C195-203.

Mridula S, Craig M, Ravi K, et al. Myostatin: expanding horizons. [J]. IUBMB life,2015,67(8):589-600.

Zhaochanghong, wangfeifei, Lian Hongqiang, et al The role and mechanism of osteomuscular crosstalk in the prevention and treatment of osteosarcopenia [j/ol]. advances in biochemistry and Biophysics, 1-12 [2024-11-06]

Li Yan, Dou Qunli, Yang Feng Study on the theory of “kidney is the foundation of sealing up” and the pathogenesis of primary osteoporosis [J]. Chinese Journal of osteoporosis, 2021,27 (09): 1369-1372.

Wang Wen, Chen Xinyu, Huang Ziyi, et al Overexpression of lncrna haglr promotes osteogenic differentiation of bone marrow mesenchymal stem cells in rats with tibial fracture [J]. Journal of local surgery, 2024,33 (06): 472-478

Dingkaifang, anyajuan, wanglue Discussion on the application of TCM External Treatment of gastrointestinal dysfunction in critically ill patients from the perspective of “the foundation of successive days” [J]. Chinese Journal of TCM emergencies, 2020,29 (07): 1231-1234.

Li Jiatong, Li Nianhu Treatment of hypomyosis osteoporosis based on the theory of “spleen kidney Ying Wei collaterals” [J]. bone setting of traditional Chinese medicine, 2024,36 (03): 74-77.

Cai Yanran, Study on common spleen stomach syndrome and influencing factors of behavior and lifestyle in stable coronary heart disease [d]. Chinese Academy of traditional Chinese medicine, 2021.000048.

Wang Jing, Jia Youji, sunyueli, et al Systematic thinking on the category of kidney viscera in traditional Chinese medicine [J]. World Journal of traditional Chinese medicine, 2014,9 (06): 685-688+692.

Caiyi, zhaojirong, Chen Wen, et al Review the relationship between bone marrow mesenchymal stem cells and postmenopausal osteoporosis based on the theory of “kidney dominates bone and generates marrow”. Chinese Journal of osteoporosis, 2021,27 (11): 1666-1670.

Wang Xiangchen, He Qi, Xiao Jiacong, et al Construction of renal medullary bone regulatory mechanism of “medullary changes precede bone changes” in the theory of “kidney governs bone” [J]. Chinese Journal of osteoporosis, 2023,29 (09): 1354-1361.

Li Yuguang, Zhu Huanping Research progress of visceral state theory of traditional Chinese medicine and osteoporosis [J]. Journal of modern integrated traditional Chinese and Western medicine, 2023, 32 (12): 1741-1745.

Li Binbin, Wang Yitong, Zuo Minghuan, et al Zuo Minghuan’s experience in treating lung cancer from Fuzheng Quxie and Wuxing biochemical therapy [J]. Journal of modern integrated traditional Chinese and Western medicine, 2022,31 (10): 1414-1417+1438.

Jiang Fengyi, Shi Dan, Ji Siqin, et al Effects of Bushen Jianpi Tongluo decoction combined with five elements bone exercise on bone mineral density, bone metabolism and inflammatory level in elderly patients with osteoporosis of spleen and kidney deficiency syndrome [J]. Shaanxi traditional Chinese medicine, 2024,45 (04): 485-489.

Wang Ming, Theoretical research on spleen and kidney in traditional Chinese medicine [d]. Fujian University of traditional Chinese medicine, 2009.

Zhang Xinyi, Luo Tao, Han Ke, et al Treating sarcopenia from the perspective of “treating impotence only with Yangming Decoction” [J]. research on Integrated Traditional Chinese and Western medicine, 2023,15 (01): 63-65.

Yuan Chunchun, elzati Elbo, Wang Dabao, etc Correlation between the contents of muscle, fat and estradiol and bone mineral density in ovariectomized rats and the regulatory effect of acupoint acupuncture for tonifying the kidney and spleen [J]. Chinese Journal of traditional Chinese medicine, 2020,35 (01): 434-436.

Ma Jiaojiao, Quan Zhen, Qin Daping, et al Research progress of acupuncture and moxibustion in the treatment of postmenopausal osteoporosis from the theory of “warming Du and activating Yang” [J]. Chinese Journal of osteoporosis, 2024,30 (01): 93-97.

An Yong, A comparative study on the mechanism of differentiation of bone marrow mesenchymal stem cells into myoblasts induced by different therapies of traditional Chinese medicine based on SDF-1/CXCR4 pathway [d]. Liaoning University of traditional Chinese medicine, 2023.000304.

Liu Yandong, Deng Qiang, zhangyanjun, etc Research Progress on muscle bone symbiosis of Akt/mTOR/Wnt/β - Catenin/BMP signaling pathway and intervention of traditional Chinese medicine [J]. Chinese Journal of osteoporosis, 2024,30 (06): 900-904+920.

Han Shenglong, Kong Lingjun, Deng Yelong, etc Research progress of traditional Chinese medicine monomer and compound on OS related signaling pathway [J]. rheumatism and arthritis, 2024,13 (02): 61-66.

Ma Jiangtao, Huang Hong, Wan Lei, et al Discussion on the mechanism of Astragalus membranaceus in treating hypomyosis osteoporosis based on network pharmacology [J]. world science and technology - modernization of traditional Chinese medicine, 2019,21 (11): 2367-2374.

Liu Xiaohu, Zhao Zhihui, Zhou Yue, et al Role of PI3K/Akt/mTOR autophagy pathway in ginsenoside Rg1 delaying premature ovarian failure induced by D-gal in mice [J]. Chinese Journal of traditional Chinese medicine, 2020,45 (24): 6036-6042.

Bei Jiaxin, Xia Haishan, Lu Jiaqi, etc Research Progress on anti osteoporosis mechanism of ginsenoside Rb1 [J]. Chinese Journal of clinical pharmacology and therapeutics, 2016,21 (08): 950-955.

ChenYi T, Mengrui W, Dongfeng Z, et al. Runx1 is a central regulator of osteogenesis for bone homeostasis by orchestrating BMP and WNT signaling pathways. [J]. PLoS genetics,2021,17(1): e1009233-e1009233.

Naohiro Y, Jin E, Kenichiro K, et al. (Pro) renin receptor accelerates development of sarcopenia via activation of Wnt/YAP signaling axis. [J]. Aging cell, 2019, 18(5): e12991.

Liang Qingyue, Wang Zhong, Liu Rong, et al Observation on the curative effect of modified Bazhen decoction combined with nutritional support in the treatment of senile osteopenia [J]. Chinese Journal of integrated traditional and Western medicine, 2019,39 (07): 821-825.

Li Yan, Liu Ning, Wang Xiaoyang, et al Bibliometric and visual analysis of postmenopausal osteoporosis in highly cited SCI papers [J]. China tissue engineering research, 2024,28 (35): 5681-5687.

Zhao Changhong, Wang Feifei, Lian Hongqiang, et al The role and mechanism of osteomuscular crosstalk in the prevention and treatment of osteosarcopenia [j/ol]. advances in biochemistry and Biophysics, 1-12 [2024-11-06].

Zhang Junwei Based on the “kidney marrow bone” theory and BMSCs Wnt/β - catenin signaling pathway to explore the bone protective effect of Drynaria on ovariectomized rats [d]. Shandong University of traditional Chinese medicine, 2019.000130.

Jiang Mengchun, Hu Zhouying, Li Shuanglei, et al Analysis of the mechanism of Zhuanggu Decoction in the treatment of sarcopenia osteoporosis [J]. Shandong medicine, 2022,62 (32): 32-36.

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Published

2025-03-28

How to Cite

Xu, X., & Li, Y. (2025). Exploration of the Prevention and Treatment Strategies of Traditional Chinese Medicine for Osteosarcopenia Based on the Theory of “Bone-Muscle Disharmony” . Journal of Contemporary Medical Practice, 7(3), 99–104. https://doi.org/10.53469/jcmp.2025.07(03).20