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Osteoporosis

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Osteoporosis

Introduction

Osteoporosis is a general osteopathy manifested in the following conditions: a decrease in total quantity of bone or in bone tissue per unit volume, insufficiency in generating the organic components of bone, and a secondary decrease in calcium deposit. Gradual bone loss occurs naturally as people age, and therefore older people often have physiological osteoporosis. There are two types of osteoporosis: primary osteoporosis and secondary osteoporosis. Primary osteoporosis cannot trace its origin to other concurrent diseases or disorders, and secondary osteoporosis is mainly caused by functional disorders of the endocrine gland. In traditional Chinese medicine, osteoporosis falls into the category of "Gubi" (rheumatism involving the bone) or "Guwei" (atrophic debility of bones).

Etiology/Pathogenesis

Osteoporosis often results from congenital defects, improper postnatal nursing, improper treatment of chronic diseases, or aging-induced degeneration. Wang, et al. argue that the root cause of this disease is kidney deficiency. In essence, the disease is spleen and kidney deficiencies manifested in excessive symptoms such as qi and blood stasis, and meridian blockage. (1) Li, et al. believe that blood and kidney deficiencies are the fundamental cause of osteoporosis, and therefore treatment should equally emphasize enriching the blood and strengthening the kidney. (2)

Primary Treatments with Chinese Medicinal Herbs

Qi Bao Mei Ran Dan

Ingredients: He Shou Wu (Fleece-flower Root), Chi Shao (Red Peony), Bai Shao (White Peony Root), Fu Ling (Hoelen), Niu Xi (Achyranthes), Dang Gui (Dang Gui), Gou Qi Zi (Lycium Fruit), Tu Si Zi (Cuscuta), Bu Gu Zhi (Psoralea)

Clinical Application:
Osteoporosis: 76 cases of osteoporosis were treated with this formula. The prescription contained processed He Shou Wu (Fleece-flowered Root), Bu Gu Zhi (Psoralea), Gou Qi Zi (Lycium Fruit), Tu Si Zi (Cuscuta), Fu Ling (Hoelen), Dang Gui (Dang Gui), Niu Xi (Achyranthes), Bai Zhu (White Atractylodes), Huang Qi (Astragalus Root). Modifications were made according to symptoms. The formula was boiled with water to obtain 300ml of decoction. One dose was taken each day, at two different times. The results: 12 significantly improved, 57 improved, and the remaining 7 cases did not respond to the treatment, with a total effective rate of 90.8%. (3)

Liu, et al. treated 76 cases of osteoporosis with Qi Bao Mei Ran Dan. The formula consisted of prepared He Shou Wu (Fleece-flower Root), Bu Gu Zhi (Psoraleae Semen), Gou Qi Zi (Lycium Fruit), Tu Si Zi (Cuscuta), Fu Ling (Hoelen), Dang Gui (Dang Gui), Niu Xi (Achyranthes), Bai Zhu (White Atractylodes), and Huang Qi (Astragalus Root). Modifications of the formula were made to better suit individual patients’ symptoms. The formula was decocted in water and administered 300ml a day (divided into two portions, once in the morning and once in the evening). The results: 12 cases significantly improved, 57 improved, and the remaining 7 cases did not respond to the treatment, with a total effective rate of 90.8%. (4)

Other Treatments with Chinese Medicinal Herbs

Gu Shu Ling

Fang, et al. treated 60 cases of senile osteoporosis with Gu Shu Ling. The formula consisted of Huang Qi (Astragalus), Yin Yang Huo (Epimedium), Du Huo (Pubescent Angelica Root), Yi Mu Cao (Leonurus), etc. The patients took three capsules (each capsule containing the equivalent of one gram of raw herbs) at a time, three times a day, and one course of treatment lasted three months. The results: 21 significantly improved (symptoms significantly relieved, and the symptom index lowered by 2/3), 36 cases improved (symptoms relieved somewhat, and the symptom index lowered by 1/3 to 2/3), and 3 cases did not respond to the treatment, with a total effective rate of 95%. (5)

Nu Zhen Zi, Tu Si Zi, Fu Ling, Niu Xi, Dang Gui, Gui Ban, Chuan Duan, Gan Cao, Lu Jiao Jiao, Gou Qi Zi, Du Zhong, Bu Gu Zhi, Huang Qi, Chuan Xiong, Shu Di Huang, and Da Zao

Guo, et al. treated 37 cases of osteoporosis by reinforcing the kidney. The formula used in the treatment consisted of the following herbs: Nu Zhen Zi (Ligustrum), Tu Si Zi (Cuscuta), Fu Ling (Hoelen), Niu Xi (Achranthes), Dang Gui (Dang Gui), Gui Ban (Tortoise Plastron), Chuan Duan (Dipsacus), Gan Cao (Llicorice), Lu Jiao Jiao (Antler Glue), Gou Qi Zi (Lycium Fruit), Du Zhong (Eucommia), Bu Gu Zhi (Psoralea), Huang Qi (Astragalus), Chuan Xiong (Cnidium), Shu Di Huang (processed Rehmannia), and Da Zao (Jujube). One dose of the formula in decoction was administered orally each day for one month. Roentgenogram was taken before and after the treatment to assess changes in bone density, structure, the number of bone trabecula, and bone cortex. The results: 20 cases significantly improved, 13 improved, and the remaining 4 cases did not respond to the treatment. (6)

Dang Shen, Huang Qi, Shu Di Huang, Shan Yao, Xian Mao, Gou Ji, Chuan Duan, Dang Gui, Chi Shao and Bai Shao, Chuan Xiong, Jiang Can, E Jiao and Wu Gong

Chen treated 38 cases of senile osteoporosis owing to deficiency and stasis origins. The treatment used the following herbs: Dang Shen (Salvia), prepared Huang Qi (Astragalus), Shu Di Huang (prepared Rehmannia), Shan Yao (Dioscorea), Xian Mao (Curculigo), Gou Ji (Cibotium), Chuan Duan (Dipsacus), Dang Gui (Dang Gui), Chi Shao (Red Peony) and Bai Shao (White Peony), Chuan Xiong (Cnidium), Jiang Can (Silkworm), E Jiao (Donkey-hide Gelatin) and Wu Gong (Centipede) (ground into fine powder, this last item was orally administered separately). Modifications were made to suit individual patients’ symptoms. One dose of the formula in decoction was administered daily, and one course of treatment lasted 10 days. While under treatment with this formula, the patients were asked to stop taking calcium supplements, vitamin D, sydium fluoride, etc. The results: after 3 to 5 courses of treatment, 30 cases significantly improved, 14 cases improved, and the remaining 4 cases did not respond to the treatment, with a total effective rate of 89.47%. (7)

Combined Massage and Chinese herbs

Li combined digital acupoint pressure, cupping, and Chinese herbal treatment to treat 60 cases of senile osteoporosis affecting the thoracic and lumbar vertebrae. The following acupoints were treated by digital pressure and cupping: Shen Shu (BL 23), San Jiao Shu (BL 22), Qi Hai Shu (BL 24), Da Chang Shu (BL 25), Guan Yuan Shu (BL 26), Shang Liao (BL 31), Ci Liao (BL 32), Zhong Liao (BL 33), Xia Liao (BL 34), Wei Zhong (BL 40), and Cheng Shan (BL 57). Each acupoint was pressed with a single finger for 10 to 20 seconds, followed by cupping for about 4 to 5 minutes. The treatment was conducted once every 3 to 5 days. In addition, Chinese herbs were used for both fumigation and internal administration. For fumigation, the following herbs were used: Huang Qi (Astragalus), Chen Pi (Citrus), Chuan Shan Long (Rhizoma Dioscoreae Nipponicae), Hai Tong Pi (Erythrina Bark), Lu Lu Tong (Liquidambar), Tao Ren (Persica), Hong Hua (Carthamus), Ji Xue Teng (Milettia), Gui Zhi (Cinnamon Twig), Yu Xing Cao (Houttuynia), and Gan Cao (Licorice). The herbs were decocted and the decoction was added with rice wine (60ml). A towel soaked in the warm mixture was then applied to the lumbar region for 30 min each time, 2-3 times a day. For oral administration, different formulas were used at different phases of the treatment. In the first phase, the patients took 5-7 doses of a modification of Wen Dan Tang (a decoction for clearing away gallbladder-heat, modified by adding Shan Zha (Crataegus), Mai Ya (Malt), Bai Zhi (Angelica) and Huang Qi (Astragalus Root)). In the second phase, the patients took 5-7 doses of a modification of Er Chen Tang (“Two Old Drugs Decoction," modified by adding Dang Gui Wei (Dang Gui Tail), Ji Xue Teng (Miletta), Huang Qi (Astragalus Root), Shan Zha (Crataegus), Bai Zhu (White Atractylodes), Long Gu (Dragon Bone), and Ba Ji Tian (Morinda)). In the third phase, the patients took 5-7 doses of a modification of Qing E Tang (modified by adding Yin Yang Huo (Epimedium), Sheng Di Huang (Rehmannia Root), Huang Qi (Astragalus Root), Fu Ling (Hoelen), Ji Xue Teng (Miletta), and Gan Cao (Licorice)). And finally, for the rest of a 2-month treatment course, the patients took Zhi Bai Di Huang Wan (Bolus of Anemarrhena, Phellodendron, and Rehmannia). The results: after 5-15 days of treatment, all 60 patients experienced relief in lumbago and back pain, and were able to live independently again; after a full course of treatment, X-ray exams showed that the patients’ bone density improved to various degrees. (8)

Xiong treated two groups of 17 osteoporosis patients by different methods. The first group was treated with a combination of massage, acupuncture, and cupping. Specifically, the patients in this group received massage treatment on Shen Shu (BL 23) (one minute of gentle kneading), in the back and lumbar areas (10 minutes of palm maneuver and five minutes of finger maneuver), on Shen Shu (BL 23), Zhi Shi (BL 52), Ge Shu (BL 17), Yao Yang Guan (DU 3), Tai Xi (KI 3), and Yong Quan (KI 1) (pressing, one minute each), and on Ge Shu (BL 17), Shen Shu (BL 23), Shang Liao (BL 31), Ci Liao (BL 32), Zhong Liao (BL 33), and Xia Liao (BL 34) (palm rubbing, three minutes each). They also received acupuncture and cupping treatments (cupping following acupuncture) on Shen Shu (BL 23), Zhi Shi (BL 52), and Tai Xi (KI 3) (weak stimulation by reinforcing method), and on Yao Yang Guan (DU 3), Ge Shu (BL 17), San Yin Jiao (SP 6), and Yao Yan (EX-B 7) (strong stimulation by reducing method). The second group was treated with Gou Qi Zi (Lycium Fruit), Du Zhong (Eucommia), Fu Ling (Hoelen), Shou Di Huang (cooked Rehmannia), Ze Xie (Alisma), Rou Gui (Cinnamon bark), and with calcium supplements (450mg/day). One course of treatment lasted 10 days for both groups. The results: after 2 courses of treatment, of the first group, 11 patients significantly improved, 4 improved, and 2 did not respond to the treatment; of the second group, the corresponding numbers were: 5, 6, and 6. (9)

References

  1. Wang Ling Ling, et al. The pathogenesis of postmenopausal bone loss: The TCM approach. Journal of Nanjing TCM Univeristy. 1999;15(6):324-325.
  2. Li Xue Jun, et al. TCM treatment of osteoporosis. Journal of Guiyang College of TCM. 1999;21(4):46-47.
  3. Liu Ding An, et al. Treating 76 cases of osteoporosis with Qi Bao Mei Ran Dan. Hunan Journal of TCM. 1999;15(2):26-27.
  4. Liu Ding An, et al. Treating 76 cases of osteoporosis with Qi Bao Mei Ran Dan. Hunan Journal of TCM. 1999;15(2):26-27.
  5. Fang Zhao Hui, et al. Treating 60 cases of senile osteoporosis with Gu Shu Ling. China Journal of Medicine and Drug. 1999;14(6):30-32.
  6. Guo Hong Wei, et al. Treating 37 cases of osteoporosis by reinforcing the kidney and strengthening bone. Journal of Traditional Chinese Medicine and Herbs. 1999;27(6):32.
  7. Chen Ji Ping. Treating 38 cases of senile osteoporosis due to deficiency and stasis. Heilongiang Journal of Traditional Chinese Medicine and Pharmacology. 1999;(6):29-30.
  8. Li Dong Dong, et al. Treating senile osteoporosis of the thoracic and lumbar vertebrae with and Chinese medicinal herbs. China Journal of Bone Injury. 1999;12(2):70.
  9. Xiong Zhou Qing. Treating osteoporosis with acupuncture and cupping. Journal of Massage and Induction. 1996;(4):18-19.