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Effect of Herbal Medicine on Osteoporosis: A Review of Animal Experiment, Clinical Studies Published in Korea and Overseas

골다공증의 한약 치료 효과: 국내 및 국외 동물 실험 및 임상 연구 논문에 대한 문헌 고찰

  • Won, Jee-Yeong (Department of Korean Medicine Rehabilitation, Dongsuwon Hospital of Oriental Medicine) ;
  • Han, Dayoung (Department of Korean Medicine Rehabilitation, Dongsuwon Hospital of Oriental Medicine) ;
  • Nam, Suhyun (Department of Korean Medicine Rehabilitation, Dongsuwon Hospital of Oriental Medicine) ;
  • Kil, Bong-hun (Department of Internal Korean Medicine, Dongsuwon Hospital of Oriental Medicine) ;
  • Kim, Dong-won (Department of Internal Korean Medicine, Dongsuwon Hospital of Oriental Medicine)
  • 원지영 (동수원한방병원 한방재활의학과) ;
  • 한다영 (동수원한방병원 한방재활의학과) ;
  • 남수현 (동수원한방병원 한방재활의학과) ;
  • 길봉훈 (동수원한방병원 한방내과) ;
  • 김동원 (동수원한방병원 한방내과)
  • Received : 2021.06.09
  • Accepted : 2021.07.02
  • Published : 2021.07.31

Abstract

Objectives This study was designed to review the effect of herbal medicine on animal model and patients with osteoporosis. Methods The databases in Korea and overseas were searched with term as osteoporosis, Chinese medicine, Korean medicine, herbal medicine. Among the results, we reviewed studies published in 2011 to 2020. 420 articles were primarily selected and after processing through flowchart, finally 72 studies were selected. Results Above 72 studies, 71 studies showed that the herbal medicine was effective on treating osteoporosis, using macroscopical, osteological, histological, hematological analysis and urinalysis. Conclusions Using herbal medicine for treating osteoporosis is effective in various pathways. But further study should be conducted to clarify its treatment mechanisms and effectiveness.

Keywords

References

  1. Anonymous. Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. The American Journal of Medicine. 1993;94:646-50. https://doi.org/10.1016/0002-9343(93)90218-E
  2. The Society of Korean Medicine Obstetrics and Gynecology. Korean medicine obstetrics & gynecology. 3rd ed. Seoul:Euiseongdang. 2016:252.
  3. The Society of Korean Medicine Rehabilitation. Korean medicine rehabilitation. 4th ed. Seoul:Koonja Publishing. 2015:35, 133-4.
  4. Liu Y, Liu JP, Xia Y. Chinese herbal medicines for treating osteoporosis. Cochrane Database of Systematic Reviews. 2014;3:11.
  5. Healthcare Bigdata Hub [Internet] 2021 [cited 2021 Feb 18]. Available from: URL: http://opendata.hira.or.kr/op/opc/olapMfrnIntrsIlnsInfo.do.
  6. Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int. 1992;2(6):285-9. https://doi.org/10.1007/BF01623184
  7. Barrionuevo P, Kapoor E, Asi N, Alahdab F, Mohammed K, Benkhadra K, Almasri J, Farah W, Sarigianni M, Muthusamy K, Al Nofal A, Haydour Q, Wang Z, Murad MH. Efficacy of pharmacological therapies for the prevention of fractures in postmenopausal women: a network meta-analysis. J Clin Endocrinol Metab. 2019;104:1623. https://doi.org/10.1210/jc.2019-00192
  8. Choi HJ. Treatment for osteoporosis: focusing on bisphosphonate therapy. Korean J Fam Pract. 2013;3:16-24.
  9. Black DM, Delmas PD, Eastell R, Reid IR, Boonen S, Cauley JA, Cosman F, Lakatos P, Leung PC, Man Z, Mautalen C, Mesenbrink P, Hu H, Caminis J, Tong K, Rosario-Jansen T, Krasnow J, Hue TF, Sellmeyer D, Eriksen EF, Cummings SR; HORIZON Pivotal Fracture Trial. Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis. N Engl J Med. 2007;356(18):1809. https://doi.org/10.1056/NEJMoa067312
  10. Rozenberg S, Kroll M, Pastijn A, Vandromme J. Osteoporosis prevention and treatment with sex hormone replacement therapy. Clinical Rheumatology. 1995;14(3):14-7.
  11. Tang D, Ju C, Liu Y, Xu F, Wang Z, Wang D. Therapeutic effect of icariin combined with stem cells on postmenopausal osteoporosis in rats. J Bone Miner Metab. 2017;36(2):180-8. https://doi.org/10.1007/s00774-017-0831-x
  12. Lin J, Zhu J, Wang Y, Zhang N, Gober HJ, Qiu X, Li D, Wang L. Chinese single herbs and active ingredients for postmenopausal osteoporosis: from preclinical evidence to action mechanism. Biosci Trends. 2017;11:496-506. https://doi.org/10.5582/bst.2017.01216
  13. Kim MB, Kim SS, Chung SH. A literature review of herbal medicine on osteoporosis studies - reviewing articles published after year 2000. J Korean Med Rehabil. 2010;20(1):91-107.
  14. Park JA, Lee SO, Moon EJ, Kim M, Lim SC. Protective effect of Puerariae Radix on ovariectomy-induced bone loss in rats. Natural Product Sciences. 2011;17(3):189-97.
  15. Lee SY, Seo BI, Park JH, Rho SS, Kim DJ. Effect of Ligustri Lucidi Fructus Extract and Vici Herba Extract on treatment of osteoporosis in ovariectomized rat. Korea Journal of Oriental Medicine. 2011;17(1):153-65.
  16. Do YJ, Ku SK, Kim HT, Oh TH, Cho MY, Kim SW, Ryu IS, Lee KW. Antiosteoporotic effects of Polygoni Multiflori Radix (PMR) in ovariectomized (OVX)-induced osteoporosis ddY mice. Journal of Veterinary Clinics. 2011;29(4):375-86.
  17. Yu SJ, Ahn HB, Kim JY, Lee DN. A comparative study of BMD between osteoporosis patients taking fosamax and taking fosamax and Samgieumgamibang. The Journal of Oriental Obstetrics & Gynecology. 2012;25(1):11-9.
  18. Kim JH, Kim HS, Jun JY, Jeong DW, Cho CY, Sohn YJ, Jung HS. Effects of Cuscutae Semen extract on prevention of osteoporosis in ovariectomized rats. The Journal of Oriental Obstetrics & Gynecology. 2012;25(4):1-11.
  19. Lim DW, Kim JG, Lee YS, Cha SH, Kim YT. Preventive effects of Eleutherococcus senticosus Bark extract in OVX-induced osteoporosis in rats. Molecules. 2013;18(7):7998-8008. https://doi.org/10.3390/molecules18077998
  20. Park YS, Kang MS, Kim BK, Kim MH. The effect of Eisenia bicyclis extracts on bone tissues in ovariectomized rats. J Korean Soc Food Sci Nutr. 2013;42(1):33-9. https://doi.org/10.3746/JKFN.2013.42.1.033
  21. Kim JH, Kim JS. Effects of Lycii Fructus and Lycii Folium extracts on osteoporosis in ovariectomized rats. J Korean Soc Food Sci Nutr. 2014;43(1):24-9. https://doi.org/10.3746/JKFN.2014.43.1.024
  22. Kum CJ, Cho CY, Lim JM, Song DU, Kim JH, Lee B, Jung HS. Effects of Yoohyangheukho-dan (Ruxiangheihu-dan) on osteoporosis induced by ovariectomy in rats. J Korean Med Rehabil. 2014;24(3):29-37.
  23. Yang MY, Jang HS, Lee HJ, Moon CJ, Kim JC, Jang JS, Jung UH, Jo SK, Kim SH. Evaluation of effect of red ginseng on ovariectomy-induced bone loss in C3H/HeN mice. J Biomed Res. 2014;15(1):12-8. https://doi.org/10.12729/jbr.2014.15.1.012
  24. Kim JH, Lee HJ, Kang KS, Chun KH, Hwang GS. Protective effect of Korean red ginseng against glucocorticoid-induced osteoporosis in vitro and in vivo. Journal of Ginseng Research. 2015;39(1):46-53. https://doi.org/10.1016/j.jgr.2014.06.001
  25. Kim YO, Kim JS, Lee SW, Jo IH, Na SW. Osteoprotective effect of extract from Cirsium japonicum var. ussuriense in ovariectomized rats. Korean J Medicinal Crop Sci. 2015;23(1):1-7. https://doi.org/10.7783/KJMCS.2015.23.1.1
  26. Choi JH, Lim SK, Jang AR, Nho JH, Lim JO, Cho SK, Kim YK, Lee AC, Choi MY, Boo YM, Park SH. Safflower bud dietary prevents ovariectomy-induced osteoporosis in rats. Korean J Plant Res. 2015;28(6):704-9. https://doi.org/10.7732/kjpr.2015.28.6.704
  27. Seo IB, Ahn SH. Effect of SMO16, a Korean poly-herbal medicine, on bone mass in ovariectomized rat. International Journal of Sport. 2017;2(2):18-22.
  28. Lee MJ, An BK, Jung HK, Lee KH, Kim AH, Lee HJ, Jang JH, Sim MO, Kim TM, Kim MS, Seong TG, Woo KW, Cho JH, Kim JC, Cho HW. The anti-osteoporosis effects of Cassia tora L. seed ethanol extract in ovariectomixed rats. Kor J Pharmacogn. 2016;47(4):333-42.
  29. Jeong JH, An JH, Yang H, Kim DK, Jeong YG, Na CH, Na DS, Dong MS, Hang SY. Protective effect of Rhus verniciflua stokes extract in an experimental model of post-menopausal osteoporosis. Anatomy&Cell Biology. 2017;50(3):219-29. https://doi.org/10.5115/acb.2017.50.3.219
  30. Cho CY, Kim EY, Kim DH, Kim MB, Kim SB, Yang KJ, Sohn YJ, Jung HS. Effects of Bia-hwan (Feier-wan) on the ovariectomized rat model of osteoporosis. J Korean Med Rehabil. 2017;27(2):19-27. https://doi.org/10.18325/jkmr.2017.27.2.19
  31. Ahn BS, Lee SE, Moon CJ, Kim JC, Jang JS, Kim SH. The effect of Puerariae Radix on ovariectomy-induced bone loss in C3H/HeN mice. J of Biomed Transl Res. 2018;19(4):74-8.
  32. Cho SY, Kim DC. Anti-osteoporotic activity of Gojineumja aqueous extracts on the ovariectomized mice. J Korean Obstet Gynecol. 2018;31(4):16-38. https://doi.org/10.15204/JKOBGY.2018.31.4.016
  33. Park HI, Lee KH. Comparison of the effects of deer antler, old antler, and antler glue on osteoporosis in ovariectomized rats. Journal of Acupuncture Research. 2018;35(1):21-7. https://doi.org/10.13045/jar.2018.00031
  34. Kim HH, Ahn SH, Park SY. Effects of Bombycis Corpus on male osteoporosis. J Physiol & Pathol Korean Med. 2019;33(1):56-62. https://doi.org/10.15188/kjopp.2019.02.33.1.56
  35. Kim HJ, Ahn SH, Park SY. The effects of Alpiniae Oxyphyllae Fructus on osteoporosis and muscle dystrophy of male mice. J Int Korean Med 2019;40(1):1-12.
  36. An TEB, Kim DC. Selection of the fittest anti-osteoporotic mixed compositions consist of Morindae Radix and Cistanchis Herba Aqueous extracts on ovariectomized mice. J Korean Obstet Gynecol. 2019;32(3):1-19. https://doi.org/10.15204/JKOBGY.2019.32.3.001
  37. Yun GW, Lee H. Effect of Cheongawongagam extract on the ovariectomized rat model of osteoporosis. The Society of Pathology in Korean Medicine. 2020;34(1):14-23.
  38. Seo IB, Ahn SH. A Korean poly-herbal medicine, SMO16, regulates the RANKL/OPG bone remodeling in OVX rat model. Kinesiology. 2020;5(1):58-64.
  39. Ramli ESM, Soelaiman IN, Othman F, Ahmad F, Shuib AN, Mohamed N, Muhammad N, Suhaimi FH. The effects of piper sarmentosum water extract on the expression and activity of 11β-Hydroxysteroid dehydrogenase type 1 in the bones with excessive glucocorticoids. Iran J Med Sci. 2012;37(1):39-46.
  40. Shi ZY, Zhang XG, Li CW, Liu K, Liang BC. Effect of traditional Chinese medicine product, QiangGuYin, on bone mineral density and bone turnover in Chinese postmenopausal osteoporosis. Evidence-Based Complementary and Alternative Medicine. 2017;2017(6062707):1-8.
  41. Chen L, Tao ZS, Chen H, Zhou K, Zhou DS. Combined treatment with alendronate and Drynaria rhizome extracts effect on fracture healing in osteoporotic rats. Z Gerontol Geriat. 2018;51(8):875-81. https://doi.org/10.1007/s00391-017-1326-z
  42. Wang Q, Zi CT, Wang J, Wang YN, Huang YW, Fu XQ, Wang XJ, Sheng J. Dendrobium officinale orchid extract prevents ovariectomy-induced osteoporosis in vivo and inhibits RANKL-induced osteoclast differentiation in vitro. Frontiers in Pharmacology. 2018;8(966):1-13.
  43. Guo N, Li BL, Jiang XR. The efficacy of a phytoestrogen-rich Chinese medicine on senile osteoporosis. Farmacia. 2018;66(6):1076-80. https://doi.org/10.31925/farmacia.2018.6.23
  44. Li WX, Zhang KQ, Liu Z, Liu L, Cheng Y, Yin JC, Sun YD, Yang F. Effect of Zuogui pill and Yougui pill on osteoporosis: a randomized controlled trial. Journal of Traditional Chinese Medicine. 2018;38(1):33-42. https://doi.org/10.1016/j.jtcm.2018.01.005
  45. Jiang YC, Li YF, Zhou L, Zhang DP. UPLC-MS metabolomics method provides valuable insights into the effect and underlying mechanisms of Rhizoma Drynariae protecting osteoporosis. Journal of Chromatography B. 2020;1152(122262):1-8.
  46. Wang JJ. A clinical study of Qiangguhuoxue decoction combined with PKP in the treatment of osteoporotic thoracolumbar vertebral compression fractures [dissertation]. HuNan:HuNan University of Chinese Medicine; 2011.
  47. Zhu H, Zheng HX, Yang F, Wang J, Zhang GZ. Effects of nourishing-kidney herbs on expression of TRPV5 in kidney of rats with osteoporosis induced by dexamethasone. CJTCMP. 2011;26(5):1110-4.
  48. Deng AL, Zhou ZM, Jiang HZ, Zhang YB, Jing J. Effect of traditional Chinese medicine for nourishing liver and kidney on bone tissue pathology of ovariectomized osteoporosis model rats. China Pharmacist. 2011;14(2):154-7. https://doi.org/10.3969/j.issn.1008-049X.2011.02.002
  49. Chen HS. A clinical study on Tonifying Ki, resolving blood stasis and strengthening bone for senile osteopososis [dissertation]. NanJing:Nanjing University of Traditional Chinese Medicine; 2011.
  50. Cheng ZY. Filling kidney invigorate the decoction in the treatment of osteoporotic vertebral compression fracture PKP postoperative clinical curative effect observation [dissertation]. Hunan:Hunan University of Chinese Medicine; 2012.
  51. Gong JC, Chen SH, Xu WG, Lu GQ. Cinical study on "xian ling gu bao" plus alendronate in treating osteoporosis of insufficiency of the kidney-Yang. Journal of Traditional Chinese Orthopedics and Traumatology. 2012;24(5):7-9. https://doi.org/10.3969/j.issn.1001-6015.2012.05.002
  52. Gao L, Zheng HX, Shang DY, Zhong ZH, Lin SR. Regulation of kidne y-tonifying compound on the ovariectomized rats MEK1, ERK2 gene expression. Chin J Osteoporos. 2014;20(5):471-84.
  53. Wang J, Zheng HX, Zhang JP, Liu Y, Liu JH, Song GY, Liu RH. Effects of antler prescription on the expression of Msx2 mRNA and protein in renal tissue of ovariectomy osteoporosis rats. Journal of Basic Chinese Medicine. 2015;21(7):800-2, 836.
  54. Wang J, Zheng HX, Zang JP, Liu Y, Liu JH, Song GY, Liu RH. Effect of reinforcing kidney to strengthen bone traditional Chinese medicine compound on mRNA and protein expression of Dlx5 in bone tissues of ovariectomized osteoporosis rats. Journal of Basic Chinese Medicine. 2015;21(10):1238-40, 1316.
  55. Ma W, Pan J, Hu BC, Zhang Y. Effect of enriching kidney and promoting blood flow TCM on Wnt signal in osteoporotic rats. Chin J Osteoporos. 2015;21(7):820-3.
  56. Liu W, Zhang L, Wu YH. Effects of tonifying kidney and invigorating blood therapy in treating 100 senile osteoporosis patients: a randomized controlled trial. Journal of Traditional Chinese Medicine. 2015;56(9):769-72.
  57. Zhou XM, Wu JZ, Wang WQ, Wu MY, Zeng YG, Shi XG. Experimental study on the treatment of the secondary osteoporosis of spinal cord injury with Erxian decoction. Chin J Osteoporos. 2015;21(2):223-7.
  58. Yao JL, Wang B, Wu P, Liu K, Shi XL. The effect of strengthening-bone receipt on the change of trabecular bone of fracture healing under micro-CT in rat osteoporotic model. Chin J Osteoporos. 2016;22(11):1395-8, 1403.
  59. Li H, Dai Y, Fan YB, Luo K. Effect of Eucommia ulmoides and Fructus Psoraleae on osteoblasts proliferation and the expression of signal pathway protein in the osteoblasts from ovariectomized rats. Lishizhen Medicine and Materia Medica Research. 2016;27(7):1610-3.
  60. Lu YF. Clinical study of Bushenjianpihuoxuefang on the treatment of senile osteoporosis [dissertation]. Anhui: Anhui University of Traditional Chinese Medicine; 2016.
  61. Ge J, Li SQ, Chen J, Xie LH, Xu HJ, Ma HZ. The effect of Xuling invigorating bone prescription on bone mineral density and the protein expression of OPG and RANKL in rat osteoporosis model. Chin J Osteoporos. 2016;22(5):592-5.
  62. Su L, Li SL, Chen WH, Ma RJ, Mo WQ. The effect of Zhuanggu-decoction on the treatment and on serum IGF-1 and TNF-α in type 2 diabetes rats with oste oporosis. Chin J Osteoporos. 2016;22(4):428-32.
  63. Sun Y, Chen R, Wang XQ, Zhang Y, Jiang G, Hu M, Zhao HB, Li WH. The e ffects of Osteoking on ovariectomized female rat model of osteoporosis. Chin J Osteoporos. 2016;22(12):1513-5, 1539.
  64. Zhong JX, Jin ZM, Jia HH, Wu Y, Chen J, Cao Q, Cao KG, Li QN. Effect of Hugu capsules on bone metabolic indexes in ovariectomized rats. Chin J Osteoporos. 2016;22(5):602-7.
  65. Wang F, Gao Y, Li WM, Chen J. The effects of Huang-Qi san on diabetic rats femur and tibia. Chin J Osteoporos. 2016;22(3):278-82, 287.
  66. Wei YX. Clinical study of using Bushenjiangu fang for treatment of osteoporosis patients with renal and liver insufficiency [dissertation]. Hunan:Hunan University of Traditional Chinese Medicine; 2017.
  67. Li YX, Zhang SC, Liang D, Guo DQ, Mo GY, Li DX, Guo HZ, Feng PB, Li YW, Mo L, Yang ZD, Tang YC. The effect of Chinese kidney-tonifying herbal medicine on osteoporotic fractures by regulating Notch1 protein in rats. Chin J Osteoporos. 2017;23(11):1425-30.
  68. Wang XY, Chang SX, Li GW, Zhou ZM, Yuan J, Wang L, Song YY, Miao Y. Experimental study on the effect of Qing E Formula on postmenopausal osteoporosis in rats induced by ovariectomy. Chin J Osteoporos. 2017;23(2):197-202.
  69. Zhang W, Zheng HX. Effect of Tonifying kidney and strengthening bone Chinese herbs on the expression of hormone level and bone mineral density in ovariectomized rats. Clinical Journal of Traditional Chinese Medicine. 2018;30(3):479-82.
  70. Wang F, Lou J. Clinical observation of the DOP rats model treated by Bushen Qianggu decoction. Shanxi Zhongyi. 2018;39(5):557-60.
  71. Chang BL, Chai Y, Li Q, Yang JX, Liu SW. Effect of Shenggumigu recipe on the levels of serum cytokines in rats with osteoporosis. China Pharmaceuticals. 2018;27(15):17-9.
  72. Ren SJ, Liang YL, Ren MH, Wang YQ, Tan FZ, Xing GL, Jiang YC. Effects of Sheng Sui Jian Gu capsule on femur biomechanics in rats with alcoholic oste oporosis. Chin J Osteoporos. 2018;24(10):1289-93, 1304.
  73. Xie J. Evaluation of Zhuanggufang decoction powder's curative effect on spleen and kidney merged stagnation blood type of postmenopausal low bone mass population [dissertation]. GuangXi:GuangXi University of Chinese Medicine; 2018.
  74. An J. Clinical study on treatment of senile osteoporosis with kidney deficiency and blood stasis by Longzhong injury capsule combined with calcium D [dissertation]. Gansu:Gansu University of Chinese Medicine; 2019.
  75. Zou PH, Liu GT, Liu P. Experimental research on the effect of bone mineral density in osteoporosis model rats after ovariectomy by Dexian Zhuanggu decoction. J Med Theor & Prac. 2019;32(7):943-5.
  76. Wan JM, Zhang JF, Huang K, Zhang PL, Zuo SY. Comparison of the clinical effects between Dihuang decoction and alendronate sodium in the treatment of primary osteoporosis. China J Orthop Trauma. 2019;32(6):535-8.
  77. Yang JX, Jia YS, Gu SM, Yang SH, Wu JZ, Ou HN, Chen JM. A clinical trial of Hugu capsule in the treatment of primary osteoporosis syndrome of deficiency of kidney essence. Chin J Osteoporos. 2019;25(11):1599-605.
  78. Gong YL, Song M, Dong WT, Dong P, Song ZJ, Huang K, Wang K. Randomized controlled clinical study on the treatment of osteoporosis with consolidating origin and improving bone formula in the elderly. Chin J Osteoporos. 2020;26(5):676-9, 701.
  79. Chen HY. Effects of Gujian decoction on estrogen, balance and lumbar function in postmenopausal osteoporosis with kidney deficiency and blood stasis [dissertation]. Fujian:Fujian University of Traditional Chinese Medicine; 2020.
  80. Cheng JL, Zhang X, Pan HS, Jian XB, Wang J, Liu CH, Tu P, Chen SH, Wang GG, Zhong SM, Wang XF, Xu HB, Zhu XQ, Lei ZM. Clinical effect of Jintiange capsule in treatment of primary osteoporosis: a prospective multi-center randomized double-blind controlled clinical trial. Chinese Archives of Traditional Chinese Medicine. 2020;39(1):36-41.
  81. Yu DD, Zhao DY, Yang F, Yang DX, Yang GL. Study on the mechanism of Chinese herbal compound deer horn glue pill in the prevention and treatment of postmenopausal osteoporosis. Chin J Osteoporos. 2020;26(11):1668-73.
  82. Wang J, Liu JH, Li Y, Wang S, Liu Y, Feng XN, Liu YL, Liu WY, Song GY, Zheng HX. The therapeutic mechanism of kidney-reinforcing traditional Chinese medicine compound on ovariectomized osteoporosis rats based on methylation of Dlx5 promoter in bone. Chin J Osteoporos. 2020;26(5):640-5.
  83. Liu ZJ, Liu SJ, Wei HW, Wan L, Huang HX, Qiao RQ. Effect of Bushen Jianpi Huoxue recipe on transforming growth factor beta/bone morphogenetic protein 2 signaling pathway in the muscle and skeleton of ovariectomized rats. Chinese Journal of Tissue Engineering Research. 2020;25(14):2219-23.
  84. Liu YP, Li YG, Guo Z, Chang CF, Li Q, Bai HJ, Pan YL. Analgesic effect of Yaotongning capsule combined with calcium carbonate and vitamin D3 in treatment of senile osteoporotic bone pain. Chinese Traditional and Herbal Drugs. 2020;51(21):5421-5.
  85. Cao SX, Song YZ, Li M, Ma W, Zhou N. Research on mechanism of Kanggu Zengsheng capsule in regulating bone metabolism and oxidative stress in ovariectomized rats with osteoporosis. Hebei J TCM. 2020;42(4):580-5.
  86. Shin GS. Power internal medicine endocrinology. 3rd ed. Seoul:Koonja Publishing. 2013:330-4.