Review

Theory of “kidneys storing essence and dominating bones” and male osteoporosis

  • SHEN Shizhong ,
  • SUI Liang ,
  • CHEN Kang ,
  • SHI Xiao ,
  • SHI Dan
Expand
  • 1. Department of Geriatrics, Yueyang Hospital of Integrative Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
    2. Department of Emergency Surgery ; b.Department of Cardiovascular Medicine ,Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025,China

Received date: 2024-10-22

  Online published: 2025-04-30

Abstract

Male osteoporosis (MOP) is often not taken seriously by the public, while MOP may cause more severe consequence compared with female osteoporosis. Based on the theory of “kidney storing the essence and dominating the bones” in traditional Chinese medicine (TCM), it was believed that the concurrence of MOP is related to kidney’s physiological function in TCM. It is proposed that “kidney essence deficiency, marrow loss and bone atrophy” is the core pathogenesis of MOP, which is related to the pathogenesis of various osteoporosis in modern medicine. In terms of treatment, both ancient and modern TCM doctors have mostly adopted the methods of tonifying kidney, strengthening bone and replenishing the essence and nourishing the marrow to effectively prevent and treat osteoporosis.

Cite this article

SHEN Shizhong , SUI Liang , CHEN Kang , SHI Xiao , SHI Dan . Theory of “kidneys storing essence and dominating bones” and male osteoporosis[J]. Journal of Internal Medicine Concepts & Practice, 2025 , 20(01) : 94 -100 . DOI: 10.16138/j.1673-6087.2025.01.20

References

[1] 刘岩岩, 姜兆荣, 王丽敏, 等. 骨痹源流研究[J]. 辽宁中医药大学学报, 2019, 21(7):157-160.
[2] Khosla S, Hofbauer LC. Osteoporosis treatment: recent developments and ongoing challenges[J]. Lancet Diabetes Endocrinol, 2017, 5(11):898-907.
[3] Liu J, Curtis EM, Cooper C, et al. State of the art in osteoporosis risk assessment and treatment[J]. J Endocrinol Invest, 2019, 42(10):1149-1164.
[4] Harris K, Zagar CA, Lawrence KV. Osteoporosis: common questions and answers[J]. Am Fam Physician, 2023, 107(3):238-246.
[5] Camacho PM, Petak SM, Binkley N, et al. American association of clinical endocrinologists/American college of endocrinology clinical practice guidelines for the diagnosis and treatment of postmenopausal osteoporosis-2020 update[J]. Endocr Pract, 2020,6 Suppl 1:1-46.
[6] Arceo-Mendoza RM, Camacho PM. Postmenopausal osteoporosis: latest guidelines[J]. Endocrinol Metab Clin North Am, 2021, 50(2):167-178.
[7] Zikán V. Osteoporosis in men: underappreciated and undertreated[J]. Vnitr Lek, 2021, 67(5):271-283.
[8] 高远, 尹纪伟, 马倩倩, 等. 83057例20-49岁男性骨密度Z值多因素回归分析[J]. 中国骨质疏松杂志, 2024, 30(6):802-806.
[9] 王辰, 肖丹, 池慧. 《中国吸烟危害健康报告2020》概要[J]. 中国循环杂志, 2021, 36(10):937-952.
[10] 朴玮, 赵丽云, 房红芸, 等. 中国18岁及以上成人饮酒行为现况[J]. 中国食物与营养, 2021, 27(10):15-19.
[11] Hernlund E, Svedbom A, Iverg?rd M, et al. Osteoporosis in the European Union: medical management, epidemiology and economic burden[J]. Arch Osteoporos, 2013, 8(1):136.
[12] Wu LF, Zhu DC, Tang CH, et al. Association of plasma irisin with bone mineral density in a large Chinese population using an extreme sampling design[J]. Calcif Tissue Int, 2018, 103(3):246-251
[13] Burge R, Dawson-Hughes B, Solomon DH, et al. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005-2025[J]. J Bone Miner Res, 2007, 22(3):465-475.
[14] Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures[J]. Osteoporos Int, 2006, 17(12):1726-1733.
[15] Kim SH, Meehan JP, Blumenfeld T, et al. Hip fractures in the United States: 2008 nationwide emergency department sample[J]. Arthritis Care Res (Hoboken), 2012, 64(5):751-757.
[16] Diamantopoulos AP, Rohde G, Johnsrud I, et al. Incidence rates of fragility hip fracture in middle-aged and elderly men and women in southern Norway[J]. Age Ageing, 2012, 41(1):86-92.
[17] 杜丽坤, 李佳睿. 骨质疏松症的中医认识及防治[J]. 中国骨质疏松杂志, 2022, 28(02):296-299.
[18] Zeng Q, Li N, Wang Q, et al. The prevalence of osteoporosis in China, a Nationwide, multicenter DXA survey[J]. J Bone Miner Res, 2019, 34(10):1789-1797.
[19] 中华医学会骨质疏松和骨矿盐疾病分会. 中国骨质疏松症流行病学调查及“健康骨骼”专项行动结果发布[J]. 中华骨质疏松和骨矿盐疾病杂志, 2019, 12(4):317-318.
[20] Wang L, Yu W, Yin X, et al. Prevalence of osteoporosis and fracture in China: the China osteoporosis prevalence study[J]. JAMA Netw Open, 2021, 4(8):e2121106.
[21] 罗湘杭, 周若玙. 骨质疏松的病因及发病机制研究进展[J]. 山东大学学报(医学版), 2021, 59(6):10-15.
[22] Zhou Q, Zhu L, Zhang D, et al. Oxidative stress-related biomarkers in postmenopausal osteoporosis: a systematic review and meta-analyses[J]. Dis Markers, 2016, 7067984.
[23] Li S, Kim MJ, Lee SH, et al. Metallothionein 3 promotes osteoblast differentiation in C2C12 cells via reduction of oxidative stress[J]. Int J Mol Sci, 2021, 22(9):4312.
[24] Wang N, Hao Y, Fu L. Trimethylamine-n-oxide promotes osteoclast differentiation and bone loss via activating ROS-dependent NF-κB signaling pathway[J]. Nutrients, 2022, 14(19):3955.
[25] 男性骨质疏松症诊疗指南[J]. 中华骨质疏松和骨矿盐疾病杂志, 2020, 13(5):381-395.
[26] Hackney AC. Hypogonadism in exercising males: dysfunction or adaptive-regulatory adjustment?[J]. Front Endocrinol (Lausanne), 2020,11:11.
[27] 张萌萌, 张秀珍, 邓伟民, 等. 骨代谢生化指标临床应用专家共识(2020)[J]. 中国骨质疏松杂志, 2020, 26(6):781-796.
[28] Khosla S, Melton LJ 3rd, Atkinson EJ, et al. Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: a key role for bioavailable estrogen[J]. J Clin Endocrinol Metab, 1998, 83(7):2266-2274.
[29] Golds G, Houdek D, Arnason T. Male hypogonadism and osteoporosis: the effects, clinical consequences, and treatment of testosterone deficiency in bone health[J]. Int J Endocrinol, 2017,2017:4602129.
[30] 黄佳涌, 郑博, 胡良聪, 等. 血清睾酮水平与老年男性骨质疏松性髋部骨折的相关性[J]. 中华骨质疏松和骨矿盐疾病杂志, 2019, 12(4):362-368.
[31] 唐冲, 张克石, 刘正, 等. 肠道菌群与骨质疏松症的发病机制[J]. 中华骨质疏松和骨矿盐疾病杂志, 2021, 14(1):100-106.
[32] 张悦怡, 刘田园, 王钐, 等. 肠道菌群对骨代谢作用机制的研究进展[J]. 中国骨质疏松杂志, 2022, 28(12):1813-1818.
[33] Stallhofer J, Veith L, Diegelmann J, et al. Iron deficiency in inflammatory bowel disease is associated with low levels of vitamin D modulating serum hepcidin and intestinal ceruloplasmin expression[J]. Clin Transl Gastroenterol, 2022, 13(1):e00450.
[34] Goltzman D. Functions of vitamin D in bone[J]. Histochem Cell Biol, 2018, 149(4):305-312.
[35] 邬佳瑜, 李玲, 胡予. 肠道菌群与骨质疏松的关系[J]. 生命的化学, 2022, 42(12):2200-2207.
[36] Silva BC. Skeletal and nonskeletal consequences of hypoparathyroidism[J]. Arch Endocrinol Metab, 2022, 66(5):642-650.
[37] Minisola S, Arnold A, Belaya Z, et al. Epidemiology, pathophysiology, and genetics of primary hyperparathyroidism[J]. J Bone Miner Res, 2022, 37(11):2315-2329.
[38] Xie J, Guo J, Kanwal Z, et al. Calcitonin and bone physiology: in vitro, in vivo, and clinical investigations[J]. Int J Endocrinol, 2020:3236828.
[39] Dar HY, Azam Z, Anupam R, et al. Osteoimmunology: the nexus between bone and immune system[J]. Front Biosci (Landmark Ed), 2018, 23(3):464-492.
[40] Cline-Smith A, Axelbaum A, Shashkova E, et al. Ovariectomy activates chronic low-grade inflammation mediated by memory T cells, which promotes osteoporosis in mice[J]. J Bone Miner Res, 2020, 35(6):1174-1187.
[41] Iseme RA, Mcevoy M, Kelly B, et al. Is osteoporosis an autoimmune mediated disorder?[J]. Bone Rep, 2017,7:121-131.
[42] Ni S, Yuan Y, Qian Z, et al. Hypoxia inhibits RANKL-induced ferritinophagy and protects osteoclasts from ferroptosis[J]. Free Radic Biol Med, 2021,169:271-282.
[43] Liu J, Curtis EM, Cooper C, et al. 2019. State of the art in osteoporosis risk assessment and treatment[J]. J Endocrinol Invest, 2019, 42(10):1149-1164.
[44] 李红专, 史恒蔚, 张敏, 等. 基于“血瘀”理论探讨绝经后骨质疏松症的“铁过载”相关机制[J]. 中国骨质疏松杂志, 2021, 27(7):1071-1074.
[45] 杭海峰, 徐又佳. 铁蓄积骨质疏松模型凝血状态及微血栓和血管密度变化的研究[J]. 中国骨伤, 2020, 33(10):954-959.
[46] 葛继荣, 王和鸣, 郑洪新, 等. 中医药防治原发性骨质疏松症专家共识(2020)[J]. 中国骨质疏松杂志, 2020, 26(12):1717-1725.
[47] 田琦. 老年男性骨质疏松症与相关危险因素及其中医证型分析[D]. 广州: 广州中医药大学, 2015.
[48] 杨艳忠. 温阳补骨丸治疗脾肾阳虚型老年男性原发性骨质疏松症的疗效观察[D]. 哈尔滨: 黑龙江中医药大学, 2021.
[49] 王璐, 许鸿新, 张思伟, 等. 补肾健脾针刺法治疗老年男性原发性骨质疏松症的临床疗效评估研究[J]. 中国骨质疏松杂志, 2019, 25(2):224-227.
[50] 王起云. 生髓健骨胶囊治疗肾阳虚型原发性老年男性骨质疏松的临床疗效观察[D]. 哈尔滨: 黑龙江中医药大学, 2024.
[51] 田琳, 康浩辰, 王淑丽, 等. 补肾活血方治疗肾虚血瘀型原发性骨质疏松症临床研究[J]. 中国中医药信息杂志, 2017, 24(9):11-14.
[52] 胡俊桥, 冷文飞. 中西医结合治疗原发性骨质疏松肝肾阴虚证临床研究[J]. 实用中医药杂志, 2020, 36(8):1017-1018.
[53] 王丽. 中西医结合治疗原发性骨质疏松症肝肾阴虚证的疗效观察[J]. 婚育与健康, 2023, 29(2):193-195.
[54] 高子任, 李跃华. 中医血瘀证与骨质疏松症关系的研究[J]. 中华中医药杂志, 2017, 32(11):5154-5157.
[55] 李雪, 申意伟, 张晓峰, 等. 从“血瘀”论治骨质疏松症之古代方药研究[J]. 中医药学报, 2019, 47(1):11-14.
[56] 赵应菊, 田琦, 严兴茂. 补中益气汤联合针灸治疗脾胃虚弱证骨质疏松症效果观察[J]. 医学理论与实践, 2024, 37(5):777-779.
[57] 吴港发, 唐本夫. 加味归脾汤联合四烯甲萘醌软胶囊治疗脾胃虚弱型老年性骨质疏松症临床观察[J]. 云南中医中药杂志, 2023, 44(4):45-47.
[58] 魏戌, 刘宁, 章轶立, 等. 骨质疏松症的共病研究与早期筛查[J]. 中国全科医学, 2022, 25(35):4369-4374.
Outlines

/