Mei-Mei Wu, Xing-Peng He, Wan-Ting Wu, Wen-Jie Lu, Yan-Yang Mai, Kun-Cai Xu, Yao-Feng Zhi, Hai-Xin Mo, Jia-Di He, Xin Zhang, and Peng-Fei Li
Background: In traditional Chinese medicine, You-Gui-Wan (YGW) is typically used to treat osteoporosis associated with kidney-yang deficiency. However, there have been few mechanistic studies on the effectiveness of kidney-yang deficiency-type osteoporosis with YGW. To further clarify the role of YGW in the effect of osteoporosis with kidney-yang deficiency, the study analyzed the therapeutic advantages of YGW by comparing the therapeutic effects of YGW and alendronate (ALN) on osteoporosis with kidney-yang deficiency. Methods: SPF female SD rats were randomly divided into control, osteoporosis, osteoporosis with kidney-yang deficiency, osteoporosis with kidney-yang deficiency + YGW and osteoporosis with kidney-yang deficiency + ALN groups. Except for the control group, osteoporosis was induced by the removal of bilateral ovaries. After 12 weeks, rats with osteoporosis in the kidney-yang deficiency group had kidney-yang deficiency syndrome triggered by hydrocortisone for 14 days. Rats were treated with YGW or ALN for 12 weeks. The weights of rats were recorded. Hematoxylin-eosin staining staining was used to observe pathological changes in bone trabeculae, liver, spleen, and kidneys of rats. Depletion of the growth plate cartilage of rats in different groups was observed by safranine-O staining. The expression of osteoclast key indices (ACP) and osteoblast key indices (ALP) in the bone tissue of rats in the different groups was observed by immunohistochemical staining. The expression of bone resorption-related indicators (TRAP and NXT-1), bone formation-related indicators (BALP, BGP, and P1NP), and major indicators of kidney-yang deficiency (ACTH, T3, T4, cAMP, and cGMP) were observed using an ELISA detection kit. The expression levels of the main indices of liver function (ALT and AST) were detected in different groups. Results: The differences between the osteoporosis with kidney-yang deficiency group and osteoporosis group were that the weight of rats and the expression of ACTH, T3, T4, and cAMP decreased significantly, and the expression of cGMP increased in the osteoporosis with kidney-yang deficiency group. Moreover, both YGW and ALN effectively improved the symptoms of osteoporosis, including the injury of bone trabeculae and growth plates, as well as the expression of bone metabolism-related indicators. However, unlike ALN, YGW simultaneously ameliorated the expression of key indicators of kidney-yang deficiency and prevented weight loss in rats. In addition, YGW caused no obvious damage to the liver, spleen, or kidney, whereas ALN led to liver cirrhosis. Conclusion: The results reveal that YGW plays a crucial part in osteoporosis with kidney-yang deficiency, increases bone mineral density, and improves bone metabolism indicators, and is safe and efficient for the efficacy of osteoporosis with kidney-yang deficiency. YGW might have a better therapeutic effect on osteoporosis in patients with kidney-yang deficiency. Therefore, alendronate should be used cautiously in patients with osteoporosis and poor liver function. [ABSTRACT FROM AUTHOR]