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Efficacy of Chinese Polyherbal Preparations Combined with Biomedicine for Diabetic OsteoporosisHerbal additions may improve outcomes for patients with diabetic osteoporosis

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Key Takeaway
Combining specific Chinese polyherbal preparations with biomedicine improves bone density and glucose levels in DOP.

This network meta-analysis evaluated the efficacy of six commercial Chinese polyherbal preparations (CCPPs) when integrated with standard biomedical treatments for patients with diabetic osteoporosis (DOP). The study analyzed data from 3,720 patients to assess impacts on bone mineral density, metabolic markers, and safety profiles.

Results indicate that combination therapies outperformed standard medicine alone across multiple metrics. Specifically, the Guskang (GSK) preparation showed the highest overall response rate. For bone mineral density, XLGB, JTG, and GSK demonstrated significant improvements. Furthermore, JTG was identified as the most effective for increasing osteocalcin levels.

Metabolic improvements were also noted, with LWDHW showing the greatest reduction in fasting blood glucose. Additionally, combination therapies were associated with a lower incidence of adverse events than monotherapy. While these preliminary findings suggest clinical benefits for DOP management, the authors emphasize that high-quality, rigorously designed trials are necessary to validate these results.

How this fits prior evidence

This finding addresses a gap in the management of diabetic osteoporosis by evaluating the role of polyherbal preparations. While existing evidence notes a lack of consistency in treatment recommendations across Chinese clinical specialties for osteoporosis, this meta-analysis provides specific evidence for the combination of CCPPs and biomedicine. It also provides a different approach than the microbiota-directed interventions, which currently show inconsistent clinical efficacy for reducing fracture risk in osteoporosis.

Managing osteoporosis in patients who also have diabetes presents a complex challenge for doctors. New data suggests that adding certain Chinese polyherbal preparations to standard medical treatments might offer better results than using standard medicine alone. This analysis looked at 3,720 patients to see how these combinations affected bone health and blood sugar levels.

Researchers found that these herbal combinations performed better than standard medicine alone across several measures. Specifically, some preparations helped improve bone mineral density, while others were more effective at lowering fasting blood glucose. For example, one specific herbal mix was noted for its ability to lower blood sugar, while others showed promise in improving bone turnover markers.

While the results are promising, it is important to note that these findings are still preliminary. The study highlights that more high-quality, strictly designed clinical trials are needed to confirm these results. Because the evidence is still early, patients should always talk to their doctor before changing their treatment plan.

What this means for you:
Adding specific herbal preparations to standard care may improve bone density and blood sugar in some patients.

Common questions

What did the study find about bone health?

The study found that combining herbal preparations with standard medicine led to better outcomes for bone mineral density than using standard medicine alone. Specifically, three different herbal preparations showed notable effects on bone density, and another was best for increasing a bone turnover marker called osteocalcin.

How did these treatments affect blood sugar?

Patients who received a combination of herbal preparations and standard medicine showed better results for fasting blood glucose than those who received standard medicine alone. One specific herbal preparation, known as LWDHW, was noted for producing the greatest reduction in blood sugar levels.

Is it safe to use these herbal preparations?

The study reported that combining herbal preparations with standard medicine showed a lower number of adverse events compared to using standard medicine alone. However, because these results are preliminary, you should talk to your doctor to see if these options are right for your specific health needs.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
BackgroundBiomedicine for diabetic osteoporosis (DOP) is often associated with serious side effects, such as osteonecrosis of the jaw and atypical femoral fractures. In contrast, recent clinical studies have highlighted the potential of commercial Chinese polyherbal preparations (CCPPs) as effective alternatives. These studies suggest that CCPPs help increase bone mineral density, relieve pain, regulate bone turnover markers, and lower blood glucose, thereby improving osteoporosis. This study aimed to evaluate the effectiveness of six CCPPs combined with biomedicine for the treatment of DOP. A network meta-analysis (NMA) was used to compare and rank the therapeutic effects of these CCPPs.Materials and MethodsWe conducted a comprehensive search of multiple databases up to November 2025 to screen for studies assessing the effectiveness of CCPPs for DOP. Two independent reviewers performed study screening, data extraction, and risk of bias assessment. Risk of bias was evaluated using the Cochrane Risk of Bias tool version 2.0, and the certainty of evidence was graded according to the Confidence in Network Meta-Analysis (CINeMA) framework. Continuous outcomes were expressed as mean differences (MD) with 95% confidence intervals (CI); dichotomous outcomes were summarized as odds ratios (OR) or risk ratios (RR) with their corresponding 95% CIs. All analyses were completed using StataMP 18 software, and treatment rankings were determined using the surface under the cumulative ranking curve (SUCRA) method.ResultsThis study included 34 studies involving 3,720 patients with DOP, evaluating six different CCPP regimens. All CCPP regimens showed benefits in increasing bone mineral density, relieving pain, regulating bone turnover markers, and lowering blood glucose. Compared with biomedicine alone, CCPPs combined with biomedicine demonstrated superior outcomes in overall response rate, bone mineral density, bone turnover markers, alkaline phosphatase reduction, and fasting blood glucose, while also showing a lower incidence of adverse events. Specifically, the Guskang (GSK) regimen ranked highest in overall response rate; Xianling Gubao (XLGB), Jintiange (JTG), and GSK showed notable effects on improving bone mineral density; JTG was best for increasing osteocalcin levels; XLGB ranked highest for calcium and phosphorus; and Liuwei Dihuang Wan (LWDHW) produced the greatest reduction in fasting blood glucose. GL had the lowest incidence of adverse events.ConclusionCompared with biomedicine alone, combining CCPPs with biomedicine for DOP treatment improves clinical outcomes. However, high-quality, rigorously designed clinical trials are needed to validate these preliminary results.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251240840, identifier CRD420251240840.
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