The impact of traditional Chinese medicine kidney-tonifying methods on osteoporosis or bone loss in HR+ breast cancer patients following endocrine therapy.

Objective: This study aims to systematically assess the therapeutic effects of Traditional Chinese Medicine (TCM) kidney-tonifying methods on osteoporosis in HR+ breast cancer patients after endocrine therapy, and to explore their clinical application value.

Methods: This systematic review and meta-analysis adhered to the PRISMA guidelines and aimed to evaluate the impact of TCM kidney-tonifying methods on osteoporosis in HR+ breast cancer patients after endocrine therapy. Literature searches were conducted through October 2024 in databases including CBM, CNKI, Wanfang Data, PubMed, Web of Science, Cochrane Central, VIP, and renowned TCM databases such as TCM Online. Randomized controlled trials reporting lumbar spine bone density, femoral neck bone density, osteocalcin levels, pain VAS scores, and drug safety were included. The Cochrane tool was used for quality assessment, and meta-analysis was performed using RevMan 5.3 and Stata software.

Results: This meta-analysis included 25 studies, covering 1795 patients. The combined results showed significant improvements in lumbar spine bone density (SMD = 0.98, 95 % CI: 0.52-1.44, P < 0.0001), femoral neck bone density (SMD = 0.73, 95 % CI: 0.35-1.10, P = 0.0001), and osteocalcin levels (SMD = 1.23, 95 % CI: 0.52-1.93, P = 0.0007) in patients treated with TCM kidney-tonifying methods compared to those in the control group. There was also a significant reduction in pain VAS scores (SMD = -1.14, 95 % CI:1.55 to -0.72, P < 0.00001). The safety data indicated no significant adverse reactions associated with the treatment.

Conclusion: TCM kidney-tonifying methods can significantly improve osteoporosis symptoms post-endocrine therapy in HR+ breast cancer patients, enhance bone density, and effectively reduce pain, demonstrating good safety and potential clinical value. Future research should further validate these findings through large-scale, multi-center randomized controlled trials to optimize treatment strategies.