With the accelerating aging process of China's population, the incidence rate of postmenopausal osteoporosis (PMOP) continues to rise. It has become a major public health issue affecting the health of middle-aged and elderly women, and imposing a heavy burden to patients' families and the social healthcare system. Modern medicine believes that PMOP is a chronic inflammatory systemic metabolic bone disease closely associated with a significant decline in estrogen levels. Its core pathological mechanism lies in the disruption of the balance between bone formation and bone resorption, reduced bone mineral density, degeneration of bone microstructure, and increased bone fragility, thereby significantly increasing the risk of fracture occurrence. Traditional Chinese medicine theory emphasizes that "the kidney stores essence and governs bone and marrow production", and believes that kidney essence deficiency is the core pathogenesis of PMOP, resulting in bone marrow loss of nourishment and brittle bones. In recent years, numerous experimental and clinical studies have demonstrated that kidney-tonifying traditional Chinese medicine formulas and single herbs show significant efficacy in preventing and treating PMOP, offering the advantages of multi-component, multi-target, and holistic regulation. This article systematically reviews the latest research progress on kidney-tonifying formulas in the treatment of PMOP, with a focus on regulating pharmacological mechanisms related to bone metabolism balance, inhibition of the inflammatory response, regulation of oxidative stress and signaling pathways. The aim is to provide a theoretical basis and practical reference for further exploration of the clinical application value of kidney-tonifying formulas and subsequent related research.

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