绝经后骨质疏松症（postmenopausal osteoporosis，PMOP）是由雌激素缺乏所触发的慢性低度炎症、线粒体功能障碍导致的成骨损害与破骨激活，及肠道菌群失调引起的全身性炎症与代谢紊乱等多重病理机制共同驱动的结果。面对这一错综交织的多维病理网络，传统的单靶点治疗策略显示出明显局限。中医药凭借“整体观”和“辨证论治”的理论优势，展现出多靶点、多途径协同调控的系统性干预潜力。现有研究表明，多种中药复方及活性成分能够通过综合调节上述多维病理网络，有效恢复骨免疫微环境稳态、菌群与骨代谢平衡。系统综述了PMOP的多维作用机制，重点阐述了中医药在该病理网络中的多靶点调控作用，为深入解析PMOP病理机制、推动中西医融合的整合防治策略提供理论依据与研究思路。

Postmenopausal osteoporosis (PMOP) results from a combination of multiple pathological mechanisms, including osteogenic impairment and osteoclast activation triggered by estrogen deficiency-induced chronic low-grade inflammation and mitochondrial dysfunction, as well as systemic inflammation and metabolic dysregulation caused by gut microbiota imbalance. Faced with this intricate and multidimensional pathological network, conventional single-target therapeutic strategies exhibit obvious limitations. Traditional Chinese medicine (TCM), with its theoretical advantages of “holistic view” and “syndrome differentiation-based treatment,” demonstrates potential for systematic intervention through multi-target and multi-pathway coordinated regulation. Current studies indicate that various TCM formulas and active components can effectively restore the homeostasis of the bone-immune microenvironment and balance between gut microbiota and bone metabolism by comprehensively modulating these multidimensional pathological networks. Based on this, this review systematically summarizes the multidimensional mechanisms of PMOP, highlighting the multi-target regulatory effects of TCM within this pathological network, thereby providing theoretical support and research ideas for in-depth elucidation of PMOP pathogenesis and for advancing integrated prevention and treatment strategies combining TCM and western medicine.

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国家自然科学基金资助项目（82460897）；甘肃省自然科学基金资助项目（24JRRA558）；甘肃省中医药研究中心专项开放课题（zyzx-2024-zx01）；甘肃省高等学校产业支撑计划项目（2021CYZC-03）；宁夏回族自治区II型糖尿病中医药态靶辨治基础与临床研究创新团队（2022BSB03113）；甘肃省中医药研究中心专项开放课题（zyzx-2025-zx08）；甘肃中医药大学研究生创新创业项目（2026CXCY-208）