Xianling Gubao Capsule for Osteoporosis: A Review of Active Components and Underlying Mechanisms.

Osteoporosis is a metabolic bone disorder that poses a serious threat to the health of middle- aged and elderly individuals. Xianling Gubao Capsule is a clinical medication used to treat osteoporosis, comprising six Chinese medicinal herbs: Epimedii Folium, Dipsaci Radix, Psoraleae Fructus, Rehmanniae Radix, Salviae Miltiorrhizae Radix Et Rhizoma, and Anemarrhenae Rhizoma. This article reviews the research progress on the active constituents and pharmacological mechanisms of treating osteoporosis in this capsule. Network pharmacology and mass spectrometry have identified flavonoids (e.g., Icariin), coumarins (e.g., Psoralen), and saponins(e.g., Timosaponin BII) as the major active constituents. Regarding the mechanism of treating osteoporosis, this capsule promotes osteoblast differentiation by activating pathways such as Wnt/β-catenin and p38 MAPK, regulates the OPG/RANKL/RANK pathway to inhibit osteoclast activity, and exerts effects by modulating estrogen metabolic homeostasis. Despite these advances, the complete repertoire of active constituents and the detailed multi‑component synergy remain incompletely understood. Future work must deepen the analysis of multi-component synergistic networks, explore emerging signaling pathways, such as the histamine pathway mediated by histidine decarboxylase, and resolve safety concerns to provide robust support for its precise clinical application.