ABSTRACT
Osteoporosis （OP） is a systemic metabolic disease that affects the health of middle-aged and elderly people by crosslinking multiple signaling pathways. With the increasing aging of the population， the incidence of OP is also increasing year by year. Because of a series of problems such as high incidence， difficulty in treatment， and poor prognosis， it has been widely studied and reported by scholars in China and abroad. At present， the drugs used by western medicine are mainly divided into two categories： Bone resorption inhibitors and bone formation promoters. Although the efficacy is reliable， there are still deficiencies such as poor dependence of patients on the drug， uncontrollable side effects， and high costs. However， in recent years， with the continuous deepening and innovation of traditional Chinese medicine （TCM） research， the treatment of OP by TCM has been widely recognized in clinical practice. Many scholars have found that the mechanism of TCM in the treatment of OP includes the widespread involvement of mitogen-activated protein kinase （MAPK） signaling pathway， which mainly promotes the differentiation of bone marrow mesenchymal stem cells （BMSCs） to osteoblasts （OB）， inhibits the differentiation of osteoclasts （OC）， and improves the expression of osteogenesis-related factors alkaline phosphatase （ALP）， Runt-associated transcription factor 2 （Runx2）， type Ⅰ collagen （ColⅠ） to treat OP. Although the current research on the TCM treatment of OP through the MAPK pathway is deepening， there are still certain deficiencies in the study of its molecular mechanism. Therefore， this paper reviewed the relationship between the MAPK signaling pathway and key target protein factors and OP to clarify the important role of the MAPK signaling pathway in OP. At the same time， the targeted regulation of MAPK signaling pathways by TCM to treat OP was systematically summarized in order to provide a scientific basis for the further accurate treatment of OP in TCM.