Zuoguiwan is one of classic formulas of traditional Chinese medicine(TCM)

which is represented the method of seeking yin from yang and characterized by the effect of enriching and nourishing kidney Yin and the complete supplement without any drain. Osteoporosis is a systemic bone disease characterized by low bone mass

structural failure of bone tissue

increased bone brittleness

decreased bone strength and increased risk of fracture

and become one of the threatening in human health. TCM believes that kidney contains the essence and kidney governs the bones and engenders marrow

and Zuoguiwan has a better clinical efficacy in treating osteoporosis and fewer side effect. There have been an increasing number of experimental studies in treating osteoporosis with Zuoguiwan

especially for molecule and mechanism of signaling pathway. The objective of this research was to summarize signaling pathways of Zuoguiwan in treating osteoporosis

including cyclicadenosine 3'

5'-monophosphate/protein kinase/cAMP response element-binding protein(cAMP/PKA/CREB)signaling pathway

Notch signaling pathway

transforming growth factor-beta 1(TGF-β1)/Smad signaling pathway

Wnt/β-catenin signaling pathway and mitogen-activated protein kinase(MAPK) signaling pathway. This study also confirmed that Zuoguiwan had intervention characteristics of multiple target points and multiple paths. Although the effect and basic mechanisms of Zuoguiwan were proved

there are still some limitations. More comprehensive and in-depth studies shall also be conducted using the latest modern research methods and techniques.