Exclusion criteria:
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Secondary Osteoporosis
Patients with secondary osteoporosis caused by endocrine disorders (e.g., thyroid, parathyroid, adrenal, gonadal, or pituitary gland diseases).
Recent Use of Bone-Modifying Medications
Patients who have taken medications affecting bone metabolism within the past 12 weeks, including:
Sex hormones (e.g., estrogen, testosterone);
Analgesics (e.g., long-term NSAIDs, opioids);
Other: Bisphosphonates, denosumab, or teriparatide.
Recent Fractures
Patients with fractures occurring within the last 3 months (verified by X-ray or MRI).
Severe Skeletal Destruction
Patients with advanced skeletal lesions (e.g., widespread osteolysis, metastatic bone disease) rendering them functionally disabled.
Organ Dysfunction
Hepatic impairment: Child-Pugh Class C or ALT/AST > 3× upper limit of normal (ULN);
Renal impairment: eGFR <30 mL/min/1.73m² or serum creatinine >2.5 mg/dL.
Pregnancy or Lactation
Women who are pregnant, breastfeeding, or planning pregnancy during the study period.
Hypersensitivity
Patients with known allergies to Tian Gui San components (e.g., Psoralea corylifolia, Cistanche deserticola) or acupoint patch materials (e.g., medical adhesives).
Poor Compliance
Patients unable to complete the 12-week treatment course due to geographic mobility, cognitive impairment, or refusal to follow protocols (anticipated loss to follow-up >20%).
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