• Kidney yin-yang deficiency syndrome in postmenopausal osteoporosis exhibits a unique and complex gene expression profile distinct from other kidney deficiency subtypes.
• Integration of traditional Chinese medicine theory with modern genomics via transcriptome sequencing and bioinformatics analysis (GO/KEGG) translates abstract syndrome concepts into concrete signaling pathways and biological processes.
• qRT-PCR validation of four key genes (HSP90AB4P, CTU1, ST6GALNAC2, PTGS2) enhances the reliability and scientific rigor of the findings.
• The differential genes in the kidney yin-yang deficiency group reflect multi-system and multi-pathway dysfunction, providing molecular evidence for understanding the pathophysiological mechanisms and developing syndrome-specific therapies.