Abstract：Objective：To observe the clinical effect of Xianling Gubao capsules combined with alendronate sodium tablets for osteoporosis in senile patients and its effect on cytokines and bone metabolism. Methods：A total of 86 cases of senile patients with osteoporosis were selected and divided into the control group and the observation group according to the random number table method， 43 cases in each group. The control group was given alendronate sodium tablets， and the observation group was additionally given Xianling Gubao capsules based on the treatment of the control group. The clinical effect， bone mineral density of lumbar vertebrae L2~4 and femoral neck， the scores of Oswestry dysfunction and Visual Analogue Scale(VAS)，and the changes in levels of cytokines and bone metabolism were compared between the two groups. Results：The total effective rate was 93.02% in the observation group，higher than that of 67.44% in the control group，the difference being significant(P＜0.05). After treatment，bone mineral density of lumbar vertebrae L2~4 and femoral neck in the two groups was increased when compared with that before treatment(P＜0.05)； bone mineral density of lumbar vertebrae L2~4 and femoral neck in the observation group was higher than that in the control group(P＜0.05). After treatment，the scores of Oswestry dysfunction and VAS in the two groups were decreased when compared with those before treatment(P＜0.05)； the two scores in the observation group were lower than those in the control group(P＜0.05). In the observation group，the level of insulin-like growth factor-1(IGF-1) in serum after treatment was higher than that before treatment and in the control group(P＜0.05). In the observation group，the levels of leptin and tumor necrosis factor- α(TNF- α) were higher than those before treatment and in the control group(P＜0.05). After treatment，the levels of bone-specific alkaline phosphatase(B-ALP) and collagen cross-linking C-terminal peptide(CTX) in serum in the two groups were decreased when compared with those before treatment(P＜0.05)； the two levels in serum in the observation group were lower than those in the control group (P＜0.05). Conclusion： The therapy of Xianling Gubao capsules combined with alendronate sodium tablets has significant curative effect in the treatment of senile patients with osteoporosis，which can up-regulate the expression level of IGF- 1， down-regulate the expression levels of leptin and TNF-α，and reduce the levels of B-ALP and CTX.