Abstract： Objectives： To observe the clinical effect of Guyu Fuyuan tangon patients with osteoporotic thoracolumbar vertebral compression fractures after percutaneous kyphoplasty. Methods：A total of 90 cases of patients with osteoporotic thoracolumbar vertebral compression fractures were divided into the observation group and the control group according to the random number table method， with 45 cases in each group. The control group was simply treated with percutaneous kyphoplasty，and the observation group was additionally treated with Guyu Fuyuan tang based on the treatment of the control group. The clinical effects in the two groups were observed. Before and after the treatment，the bone metabolism indexes including carboxyterminal cross- linked telopeptides of type I collagen(CTXI)， bone- specific alkaline phosphatase(BALP)， tartrate resistant acid phosphatase 5b(TRACP5b) and bonegla protein(BGP)， as well as Cobb angle of injured vertebra and anterior vertebral height loss in the two groups were compared. Results：After two months of treatment，the total effective rate was 93.33% in the observation group and 75.56% in the control group，the difference being significant(P＜0.05). After treatment， the values of CTXI and TRACP5b in the two groups were decreased when compared with those before treatment，and the values of BALP and BGP were increased，differences being significant(P＜0.05). The values of CTXI and TRACP5b in the observation group were lower than those in the control group， and the values of BALP and BGP were higher， differences being significant(P＜0.05). After treatment， the Cobb angle of injured vertebra and anterior vertebral height loss in the two groups were decreased when compared with those before treatment，and the above two items in the observation group were lower than those in the control group， differences being significant(P＜0.05). Conclusion： Guyu Fuyuan tang combined with percutaneous kyphoplasty can effectively enhance the curative effect on osteoporotic thoracolumbar vertebral compression fractures， improve bone metabolism， and restore the morphology of thoracolumbar vertebrae，which can be served as a clinical treatment for osteoporotic thoracolumbar vertebral compression fractures.