Abstract:Objective To analyze the effect of Bushen Jianpi prescription on serum osteoclast, osteogenesis related factors and intestinal flora in postmenopausal osteoporosis (PMOP). Methods Eighty patients with PMOP admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from March 2021 to December 2022 were randomly divided into combined group and control group by simple randomization method, with 40 patients in each group. The control group was treated with calcium carbonate vitamin D3 tablets, while the combined group was supplemented with Bushen Jianpi prescription on the basis of the control group. The treatment of both groups lasted for 8 weeks. The changes of serum osteoclast and osteogenesis-related factors ［β-isomer of C-terminal telopeptide of type Ⅰ collagen（β-CTX）, procollagen type Ⅰ Nterminal propeptide (P1NP)］in the two groups before and after treatment were detected, and the changes of Chinese medicine symptom score before and after treatment were evaluated, and the changes of intestinal flora were compared. Results After 8 weeks of treatment, β-CTX and P1NP in both groups decreased compared with those before treatment,and in the combined group were lower than those in the control group, and the difference was statistically significant (P＜0.05). After 8 weeks of treatment, the scores of symptoms of low back pain, weakness of waist and knees, lower limb cramps, difficulty in walking and difficulty in carrying weight in both groups decreased compared with those before treatment,and in the combined group were lower than those in the control group, the difference was statistically significant (P＜0.05). After 8 weeks of treatment, the total effective rate of the combined group was 92.50%, which was higher than that of the control group (75.00%) (P＜0.05). After 8 weeks of treatment, the number of Bifidobacterium and Lactobacillus in feces in both groups increased compared with that before treatment, while the number of Escherichia coli decreased compared with that before treatment. After 8 weeks of treatment, the number of Bifidobacterium and Lactobacillus in feces of the combined group was higher than that of the control group, and the number of Escherichia coli was lower than that of the control group (P＜0.05). There was no obvious adverse reactions in both groups during treatment. Conclusion For patients with PMOP, Bushen Jianpi prescription on the basis of calcium supplementation is helpful to regulate the levels of serum osteoclast, osteogenesis-related factors and intestinal flora, improve the clinical symptoms of patients and further improve the therapeutic effect, and it is safe.