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Objective: Systematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication. Methods: electronic retrieval of CNKI, Wangfang Data, VIP, CBM, PubMed, Embase, Cochrane Library and other databases was conducted to include the clinical randomized controlled trial (RCT) of TCM compound as intervention measures for the treatment of senile osteoporosis as the study object. The retrieval time was set up until October 2019. The two researchers independently screened the literature according to inclusion criteria, extracted the data, and evaluated the quality of the included studies using Cochrane 5.1.0 bias risk assessment tool, and then used RevMan5.3 software for data analysis. Results: a total of 19 RCT literatures were included in the experimental group. In the control group, 844 patients were treated with calcium or non-calcium. Meta analysis showed that total effective rate (RR=1.30, 95％ci: 1.19-1.43, P < 0.05), lumbar vertebral bone density (MD=0.02, 95％ci: 0.01-0.04, P < 0.05), femoral neck bone density (MD=0.01, 95％ci: 0.00 ～ 0.02, P < 0.05), VAS score (MD=-1.04, 95％ci:-1.67 ～ 0.40, P < 0.05), BMC value (MD=0.06, 95％ci: 0.01 ～ 0.11, P=0.03), radial bone density (MD=0.04, 95％ci: 0.03 ～ 0.05, P < 0.05), TCM syndrome score (MD=-6.76, 95％ci:-7.94 ～-5.59, P < 0.05), and TCM syndrome efficacy rate (RR=1.49, 95％ci: 1.28 ～ 1.73, P < 0.05) were all statistically significant. ALP (MD=4.72, 95％ci:-6 ～ 15.44, P=0.39), estradiol (MD=10.45, 95％ci:-1.75 ～ 22.64, P=0.09), root bone index (MD=0.01, 95％ci:-0.17 ～ 0.18, P=0.95), other bone mineral density (MD=0.11, 95％ci: -0.01 ～ 0.22, P = 0.06), urinary calcium/urinary creatinine (MD=-0.09, 95％ci: There was no significant difference in serum calcium (MD=-0.01, 95％ci:-0.11 ～ 0.09, P=0.83), serum phosphorus (MD=0.03, 95％ci:-0.01 ～ 0.07, P=0.09). Among the Chinese herbal compounds used, astragalus is the most frequently used tonic. Conclusions: traditional Chinese medicine compound is effective in treating senile osteoporosis, and it is mainly used as tonic.