Objective To investigate the application value of Yishen Huayu Xugu prescriptionin the management of osteoporotic lumbar compression fracture among elderly patients. Methods From March 2022 to August 2023， all elderly patients with osteoporotic lumbar compression fractures were enrolled in our hospital and randomly assigned into two groups. The patients were diagnosed with kidney deficiency and blood stasis syndrome through physical identification. After admission， both groups （85 cases each） underwent percutaneous kyphoplasty. The control group received conventional Western medicine treatment post-surgery， while the observation group was administered Yishen Huayu Xugu prescription. This herbal formula was prepared by decocting 300 mL of juice in water， divided into two doses， and taken warmly after breakfast and dinner for a duration of 12 weeks. Therapeutic effects were compared after completion of the 12-week treatment period. Results After treatment， the serum levels of D-dimer （D-dimer， D-D） were （5.02 ± 0.63）， interleukin-17 （IL-17） was （53.68 ± 5.47）， β-collagen special sequence （β-CTX） was （0.37 ± 0.06， interleukin-6 （IL-6） was （69.38 ± 8.27） compared to the control group； bone morphogenetic protein-2 （BMP-2） was （2.69 ± 0.31）， 25-hydroxyvitamin D was （58.93 ± 7.17）， and vascular endothelial growth factor （VEGF） was （309.81 ± 51.49） which were higher than those in the control group with more significant improvement observed in the intervention group （P < 0.05）. Bone mineral density （BMD） increased at both week 6 and week12 after treatment with a more pronounced improvement seen in the intervention group（P < 0.05）. After treatment， the observation group exhibited a more significant reduction in the total Traditional Chinese Medicine （TCM） symptom score， Cobb Angle， and ODI， compared to the control group （P < 0.05）. Furthermore， the observation group demonstrated a higher total effective rate of 95.29% （81/85） compared to 85.88% （73/85） in the control group after treatment， with a statistically significant difference between the two groups （P < 0.05）. Conclusion The Yishen Huayu Xugu prescription holds significant positive implications for this particular medication， as it exhibits enhanced efficacy in reducing inflammation， regulating bone metabolism， improving lumbar function， promoting disease amelioration， and enhancing clinical outcomes.