Objective:To discuss the influence of Zhuyu Shenggu Decoction on early osteolysis of periprosthetic femoral after total hip replacement (THA) in elderly patients. Methods60 elderly patients who received THA were randomly divided into the combination group and control group,30 cases in each group. The control group was orally treated with alendronate after surgery, the combination group was treated with alendronate and Zhuyu Shenggu Decoction,with a course of 6 months. The changes of bone mineral density (BMD) of periprosthetic femoral, bone metabolism state and inflammatory cytokines were observed and compared.  Results:①After treatment, the BMD was significantly decreased at the region of interest(ROI)1-7 in the control group(P<0.05) and at ROI 7 in the combination group(P<0.05).Except ROI 4,the BMD of the combination group at other regions were all significantly higher than those of the control group(P<0.05). ②After treatment, the levels of total pro-collagen type I N-terminal peptide (TP I NP) and C-telopeptide β cross link of type I collagen(CTX-β)in both groups were significantly decreased compared with treatment before(P<0.05),and the levels in the combination group were significantly lower than those in the control group(P<0.05). ③After treatment, the levels of interleukin-6(IL-6),C-reactive protein (CRP) and tumor necrosis factor-α(TNF-α) in both groups were significantly decreased compared with treatment before(P<0.05),and the levels in the combination group were significantly lower than those in the control group(P<0.05).  Conclusion:Zhuyu Shenggu Decoction can effectively inhibit the inflammatory reaction in elderly patients after THA,prevent bone loss in periprosthetic femoral and delay the osteolysis.