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Objective To analyze the characteristics and distribution of TCM syndromes and syndrome types in elderly patients with osteoporosis. Methods We screened the residents (age≥50 years old) in Lujiazui and Xujiahui communities from June 2015 to December 2015. The bone mineral density of the lumbar spine (L2-4) and the hip were measured. Meanwhile, the questionnaires of TCM syndromes were filled. All the data were analyzed using SPSS 18.0 and SPSS Clementine 12.0 statistical software. Results A total of 217 osteoporosis patients aged from 50 to 86 years old were enrolled in the community. There were 60 cases of spleen-kidney yang deficiency accounting for 27.65% of the total, 65 cases of liver-kidney yin deficiency accounting for 29.95%, and 39 cases of qi stagnation-blood stasis accounting for 17.97%. Female patients with osteopenia were strongly correlated with liver-kidney yin deficiency and spleen-kidney yang deficiency, while male patients were moderately correlated with qi stagnation and blood stasis. Conclusion Elderly patients with liver-kidney yin deficiency and spleen-kidney yang deficiency are prone to osteoporosis. The treatment of osteoporosis should base on the theory of liver and kidney being the origin of congenital constitution to females and males separately. It should be emphasized that there is close association among the pathological changes of liver-spleen-kidney, qi-blood, physique, gender, age, and other factors in the clinical practice. [ABSTRACT FROM AUTHOR]