OBJECTIVE: To systematically evaluate the efficacy of Xianling Gubao capsules combined with methorexatein the treatment of rheumatoid arthritis（ RA） with osteoporisis（ OP）

so as to provide reference for the treatment of the disease with traditional Chinese medicine.METHODS: The Cochrane Library

PubMed

EMBase

CNKI

Wanfang database

CBM and VIP database were retrieved to collect the randomized controlled trial（ RCT） of Xianling Gubao capsules combined with methorexatein（ study group） vs.methotrexate alone（ control group） the treatment of RA with OP.The retrieval time was from the establishment of the database to Oct.2020.According to the inclusion and exclusion criteria

literature were screened

data were extracted

and the methodological quality of the included literature was evaluated.Rev Man 5.4 software was used for Meta-analysis.RESULTS: A total of 4 literature that met the criteria were included

with a total of 270 cases

including 135 cases in the study group and 135 cases in the control group.Significant efficiency

total effective rate

bone mineral density（ BMD）

morning stiffness time and joint function index were evaluated.Meta-analysis showed that two groups the differences of significant efficiency（ RR = 1.59

95%CI = 1.16-2.20

P = 0.005）

total effective rate（ RR = 1.29

95%CI = 1.13-1.48

P = 0.000 3）

BMD of femoral neck（ MD = 0.03

95%CI = 0.02-0.04

P<0.000 01）

morning stiffness time（ MD =-6.17

95%CI =-7.72--4.63

P <0.000 01） and joint function index（ MD =-0.33

95%CI =-0.39--0.27

P<0.000 01） and other aspects were statistically significant

the above indexes in the study group were significantly better than those in the control group.There was no significant difference in BMD of lumbar spine between two groups（ MD = 0.05

95% CI =-0.00-0.10

P = 0.06 > 0.05）.CONCLUSIONS: Xianling Gubao capsules can effectively increase the significant efficiency and total effective rate of methotrexate in the treatment of RA with OP

and improve the BMD of femoral neck

morning stiffness time and joint function index.