Abstract： This paper introduces Professor Yao Xinmiao's clinical experience in the treatment of osteoporosis based on Four Diagnostic Differentiation Theory. Professor YAO believes that the pathogenesis of osteoporosis is "deficiency leading to stasis，and stasis leading to wilting"；the disease is fundamentally caused by deficiency， with a mixture of deficiency and stasis， and it begins with spleen deficiency and gradually evolves into kidney deficiency. In clinical practice， the key to diagnosis is to differentiate the disease，symptoms，affected area，and degree of severity. This means that while focusing on syndrome differentiation and treatment，it is also crucial to consider the disease of bone wilting，the location of bone wilting， and the evolution of the disease in viscera and bowels. The treatment method is tonifying the kidney，fortifying the spleen and activating blood，with modified Yigu Decoction as the treatment. In clinical practice，treat the root and branch simultaneously，treat both spleen and kidney，and consolidate the root to fortify sinew and bone to delay the process of bone wilting.