To observe the effect of Duhuo Jisheng Decoction（独活寄生汤）on Toll-like receptor 4（TLR4）/nuclear transcription factorκB（NF-κB）signaling pathway in elderly patients with knee osteoarthritis.

A total of 118 elderly patients with knee osteoarthritis were divided into observation group and control group（59 cases in each）according to random number table method. The control group was treated with Glucosamine Hydrochloride Tablets and the observation group was treated with Duhuo Jisheng Decoction on the basis of the control group，4 weeks for 1 course of treatment，a total of 2 courses of treatment. The clinical efficacy of the two groups was compared，and the TCM syndrome scores，Western Ontario and McMaster University Osteoarthritis Index（WOMAC）scale score and visual analogue scale（VAS）score before and after treatment were compared between the two groups. Serum levels of interleukin-6（IL-6），matrix metalloproteinase-1（MMP-1），osteocalcin（BGP），carboxy-terminal peptideβdegradation product of type I procollagen（β-CTX）and carboxy-terminal peptide（PICP）of type I procollagen，and the protein expressions of TLR4 and NF-κB were observed before and after treatment in the two groups.

After treatment，the total effective rate of the observation group was 96.61%，higher than that（83.05%）of control group，and the difference was statistically significant（P<0.05）. After treatment，the scores of TCM syndrome in both groups were lower than those before treatment，and the score of the observation group was lower than that of the control group（P<0.05）. After treatment，the WOMACscores and VASscores of both groups were lower than those before treatment，and the scores of the observation group were lower than those of the control group（P<0.05）. After treatment，the levels of IL-6，MMP-1，TLR4 and NF-κB protein in two groups were lower than those before treatment，and the levels of the observation group were lower than those of the control group（P<0.05）. After treatment，the levels of serum BGP and PICP of the two groups were higher than those before treatment，and the levels of the observation group were higher than those of the control group，and the serumβ-CTX level of the two groups was lower than that before treatment，and the level of the observation group was lower than that of the control group（P<0.05）.

The application of Duhuo Jisheng Decoction in the elderly patients with knee osteoarthritis is beneficial to improve the clinical efficacy，reduce the pain，fatigue and other symptoms，and enhance the joint function. The mechanism of action may be related to improving bone metabolism indexes，inhibiting inflammatory factors through TLR4/NF-κB signaling pathway and alleviating cartilage damage.