To observe the clinical effect of Senling Baizhu san (SLBZS) on patients with sarcopenia. Eighty patients with spleen-stomach weakness sarcopenia admitted to the department of geriatrics of Hangzhou Third People's Hospital from January 2018 to March 2020 were enrolled. The patients were divided into control group and observation group by random number table method, 40 cases in each group. All patients were treated with conventional Western medicine, and the observation group was treated with SLBZS 100 mL, twice a day, on the basis of conventional Western medicine. The course of the treatments was 12 weeks. Grip strength and walking speed were recorded before and after treatment, and appendicular skeletal mass index (ASMI) was calculated. The serum levels of silence infor-mation regulator 1 (SIRT1), growth differentiation factor-8 (GDF-8) and insulin-like rowth factor-1 (IGF-1) were detected by enzyme linked immunosorbent assay (ELISA). The mRNA expression of AMP-activated protein kinase-α (AMPK-α) in serum was detected by real-time quantitative polymerase chain reaction (RT-qPCR). Compared with before treatment, grip strength, ASMI, IGF-1, SIRT1 and AMPK-α mRNA in both groups were significantly increased after treatment, while GDF-8 was significantly decreased. The changes of above indexes in the observation group were more significant than those in the control group after treatment [grip strength (kg): 20.00 (15.50, 21.00) vs. 18.20 (14.93, 19.50), ASMI (kg/m2): 5.80 (5.25, 6.00) vs. 5.30 (5.20, 5.50), IGF-1 (μg/L): 246.00 (229.00, 259.50) vs. 207.00 (187.00, 233.00), SIRT1 (ng/L): 649.2±38.3 vs. 624.6±38.6, AMPK-α mRNA (2-ΔΔCt): 0.30±0.03 vs. 0.27±0.03, GDF-8 (μg/L): 13.50 (12.00, 17.80) vs. 15.60 (14.08, 19.98), all P < 0.05]. There was no significant difference in walking speed between the two groups before and after treatment [0.56 (0.53, 0.62) m/s and 0.58 (0.55, 0.62) m/s in the control group before and after treatment, 0.58 (0.54, 0.64) m/s and 0.60 (0.56, 0.65) m/s in the observation group before and after treatment, both P > 0.05]. Spearman correlation analysis showed that IGF-1 was positively correlated with SIRT1 (r = 0.341, P = 0.002), IGF-1 was positively correlated with walking speed (r = 0.250, P = 0.026), and ASMI was positively correlated with grip strength (r = 0.367, P = 0.001). On the basis of conventional Western medicine, SLBZS has a remarkable effect on patients with sarcopenia of spleen-stomach weakness, which can provide a new idea of combining traditional Chinese and Western medicine for the treatment of sarcopenia.