The present invention relates to a novel lappaconitine derivative and a pharmaceutically acceptable salt thereof, a preparation method therefor, and a medical use thereof using osteogenesis-promoting activity. The lappaconitine derivative induces the differentiation of stem cells into preosteoblasts, and increases bone density when administered to an osteoporosis animal model, and induces osteogenesis, and thus can be effectively used for preventing, alleviating, or treating bone-related diseases such as osteoporosis.