Objective To evaluate the efficacy and safety in patients with cirrhotic ascites treated by Wuling Powder. Methods PubMed, Web of science, The Cochrane library, EMbase, CNKI, WAFANG, VIP and SinoMed database were searched. Randomized controlled studies of cirrhotic ascites were collected from the establishment of the database to February 20, 2020. EndNote was used for literature screening, RevMan 5.3 was used for data analysis, GRADEpro was used to evaluate the evidence quality. Results 11 studies with 1054 patients were analyzed, Meta-analysis: @@@2460;Total effective rate: The Wuling powder group was higher (P <0.01)). @@@2461; Liver function: The serum ALT, AST and TBIL in Wuling powder group were significantly lower (P <0.01), the ALB (Albumin) was significantly higher (P <0.05). @@@2462;The incidence of adverse events: There was no significant difference (P = 0.72>0.05). @@@2463; Recurrence rate: The Wuling powder group was lower (P <0.01). @@@2464; GRADE evaluation: The quality of evidence in the total effective rate, ALB index and incidence of adverse reactions was intermediate, the others were low or very low. Conclusions The Wuling powder combined with basic western medical treatment for cirrhotic ascites can significantly improve clinical efficiency, liver function and reduce recurrence rate, the adverse events were not obvious. However, due to the low quality of the included studies, it should be used with caution in the clinic.

目的评价五灵散治疗肝硬化腹水的疗效和安全性。方法检索PubMed、Web of science、The Cochrane library、EMbase、CNKI、WAFANG、VIP和SinoMed数据库。收集自建库至2020年2月20日的肝硬化腹水随机对照研究。文献筛选采用EndNote，数据分析采用RevMan 5.3，证据质量采用GRADEpro评价。结果共分析11项研究1054例患者，Meta分析：@@@2460；总有效率：五灵散组较高（P<0.01）。@@@2461; 肝功能：五灵散组血清ALT、AST、TBIL显着降低（P<0.01），ALB（Albumin）显着升高（P<0.05）。@@@2462;不良事件发生率：无显着差异（P=0.72>0.05）。@@@2463; 复发率：五灵散组较低（P<0.01）。@@@2464; GRADE评价：证据质量在总有效率、ALB指数和不良反应发生率方面为中等，其他为低或极低。结论五灵散联合西医基础治疗肝硬化腹水能显着提高临床有效率、肝功能和降低复发率，不良反应不明显。但由于纳入研究的质量较低，临床上应谨慎使用。