摘要Background:Viral hepatitis causes annual deaths of 1.4 million people.Antiviral therapy rarely cures the disease,and patients are usually required to maintain lifelong medication,leading to cumulative drug toxicity.Schisandrae Fructus(SF)is efficacious in the treatment of viral hepatitis.Objective:The systematic review and meta-analysis aim to examine the efficacy and safety of SF alone or in combination with specific and nonspecific treatments for treating viral hepatitis by analyzing the clinical trials performed up to date.Methods:An extensive literature was searched in 7 databases from inception to May 2023.Final outcomes were divided into the pri-mary outcomes containing the total effective rate and virological responses,as well as the secondary outcomes containing liver bio-chemical functions and frequencies of adverse events.RevMan 5.3 and GRADE pro 3.6 software were used for meta-analysis and as-sessment of evidence quality.Subgroup analysis was conducted to explore the source of the heterogeneity.Results:Twenty-nine randomized controlled trials were included in the meta-analysis.SF treatment was comparable with western medicines or other traditional Chinese treatments in terms of primary and secondary outcomes.In combination with specific treatments with antiviral med-icines,SF group reduced 18.45 U/L of alanine aminotransferase levels[weighted mean difference:18.45,95％confidence interval(CI):(16.12,20.78),p＜0.000 01]and 8.37 U/L of aspartate aminotransferase levels[weighted mean difference:8.37,95％CI:(1.25,15.48),p=0.02],and it decreased the levels of hyaluronic acid(HA)[standard mean difference(SMD):0.92,95％CI:(0.58,1.27),p＜0.000 01],laminin(LN)[SMD:0.64,95％CI:(0.38,0.90),p＜0.000 01],and procollagen type Ⅲ[SMD:0.48,95％CI:(0.28,0.67),p＜0.000 01],while increasing the total effective rate by 24％[risk ratio:1.24,95％CI:(1.15,1.32),p＜0.000 01].There were no severe adverse events during treatment.Conclusions:SF was a potential adjuvant for antiviral therapy in restoring liver function.However,the poor quality of the included ran-domized controlled trials limited the recommendations.More long-term,randomized,and double-blind studies should be performed to assess the efficacy and safety of combination therapy.