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OBJECTIVE:To evaluate the effectiveness and safe-ty of Xuanbai Chengqi decoction(宣白承气汤,XB-CQD)plus Western Medicine(WM)in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.METHODS:Randomized controlled trials(RCTs)in-vestigating the effect of XBCQD on severe pneumo-nia with symptom pattern of phlegm-heat obstruct-ing lung;were included in this study.Seven elec-tronic databases were searched up to March 2019.Meta-analysis was conducted by Review Manager 5.3 software.Risk ratio(RR)and mean difference(MD)with 95％confidence interval(Cl)were used as effect estimation.RESULTS:Eleven RCTs were included,involving 992 participants.Meta-analysis showed that XBC-QD combined with WM achieved better effective-ness than WM alone in terms of total effective rate[RR=1.23,95％CI(1.16,1.30)],clinical pulmonary in-fection score[CPIS,MD=-2.02,95％CI(-2.42,-1.63)],acute physiology and chronic health evalua-tion Ⅱ[APACHE Ⅱ,MD=-6.81,95％Cl(-8.26,5.37)],mechanical ventilation time[MD=-101.41,95％CI(-140.47,-62.34)],and lactic acid content in arterial blood[MD=-2.41,95％Cl(-2.64,-2.18)].CONCLUSION:XBCQD combined with WM had bet-ter benefit than WM alone to the patients of severe pneumonia with the symptom pattern of phlegm-heat obstructing lung.However,due to low quality of the included studies,more rigorously designed studies were required to further evaluate the effectiveness and safety of XBCQD in the treat-ment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.