Abstract: Objective To systematically review the efficacy and safety of Houpupaiqi Mixture in the treatment of postoperative lieus. Methods Eight databases, including CNKI, Wanfang , VIP , CBM, Cochrane Library, PubMed , Embase and Web of Science, were searched for RCTs that used Houpupaiqi Mixture to treat postoperative lieus and were published from inception to April 30,2021. Meta-analysis was conducted using the Cochrane Handbook for Systematic Reviews of Interventions(Version 5.1) and Revman 5.3. Results Thirteen RCTs were included, involving 1 836 patients (1 199 in the experimental group and 637 in the control group). Meta-analysis showed that Houpupaiqi Mixture combined with conventional treatments was more effective than conventional treatments alone in shortening the first anal exhaust time[MD=-8.41, 95%CI(-10.37, -6.45), P<0.000 01], the first defecation time [MD= -11.79, 95% CI(-15.14, -8.44), P<0.000 01], and hospital stay [MD=-2.35, 95% CI(-3.08, -1.62), P<0.000 01]. And Houpupaiqi Mixture was better than the blank group in shortening the first defecation time [MD=-5.27, 95% CI(-7.10, -3.45), P<0.000 01]. The adverse reactions included nausea, vomiting and diarrhea. Symptoms of nausea and vomiting were mostly mild, and disappeared without treatment. Conclusion Houpupaiqi Mixture used alone or in combination with conventional treatments for postoperative lieus has many advantages. Most of the adverse reactions are mild and can disappear by themselves. However, due to the low quality of the studies included, our conclusions need to be confirmed by RCTs up to the international standards with a large sample size and rigorous design.

Key words: Houpupaiqi Mixture, postoperative lieus, randomized controlled trial, systematic reviews, Meta-analysis, adverse drug reaetion