OBJECTIVE: To systematically evaluate the efficacy of Silybin capsules in the treatment of fatty liver disease（FLD）. METHODS: PubMed

the Cochrane Library

Embase

CNKI

CBM and Wanfang Data were retrieved to collect the randomized controlled trial（RCT） of Silybin capsules in the treatment of FLD（the study group was given Silybin capsules alone

while the control group was not limited）. The retrieval time was from the establishment of the database to Jun. 2022. After literature selection

data extraction and literature bias risk evaluation

Meta-analysis was performed by RevMan 5.4 software. RESULTS: A total of 24 RCTs were extracted

including 2 356 patients（1 193 cases in the study group and 1 163 cases in the control group）. The total effective rate（OR=5.24

95%CI=3.98-6.90

P<0.000 01）

significant effective rate（OR=2.27

95%CI=1.83-2.83

P<0.000 01）

B-ultrasound classification（OR=2.36

95%CI=1.03-5.38

P=0.04）

alanine aminotransferase（MD=-14.81

95%CI=-20.65--8.97

P<0.000 01）

aspartate aminotransferase（MD=-13.60

95%CI=-18.52--8.67

P<0.000 01）

γ-glutamyl transpeptidase（MD=-22.16

95%CI=-32.56--11.76

P<0.000 1）

triacylglycerol（MD=-0.40

95%CI=-0.76--0.05

P=0.03）

total cholesterol（MD=-0.77

95%CI=-1.20--0.34

P=0.000 4） and total bilirubin（MD=-4.33

95%CI=-5.24--3.41

P<0.000 01） in the study group were significantly better than those in the control group

with statistically significant differences. The incidence of adverse drug reactions in the study group was slightly lower than that in the control group

the difference was not statistically significant（OR=0.93

95%CI=0.50-1.73

P=0.82>0.05）. CONCLUSIONS: The available evidence suggests that Silybin capsules are safe and effective in the treatment of FLD. Due to the limitations of the number and quality of RCT selected

the above conclusions need to be validated by more high quality RCT in the future.