Objective To systematically evaluate the efficacy and safety of glycyrrhizin in patients with chronic severe hepatitis B.Methods Literature published from January 1990 to July 2014 were searched in databases including Pub Med,Cochrane Library,CBMdisc,CNKI,VIP,and Wanfang Data.The randomized controlled trials comparing the efficacy of glycyrrhizin combined with internal comprehensive therapy versus internal comprehensive therapy alone in patients with chronic severe hepatitis B were included in the analysis.The methodological quality of included trials was independently assessed and the data were extracted.Meta-analysis was carried out with Review Manager Software 5.1,and the heterogeneity,sensitivity,and bias of the analysis were evaluated.Results Seven randomized controlled trials involving298 patients in the test group and 294 in the control group were included in the analysis.The results of meta-analysis showed that glycyrrhizin combined with internal comprehensive therapy was remarkably more effective than internal comprehensive therapy alone,indicated by significantly reduced mortality rate [relative risk(RR) = 0.56,95% confidenceinterval(CI) :0.42 ~ 0.76,P < 0.01],significantly decreased level of total bilirubin(TBil) [mean difference(MD) =-92.56,95% CI:-122.92 ~-62.20,P < 0.01],and significantly higher prothrombin activity(PTA) [mean difference(MD) = 11.14,95% CI:5.40 ~ 16.87,P < 0.01].No severe adverse reactions were found in all patients.Conclusion Glycyrrhizin can significantly reduce the mortality and improve TBil and PTA in patients with chronic severe hepatitis B.