Abstract: ObjectiveTo systematically evaluate the clinical efficacy of traditional Chinese medicine （TCM） based on liver regulation theory combined with anti-thyroid drugs in the treatment of hyperthyroidism, aiming to provide more sufficient evidence of evidence-based medicine for the application of TCM in hyperthyroidism. MethodsStudies related to TCM treatment of hyperthyroidism based on liver regulation theory were retrieved from CNKI, Wanfang Database, Chongqing VIP Database, Chinese Biomedical Literature Database, Web of Science, PubMed, Cochrane Library and Embase until November 30, 2024. After screening the eligible studies, the quality of the studies was evaluated. Revman 5.4 software was used to systematically re-evaluate the efficacy. ResultsA total of 36 published studies were included, including 2 616 patients, 1 309 in the control group and 1 307 in the study group. Comparison of thyroid function improvement between two groups showed that TSH elevation in the study group was higher than that in the control group （I ²=93%,SMD=1.16,95% CI（0.81, 1.51）, P < 0.000 01）, and decreased FT₃ （I ²=95%,SMD=-1.56,95%CI （-1.98, -1.14）, P < 0.000 01） and FT₄ （I ²=96%,SMD=-1.78,95%CI （-2.25,-1.30）, P < 0.000 01） were better than those in the control group. In addition, the symptoms were more significantly mitigated in the study group （I ²=93%, SMD=-1.55, 95%CI （-1.95, 1.15）, P < 0.000 01）. The clinical response rate in the study group was higher than that in the control group （I ²=0%,RR=1.23, 95%CI （1.19, 1.27）, P < 0.000 01）. ConclusionTCM based on liver regulation theory combined with anti-thyroid drugs can better improve thyroid function, relieve clinical symptoms and improve clinical efficacy, which remains to be validated by large-scale, high-quality clinical research.