Abstract： Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine containing leech in the prevention of deep vein thrombosis(DVT)after hip arthroplasty.Method The randomized controlled trial(RCT)of traditional Chinese medicine containing leech in the prevention of DVT after hip arthroplasty from China National Knowledge Infrastructure,China biology medicine database,VIP,Wanfan database and PubMed database were searched through computer.The search period was from the establishment of the database to October 2021.The literatures that met the standards were selected and the literature information was collected.The Review Manager 5.3 and Stata 16 were used for system evaluation and statistical analysis,continuous variables were represented by mean difference(MD),and categorical variables were represented by risk ratio(RR).Result A total of 15 RCT were included,including 1481 patients with DVT after hip arthroplasty,including 740 in the observation group and 741 in the control group.The Meta-analysis results showed that the incidence of DVT in the observation group was significantly lower than that in the control group,and the difference was statistically significant(RR=0.34,95%CI:0.23-0.49,P<0.01);D-dimer level was significantly lower than that in the control group,and the difference was statistically significant(MD=-0.58,95%CI:-0.72--0.44,P<0.01);fibrinogen(FIB)level was significantly lower than that in the control group,with statistical significance(MD=-0.71,95%CI:-1.01--0.42,P<0.01);activated partial thromboplastin time(APTT)was significantly longer than that in the control group,and the difference was statistically significant(MD=4.40,95%CI:2.64-6.16,P<0.01).The random effects model analysis result showed that the whole blood high shear viscosity of the observation group was significantly lower than that of the control group,and the difference was statistically significant(MD=-0.69,95%CI:-0.92--0.46,P<0.01).The subgroup analysis results of three RCT studies showed that the whole blood high shear viscosity of the observation group were significantly lower than those of the control group,and the difference were statistically significant(MD=-0.76,95%CI:-0.89--0.62,P<0.01);the subgroup analysis results of two RCT studies showed that there were no statistically significant differences in whole blood high shear viscosity between the two groups of patients(P=0.08).The plasma viscosity of the observation group was significantly lower than that of the control group,and the difference was statistically significant(MD=-0.19,95%CI:-0.28--0.09,P<0.01).There was no statistically significant difference in platelet count(PLT)and incidence of adverse reactions between the two groups of patients(P>0.05).According to Egger's test,the possibility of publication bias in RCT was relatively small.Conclusion Traditional Chinese medicine containing leech has more advantages than simple western medicine in preventing DVT after hip arthroplasty,and will not increase the incidence of adverse reactions.