Objective: To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney. Methods: We developed a search strategy and then retrieved the database including CNKI, Wanfang data knowledge service platform, VIP journals resource integration service platform, PubMed, Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy. The search deadline was set to June 30,2020. For the included literature, we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality, and evaluated the level of evidence according to GRADE standards. Quantitative data was analyzed by RevMan5.3 software, and trial sequential analysis method was used to analyze its efficiency. Results: A total of 709 cases in 10 articles were included. Compared with the control group, the related traditional Chinese medicine group improved the effective rate [RR=1.45,95％CI(1.32,1.58)], reduced the level of UA [MD=-36.24,95％CI(-41.03,-31.45)], BUN [SMD=-1.27, 95％CI(-1.47,-1.07)] and SCR [MD=-36.33, 95％CI(-55.79,-16.87), P=0.0003], the difference between the two groups was statistically significant (P<0.05). There was no evidence that a significant adverse reaction occurred. The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency. According to the GRADE evaluation criteria, the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence. Conclusions: Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency, reduced the level of UA, BUN, SCR. Meanwhile, the therapy was proved to be safe. Nevertheless, the conclusions need further high-quality evidence to support.