OBJECTIVE：To systematically evaluate the effectiveness and safety of classical prescription versus antihistamines in the treatment of eczema. METHODS ：Retrieved from CBM and CNKI ，randomized controlled trials （RCTs）about classical prescription（trial group ）versus antihistamines （control group ）in the treatment of eczema were collected. The qualities of included literatures were evaluated by modified Jadad scale after literature screening and data extraction ，and Meta-analysis was performed by using Rev Man 5.3 software. RESULTS ：Totally 19 RCTs involving 1 829 patients were included. Meta-analysis showed that total response rate of patients with Shire Yunfu type [OR ＝5.67，95％CI（3.44，9.33），P＜0.000 01]，Pixu Shiyun type [OR ＝4.23， 95％ CI（1.89，9.46），P＝0.000 4]，Xuexu Fengzao type [OR ＝3.57，95％ CI（2.36，5.41），P＜0.000 01] in trial group were significantly higher than that of control group. There were no statistical differences in the incidence of ADR between patients with Shire Yunfu type [OR ＝0.72，95％CI（0.21，2.41），P＝0.59]，Pixu Shiyun type [OR ＝0.31，95％CI（0.01，13.57），P＝0.54]，Xuexu Fengzao type [OR＝1.08，95％ CI（0.18，6.59），P＝0.93] in trial group and control group. After treatment ，the levels of TNF-α [SMD＝－1.67，95％CI（－2.04，－1.31），P＜0.000 01]，IL-6 [SMD＝－1.53，95％CI（－1.88，－1.17），P＜0.000 01] and IL-8 [SMD＝－1.75，95％CI（－2.28，－1.21），P＜0.000 01] in patients with Shire Yunfu type in trial group were significantly lower than control group. There was no statistical significance in CD 4+ levels [SMD ＝1.51，95％CI（－0.37，3.38），P＝0.12] between Shire Yunfu type patients in trial group and control group. CONCLUSIONS ：Therapeutic efficacy of classical prescription in treatment of eczema is better than antihistamines，with similar safety . Modified Longdan xiegan decoction can significantly reduce the levels of inflammatory cytokines in patients with Shire Yunfu type.