Objective To systematically evaluate the efficacy and safety of the oral Chinese herbal compound in the treatment of cardiac neurosis and to analyze the regularity of its medication rules. Methods The clinical trial data on the treatment of cardiac neurosis by Chinese herbal compounds were comprehensively searched by literature retrieval system, the search time is from database creation to December 2019. Two researchers screened and extracted data independently,the cochrane systematic was used to assess the quality of the literature. Finally, the RevMan 5.3 software was employed for Meta-analysis. Results A total of 1 778 patients were included in 20 clinical studies．Meta-analysis showed that the clinical effect of oral Chinese herbal compound is better than that of western medicine[OR=3.89, 95%CI(2.93, 5.18)， P＜0.000 01]. Chinese herbal compound is better than western medicine in improving TCM symptom score[SMD= -1.04, 95%CI (-1.39, -0.70)， P＜0.000 01]. Chinese herbal compound is better than western medicine in improving negative psychological mood, the SAS score before and after treatment[MD= -5.61, 95%CI(-6.68, -4.54)， P＜0.000 01], the SDS score before and after treatment[MD= -5.87, 95%CI(-7.00， -4.73), P＜0.000 01]. Meta-analysis of the safety of the Chinese herbal compound treatment showed[OR= 0.34， 95%CI (0.14, 0.84), P=0.02]. Among the Chinese herbal compound used, poria cocos is the most frequently used single herb,and radix paeoniae alba is the most frequently used tonic herb. Conclusion Compared with western medicine alone, oral Chinese herbal compound has a better comprehensive effect on cardiac neurosis, and no significant adverse reaction. And it is mainly used as tonic or tranquilizer.