Objective To explore the efficacy,mechanism and safety of silibinin combined with Ruangan pills(a Chinese herbal preparation)in the treatment of schistosomiasis liver fibrosis. Methods A total of 200 patients with schistosomiasis liver fibrosis were randomly divided into a control group and a treatment group,and 100 patients in each group were respectively admin-istered with oral silibinin alone and oral silibinin combined with Ruangan pills,respectively. The curative effects in the two groups were evaluated in 3 months,6 months,9 months and 12 months respectively. Results The common five clinical symptoms of schistosomiasis liver fibrosis patients significantly relieved in the treatment group 12 months after the therapy,and the total effi-ciency reached more than 75%,which were significantly higher than that in the control group. In the treatment group and the con-trol group,there was no improvement in the liver B ultrasonic classification 3 months and 6 months after the therapy(P>0.05);however,in 9 months and 12 months,the liver B ultrasonic classification in the treatment group was better than that in the control group(P<0.05,P<0.01,respectively). For the four serum indexes of liver fibrosis,there was no significant differences between the two groups in 3 months,however,in 6 months,9 months,and 12 months,there was a significant improvement in the treat-ment group compared with the control group. There were no obviously adverse effects in two groups. Conclusion Silibinin com-bined with Ruangan pills has a better curative effect in the treatment of schistosomiasis liver fibrosis.