Efficacy and safety of Chinese Medicine compounding for anti-aging: A systematic review and meta-analysis of preclinical and clinical studies

Background: Traditional Chinese Medicine (TCM) compounds, characterized by multi-component, multi-target, and multi-pathway actions, show potential in delaying aging and promoting health. This study aims to systematically evaluate the efficacy and safety of TCM compounds in anti-aging through animal and clinical studies. Methods: A comprehensive search of databases (PubMed, Web of Science, Embase, CNKI, Wan Fang, VIP) was conducted up to July 2024. Study quality was assessed using Cochrane and SYRCLE’s Risk of Bias tools. Meta-analyses, sensitivity, and subgroup analyses were performed in RevMan 5.3, with publication bias assessed via funnel plots. Results: This meta-analysis included 60 animal studies and 19 clinical trials. In animal studies, TCM compounds increased weight, enhanced superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activity, reduced malondialdehyde (MDA), lipid peroxidation (LPO) and Lipofuscin (LPF) levels, improved high-density lipoprotein (HDL) and low-density lipoprotein (LDL) ratios, and elevated estradiol and testosterone levels (P < 0.05). They also boosted spleen and thymus indices and improved cognitive performance in the Morris water maze test (P < 0.05). In clinical studies, TCM compounds significantly improved efficacy, increased SOD activity, reduced MDA level, and enhanced activities of daily living (ADL) scores (P < 0.05). Conclusion: This first meta-analysis of animal and clinical studies on TCM compounds indicates their potential to delay aging, enhance cognition, and reduce cardiovascular risk by modulating oxidative stress, immunity, endocrine function, and lipid metabolism. This study provides evidence-based support for the clinical application of TCM compounds in anti-aging. Systematic review registration: This study has been registered in PROSPERO (CRD42024580741 and CRD42024580853).