Efficacy and safety of Xiangju capsules for allergic rhinitis: a systematic review and meta-analysis of randomized controlled trials.

2026-05-28
Frontiers in pharmacology 17
- Min Chen
- Ya-Wen Lu
- Jun Shi
- Ping-Min Ni
- Xiao-Ning Chen

PubMed: 42292827
DOI: 10.3389/fphar.2026.1788708

Study Design

Type: Systematic Review
Sample size: n = 968
Population: 1,968 patients with allergic rhinitis
Methods: Systematic review and meta-analysis of 14 RCTs evaluating XJ capsules alone or in combination with conventional treatment; subgroup and sensitivity analyses; Cochrane Risk of Bias and GRADE assessment

Background

Allergic rhinitis (AR) is a common chronic inflammatory disease, which seriously affects patients' quality of life. Xiangju (XJ) capsules are often used as an adjunctive drug for AR treatment in clinical practice, but its efficacy and safety have not been systematically evaluated.

Methods

This study systematically searched eight Chinese and English databases for data from inception to 30 November 2025. Randomized controlled trials (RCTs) evaluating XJ capsules alone or in combination with conventional treatment for AR were included. Subgroup analyses and sensitivity analyses were used to test outcome stability. Funnel plots, Egger's regression test and Begg's rank correlation test were used to assess publication bias. When publication bias was detected, its potential influence was further assessed using the trim-and-fill method. The methodological quality of the included studies was evaluated using the Cochrane Risk of Bias tool, and the quality of evidence was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework.

Results

A total of 14 RCTs involving 1,968 patients were included. Meta-analysis showed that XJ capsules were associated with a higher reported overall effective rate (RR = 1.12, 95% CI: 1.08 to 1.16), lower runny nose scores (SMD = -1.81, 95% CI: -3.36 to -0.27) and lower sneezing scores (SMD = -1.14, 95% CI: -1.86 to -0.41), lower IL-4 levels (SMD = -1.55, 95% CI: -1.93 to -1.16) and lower IgE levels (SMD = -1.55, 95% CI: -2.92 to -0.18), and higher IL-12 levels (SMD = 1.76, 95% CI: 0.79 to 2.73). No significant difference was observed in adverse event incidence between groups (RR = 0.72, 95% CI: 0.43 to 1.20).

Conclusion

XJ capsules may offer additional benefits for AR symptoms and immunological markers, and were generally well tolerated in the included trials. However, given the limited certainty of the evidence, further high-quality studies are needed to confirm these findings.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/view/CRD420261279480, identifier CRD420261279480.