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TCM formulations significantly reduce TCM syndrome scores and improve response rates in Graves' diseaseChinese herbal formulas may improve symptoms of Graves' disease

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Key Takeaway
Note that TCM formulations may improve response rates and reduce syndrome scores in Graves' disease patients.

This systematic review and meta-analysis synthesized data from 44 RCTs to evaluate the efficacy of Traditional Chinese Medicine (TCM) formulations compared to Western medical treatments for patients with Graves' disease. The primary outcome, TCM syndrome scores, showed a significant reduction in the TCM group (SMD = -1.48; 95% CI: -1.89 to -1.08, P = 0.000). Additionally, the response rate was significantly higher in the TCM group (RR: 1.18; 95% CI: 1.11 to 1.24, P = 0.000).

Secondary outcomes included thyroid function-related indicators and immune system-related indices, both of which showed varying degrees of improvement in patients receiving Chinese herbal compound prescriptions. Regarding safety, the meta-analysis reported a lower incidence of adverse reactions in the TCM group compared to the Western medicine group.

Despite these findings, the authors highlight significant limitations, including a lack of robust evidence-based support and a lack of clearly defined pharmacological mechanisms for the observed effects. Clinical application should be tempered by the need for more high-quality randomized controlled trials and mechanistic studies to confirm these results.

How this fits prior evidence

This meta-analysis addresses a gap in managing Graves' disease by evaluating herbal interventions. While previous coverage noted that color Doppler ultrasound can differentiate Graves' disease from silent thyroiditis, this study focuses on the therapeutic efficacy of TCM formulations. The findings suggest an association between TCM compounds and improved immune function and reduced syndrome scores compared to Western medicine.

Living with Graves' disease means dealing with an overactive thyroid and its impact on your daily life. While standard treatments are common, some patients look for ways to manage their symptoms while minimizing side effects. A large review of 44 clinical trials looked at how traditional Chinese medicine (TCM) herbal compounds compare to Western medical treatments.

The findings show that those taking TCM formulas had a significant reduction in symptom scores and a higher response rate compared to those on standard care. The study also noted improvements in immune system markers and thyroid function indicators. Importantly, the group using herbal compounds reported fewer adverse reactions than the group receiving Western medicine.

While these results are promising for managing Graves' disease, there is still some uncertainty. The researchers noted that we do not yet fully understand the exact biological mechanisms of how these herbs work. Because the evidence is not yet robust, more high-quality trials are needed to confirm these findings before they can be widely adopted.

What this means for you:
Herbal compounds may improve symptoms and safety for Graves' disease patients compared to standard treatments.

Common questions

Is traditional Chinese medicine safe for Graves' disease?

The study found a lower incidence of adverse reactions in the group using traditional Chinese medicine compared to those receiving Western medical treatment. However, because the exact biological mechanisms are not yet clearly defined, you should talk to your doctor before making any changes to your current treatment plan.

How does herbal treatment compare to standard medicine for symptoms?

The analysis of 44 trials showed that patients using Chinese herbal compounds had a significant reduction in symptom scores and an increased response rate. These patients also showed varying degrees of improvement in immune system markers and thyroid function indicators.

Is this treatment proven for everyone with Graves' disease?

While the results show promise, the researchers noted a lack of robust evidence-based support at this time. More high-quality trials are needed to confirm these findings and understand how the medicine works before it can be widely recommended.

Study Details

Study typeSystematic review
EvidenceLevel 1
PublishedJul 2026
View Original Abstract ↓
ETHNOPHARMACOLOGICAL RELEVANCE: As a common cause of thyrotoxicosis, Graves' disease (GD) has shown potential therapeutic advantages when treated with Traditional Chinese Medicine (TCM). Immune dysfunction serves as a pathological basis of GD, and TCM formulations may regulate abnormal immune status; however, robust evidence-based support and clearly defined pharmacological mechanisms are still lacking. AIM OF THE STUDY: Therefore, this study aims to employ meta-analysis and network pharmacology methods to confirm the therapeutic effects of TCM compound prescriptions on thyroid function and related immune functions, and to explore the potential mechanisms of TCM in treating GD. MATERIALS AND METHODS: A systematic review and meta-analysis were performed focusing on RCTs that examined the efficacy of Chinese herbal compound prescriptions for the treatment of Graves' disease. The studies were collected from eight major electronic databases: the Cochrane Library, PubMed, Web of Science, Embase, Chinese National Knowledge Infrastructure (CNKI), Sinomed, Wanfang Database, and the VIP Information-Chinese Scientific Journal Database. The search included publications available up to August 2025. Outcomes assessed included TCM syndrome scores, thyroid function-related indicators, immune-related indicators, and adverse reactions associated with Chinese herbal treatments. After conducting the systematic review and meta-analysis, we utilized cluster analysis and network pharmacology methods to pinpoint the essential herbs within Chinese herbal formulas. The potential bioactive constituents, related targets, and pathways of these core herbs were subsequently analyzed. RESULTS: In total, 44 RCTs were included to compare with the group receiving conventional Western medical treatment. The TCM group demonstrated a reduction in TCM syndrome scores (SMD = -1.48, 95% CI: -1.89 to -1.08, P = 0.000), an increased response rate (RR: 1.18, 95% CI: 1.11 to 1.24, P = 0.000; I = 60.6%), and varying degrees of improvement in both thyroid function-related indices and immune system-related indices. The incidence of adverse reactions under TCM compound treatment was lower than that in the Western medicine group (RR: 0.35, 95% CI: 0.28-0.44, P = 0.000; I = 18.8%). Furthermore, six core herbal medicines with the highest frequency of use were identified from the employed TCM formulas: Prunella vulgaris L., Rehmannia glutinosa Libosch., Radix Scrophularia, Fritillariae Thunbergii Bulbus, Bupleurum chinense DC. and Paeonia lactiflora Pall. Ultimately, 195 common targets were identified between these six core herbs and Graves' disease. The KEGG pathway analysis demonstrated that various pathways, such as the PI3K-Akt, MAPK, and HIF-1 signaling pathways, are closely associated with immune function. CONCLUSION: TCM compound prescriptions may be effective in improving immune function and treating Graves' disease. Nevertheless, additional high-quality randomized controlled trials and mechanistic studies are necessary to confirm these findings.
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