Systematic Review and Meta-Analysis of Herbal and Traditional Medicine-Derived Interventions for Sarcopenia and Exploration of Core Herbs

INTRODUCTION: Sarcopenia is a medical condition predominantly associated with the aging process. Currently, the most effective approach for sarcopenia involves a combination of physical activity and nutritional supplementation. However, older individuals may face challenges engaging in physical activity due to inconvenience or limited access to consistent nutritional resources. Previous studies suggest that herbal and traditional medicine-derived interventions can enhance muscle strength in sarcopenia patients; however, its effectiveness remains unclear. This study aimed to evaluate the efficacy of herbal and traditional medicine-derived interventions in treating sarcopenia through a systematic review and meta-analysis and to identify key herbal medicines through pharmacological analysis. METHODS: Following PRISMA guidelines, a comprehensive database search was conducted, yielding 11 randomized controlled trials with 781 participants. Studies were selected based on stringent criteria and assessed for methodological quality using the Risk of Bias 2.0 tool. A traditional Chinese medicine (TCM) network and data mining analysis to identify the core TCM from the enrolled trials and to investigate the potential pharmacological pathways through which they may exert their effects. RESULTS: The analysis suggested that herbal and traditional medicine-derived interventions, particularly Bu-Zhong-Yi-Qi (BZYQ) decoction, may improve handgrip strength and appendicular skeletal muscle mass index in patients with sarcopenia, with few reported adverse effects. Network pharmacology analysis indicated that key components, such as Astragalus membranaceus, may act through multiple signaling pathways. Core genes identified, including AKT1, TNF, IL6, and FOS, showed high centrality in the interaction network, suggesting their potential relevance as therapeutic targets. CONCLUSION: Herbal and traditional medicine-derived interventions may have potential benefits in improving muscle strength and muscle mass in patients with sarcopenia. However, the certainty of the evidence is very low, and the findings should be interpreted with considerable caution.