Multidimensional therapeutic advantages of Smilax glabra (Tufuling)-containing formulae in gout: an integrated Systematic Review and network pharmacology-based prediction
Abstract
Background: Gout, an inflammatory form of arthritis triggered by monosodium urate (MSU) crystal deposition, poses a substantial global health burden with increasing prevalence and younger onset, particularly in China. In traditional Chinese medicine (TCM), dampness-heat accumulation is a predominant pattern associated with gout. Smilax glabra (Tufuling), a medicinal and edible herb with a history of use for detoxification and elimination of dampness, is also known to promote joint mobility. It is widely used for these purposes. This study aimed to systematically evaluate the clinical efficacy and safety of Tufuling-containing TCM formulae-typically used in combination with other Chinese herbs and/or Western medicine-for gout patients with dampness-heat accumulation, and to generate testable mechanistic hypotheses using network pharmacology.
Methods: A systematic review (SR) and meta-analysis were conducted by searching PubMed, Embase, CNKI, and other databases from inception to June 2025, including randomized controlled trials (RCTs) of formulae containing Tufuling interventions for gout. Network pharmacology was utilized to identify active compounds, target genes, and key pathways involved in gout treatment, followed by molecular docking to generate mechanistic hypotheses.
Results: A total of 56 RCTs involving 4,605 participants were included in this analysis. A meta-analysis revealed that Tufuling-containing formulae, particularly when combined with Western medicine (WM)…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 4,605 participants or records.
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