What does this research mean for the field?

Xiangju capsules, used alone or as an adjunctive treatment, improve allergic rhinitis symptoms and immunological markers without increasing adverse events, although current evidence is of limited certainty. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the efficacy and safety of Xiangju capsules in treating allergic rhinitis through a systematic review of randomized controlled trials.

June 1, 2026Open Access

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

Key Points

To evaluate the efficacy and safety of Xiangju capsules in treating allergic rhinitis through a systematic review of randomized controlled trials.
Systematic search of eight databases until 30 November 2025.
Included randomized controlled trials assessing Xiangju capsules for allergic rhinitis.
Conducted subgroup analyses, sensitivity analyses, and assessed publication bias.
Xiangju capsules improved overall effective rate (RR = 1.12, 95% CI: 1.08 to 1.16).
Lower runny nose (SMD = -1.81, 95% CI: -3.36 to -0.27) and sneezing scores (SMD = -1.14, 95% CI: -1.86 to -0.41) observed.
No significant difference in adverse event incidence (RR = 0.72, 95% CI: 0.43 to 1.20).

Abstract

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.

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