Role of traditional Chinese medicine in combating metabolic disorders: A systematic review

Introduction Metabolic disorders, including type 2 diabetes, obesity, hyperuricemia, and MASLD, are increasing worldwide, and conventional therapies often have limited efficacy. Traditional Chinese Medicine (TCM), with its multi-targeted approach, shows promise as a complementary strategy. Methods A systematic literature search was conducted in PubMed and CNKI (1966–2024) using predefined keywords related to TCM, metabolic disorders, clinical trials, and mechanisms. Eligible studies were screened and synthesized according to PRISMA guidelines to evaluate pharmacological pathways and therapeutic outcomes. Results Numerous TCM studies, including those on berberine, ginsenosides, bavachinin, and resveratrol, as well as formulations such as Shenge Formula, Huangqin Decoction, and Zibu Piyin Formula, have demonstrated the ability to regulate AMPK, PPARα, SIRT1, PI3K/Akt, and NF-κB signalling pathways. These interventions improve insulin resistance, lipid metabolism, inflammation, oxidative stress, and hepatic steatosis, with most findings derived from in vitro and in vivo studies. Conclusion TCM holds significant therapeutic potential for managing a spectrum of metabolic disorders through multi-target interventions that act on multiple interconnected biological systems. While preclinical and some clinical data support the efficacy and safety of TCM, further well-designed randomized clinical trials and integrated omics-based research are necessary to elucidate precise mechanisms, standardize formulations, and validate long-term outcomes. Integration of TCM into modern metabolic therapy may offer novel strategies for personalized and holistic healthcare.