Yijing Tang for premature ovarian insufficiency: A systematic review and methodological appraisal

Background Premature ovarian insufficiency (POI) is defined by loss of ovarian function before age 40. Yijing Tang (YJT), derived from Fu Qingzhu’s Obstetrics and Gynecology (Fu Qingzhu Nüke), is widely used in mainland China and has been evaluated in clinical trials for POI. Objective This review summarizes English and Chinese-language trial evidence on YJT and appraises methodological quality. Methods We searched CNKI, Web of Science, Pubmed, and Google Scholar (2010–2025) for clinical trials evaluating YJT for POI. Two reviewers independently extracted data and assessed methodological quality using the modified Jadad scale. Due to clinical and methodological heterogeneity, findings were synthesized qualitatively. Results Nine trials ( n = 776; reported dropouts n = 6) met the inclusion criteria. Interventions included YJT alone, YJT plus hormone replacement therapy (HRT), or YJT with adjunct formulas; comparators included HRT, other herbal formulas, or supplements. Jadad scores ranged from 0–3 (maximum 5); no trial reported double blinding, and only four described an appropriate randomization method. Among the nine included studies, YJT was associated with improvements in ovarian function-related primary outcomes compared with controls ( P < 0.05). These improvements included increased serum estradiol (E2) and anti-Müllerian hormone (AMH) levels, reduced follicle-stimulating hormone (FSH), improved follicle number and ovarian volume, reductions in Kupperman menopausal symptom scores, and improvements in SF-36 quality-of-life measures Conclusion Available trials suggest YJT may improve hormonal and symptom-related outcomes in POI; however, low-to-moderate methodological quality substantially limits confidence in these findings. Higher-quality, prospectively registered trials with standardized formulas and clinically meaningful endpoints are needed.