---
title: "Multi-target mechanisms of Chinese herbal medicine for allergic rhinitis: pathways and clinical ev"
id: "pubmed-42061564"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42061564"
content_type: "clinical_feed_article"
specialty: "Critical Care"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42061564/"
doi: "10.1016/j.jep.2026.121704"
published_at: "2026-08-10T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Multi-target mechanisms of Chinese herbal medicine for allergic rhinitis: pathways and clinical ev
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42061564
- **Specialty:** [Critical Care](https://medichelpline.com/clinical-feed/critical-care.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42061564/)
- **DOI:** [10.1016/j.jep.2026.121704](https://doi.org/10.1016%2Fj.jep.2026.121704)
- **Published At:** 2026-08-10T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This review examines the **pathogenesis of allergic rhinitis (AR)**, emphasizing Th2 polarization, mucosal epithelial barrier dysfunction, microbiota dysbiosis, and neuro-immune interactions. - It synthesizes recent preclinical and clinical evidence on **traditional Chinese medicine (TCM)** and Chinese herbal formulas for AR, including classical formulas such as **Yupingfeng San**. - The authors conducted a systematic literature search across major Western and Chinese databases with inclusion criteria focused on original clinical studies, RCTs, observational studies, meta-analyses, and mechanistic studies published 2020–2025, plus seminal earlier work for core mechanisms. - Mechanistic actions attributed to TCM include modulation of transcription factors (notably **NF-κB** and **GATA3**), restoration of epithelial tight junction proteins (for example **ZO-1** and **occludin**), and regulation of gut microbiota composition with increases in **short-chain fatty acids (SCFAs)**. - Clinical data cited are preliminary but suggest safety and symptom benefit for TCM alone or combined with Western therapies; one RCT (n = 60) reported that nasal lavage with **Glycyrrhizae Radix et Rhizoma (licorice)** significantly improved SNOT-22 scores and reduced nasal airway resistance, outperforming corticosteroid or saline lavage. - Most mechanistic evidence derives from animal models; direct translational data in humans remain limited and warrant caution. - The review concludes TCM has multi-target, holistic potential for AR management but calls for large-scale, multi-center clinical trials and advanced biotechnological approaches to standardize and validate TCM interventions for global acceptance. - Conflict of interest: authors declared no competing interests.
## Clinical Analysis & Structured Key Points
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Epub 2026 Apr 28. # Multi-target mechanisms of Chinese herbal medicine in the treatment of allergic rhinitis [Jingwei Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#full-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Shuchao Pang](https://pubmed.ncbi.nlm.nih.gov/?term=Pang+S&cauthor_id=42061564)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#full-view-affiliation-2 "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China; National Clinical Research Center for Chinese Medicine, Tianjin, 300381, China."), [Yaolin Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+Y&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#full-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Jianyi Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#full-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Xialin Guo](https://pubmed.ncbi.nlm.nih.gov/?term=Guo+X&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#full-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Meiling Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+M&cauthor_id=42061564)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#full-view-affiliation-3 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: custard.chen@tjutcm.edu.cn."), [Xiaoliang Ren](https://pubmed.ncbi.nlm.nih.gov/?term=Ren+X&cauthor_id=42061564)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#full-view-affiliation-4 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: renxiaoliang@tjutcm.edu.cn.") Affiliations Expand ### Affiliations * 1 College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. * 2 First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China; National Clinical Research Center for Chinese Medicine, Tianjin, 300381, China. * 3 College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: custard.chen@tjutcm.edu.cn. * 4 College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: renxiaoliang@tjutcm.edu.cn. * PMID: **42061564** * DOI: [ 10.1016/j.jep.2026.121704 ](https://doi.org/10.1016/j.jep.2026.121704) Item in Clipboard # Multi-target mechanisms of Chinese herbal medicine in the treatment of allergic rhinitis Jingwei Liu et al. J Ethnopharmacol. 2026. Show details Display options Display options Format Abstract PubMed PMID J Ethnopharmacol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22J+Ethnopharmacol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22J+Ethnopharmacol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42061564/) . 2026 Aug 10:367:121704. doi: 10.1016/j.jep.2026.121704. Epub 2026 Apr 28. ### Authors [Jingwei Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#short-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Shuchao Pang](https://pubmed.ncbi.nlm.nih.gov/?term=Pang+S&cauthor_id=42061564)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#short-view-affiliation-2 "First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China; National Clinical Research Center for Chinese Medicine, Tianjin, 300381, China."), [Yaolin Lu](https://pubmed.ncbi.nlm.nih.gov/?term=Lu+Y&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#short-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Jianyi Liu](https://pubmed.ncbi.nlm.nih.gov/?term=Liu+J&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#short-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Xialin Guo](https://pubmed.ncbi.nlm.nih.gov/?term=Guo+X&cauthor_id=42061564)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#short-view-affiliation-1 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China."), [Meiling Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+M&cauthor_id=42061564)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#short-view-affiliation-3 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: custard.chen@tjutcm.edu.cn."), [Xiaoliang Ren](https://pubmed.ncbi.nlm.nih.gov/?term=Ren+X&cauthor_id=42061564)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42061564/#short-view-affiliation-4 "College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: renxiaoliang@tjutcm.edu.cn.") ### Affiliations * 1 College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. * 2 First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, China; National Clinical Research Center for Chinese Medicine, Tianjin, 300381, China. * 3 College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: custard.chen@tjutcm.edu.cn. * 4 College of Chinese Materia Medica, Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China. Electronic address: renxiaoliang@tjutcm.edu.cn. * PMID: **42061564** * DOI: [ 10.1016/j.jep.2026.121704 ](https://doi.org/10.1016/j.jep.2026.121704) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Ethnopharmacological relevance:** Allergic rhinitis (AR) is a prevalent chronic inflammatory condition mediated by immunoglobulin E (IgE). In traditional Chinese medicine (TCM), AR is categorized under the term "bi qiu", with its core pathogenesis attributed to dysfunction of the lung, spleen, and kidney, compounded by external pathogenic invasion. Chinese herbal formulas, such as Yupingfeng San (Jade Wind Screen Powder), documented in the Danxi Xinfa, have demonstrated therapeutic efficacy in alleviating AR symptoms, supported by centuries of clinical application in China. **Aim of the study:** This review systematically synthesizes recent advances in the multifactorial pathogenesis of AR and evaluates the therapeutic potential of TCM based on clinical efficacy data and mechanistic studies. It further elucidates the capacity of TCM to modulate AR-associated immune dysregulation, epithelial barrier dysfunction, and microbial imbalance through multi-target mechanisms. By doing so, the review establishes a theoretical framework supporting the application of TCM in AR management and proposes innovative TCM-based strategies to overcome limitations associated with conventional treatments. **Materials and methods:** This paper provides a systematic summary of the pathogenesis of allergic rhinitis (AR) and evaluates the clinical efficacy and molecular mechanisms of traditional Chinese medicine (TCM) in the treatment of AR. The findings are based on a comprehensive literature search conducted in PubMed, Web of Science, EMBASE, Cochrane Library, Wanfang Database, and China National Knowledge Infrastructure (CNKI). The search strategy employed keywords including "allergic rhinitis," "pathogenesis," "traditional Chinese medicine," "Chinese herbal medicine," "herbal medicine," and "active components of Chinese medicine.""treatment," "immunotherapy," and "biologics" in various combinations. **Inclusion criteria:** ① Original clinical studies, observational studies, randomized controlled trials (RCTs), and meta-analyses related to the topic.② Articles published in the last five years (2020-2025) on AR pathogenesis and TCM treatment, with seminal earlier studies on classical mechanisms (e.g., Th1/Th2 imbalance) also included to provide foundational context.③Research on the mechanisms, treatment strategies, or therapeutic effects of Traditional Chinese and Western medicine in AR. **Exclusion criteria:** ① Abstracts, conference proceedings, opinion pieces, or non-peer-reviewed articles. ② Studies with low methodological quality (e.g., lacking control groups). ③ Irrelevant studies or those focusing on unrelated diseases.All plant names have been verified against The World Flora Online (http://www.worldfloraonline.org, accessed February 25, 2026) to ensure compliance with current taxonomic standards. A PRISMA flowchart documenting the literature screening process has been provided in the Supplementary Materials (Figure S1). **Results:** The pathogenesis of AR involves Th2 cell polarization, impairment of the mucosal epithelial barrier, dysbiosis of the microbiota, and neuro-immune interactions. Conventional treatments are often associated with limitations, including adverse effects and high costs. TCM has been shown to ameliorate AR symptoms through mechanisms such as regulating transcription factors including NF-κB and GATA3, restoring epithelial tight junction proteins (e.g., ZO-1 and occludin), and modulating gut microbiota composition, including increasing the production of short-chain fatty acids (SCFAs). Clinical studies have provided preliminary evidence for the safety and efficacy of TCM, both as monotherapy and in combination with Western medicine, for the management of AR.However, most mechanistic insights are derived from animal models, and direct translational evidence to human applications remains limited. Notably, a randomized controlled trial (n = 60) reported that nasal lavage with Glycyrrhizae Radix et Rhizoma (licorice) significantly improved SNOT-22 scores (from 27.9 ± 15.5 to 13.2 ± 9.6, p < 0.001) and reduced nasal airway resistance (p < 0.001), with effects superior to those of corticosteroid or saline lavage. **Conclusion:** TCM demonstrates preclinical potential in the treatment of AR, which is characterized by multifactorial etiology, through holistic and multi-target regulatory mechanisms. Further validation in human studies is needed. Future research should prioritize large-scale, multi-center clinical trials and leverage advanced biotechnological approaches to facilitate the standardization and global acceptance of TCM in allergy management. **Keywords:** Allergic rhinitis; Pathogenesis; Traditional Chinese medicine treatment; Western medicine treatment. Copyright © 2026 Elsevier B.V. All rights reserved. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Conflict of interest statement Declaration of competing interest There is no conflict of interest. ## Similar articles * [ Chinese medicines as therapeutic options for treating prostate cancer: Therapeutic effects and underlying mechanisms. ](https://pubmed.ncbi.nlm.nih.gov/40882785/) Li S, Jing S, Zhou J, Li H, Yin P, Zhang Q, Gong M, Zhao Y, Lu G, Jin G, Li X, Liang Y, Su L.Li S, et al.J Ethnopharmacol. 2026 Jan 10;354:120471. doi: 10.1016/j.jep.2025.120471. Epub 2025 Aug 27.J Ethnopharmacol. 2026.PMID: 40882785 * [ Traditional Chinese Medicine for Allergic Rhinitis: Mechanisms, Evidence, and Gut-Immune Axis Targets. ](https://pubmed.ncbi.nlm.nih.gov/41541602/) Liu S, Zhang Y, Lv J, Zhou L.Liu S, et al.J Asthma Allergy. 2026 Jan 10;19:571460. doi: 10.2147/JAA.S571460. eCollection 2026.J Asthma Allergy. 2026.PMID: 41541602Free PMC article.Review. * [ Mechanisms of Traditional Chinese Medicine in regulating Nrf2-related signaling pathways for the treatment of Oligoasthenozoospermia: A review. ](https://pubmed.ncbi.nlm.nih.gov/41485624/) Li S, Jing S, Zhou J, Li H, Yin P, Su L, Gong M, Zhao Y, Lu G, Jin G.Li S, et al.J Ethnopharmacol. 2026 Apr 6;360:121162. doi: 10.1016/j.jep.2026.121162. Epub 2026 Jan 2.J Ethnopharmacol. 2026.PMID: 41485624Review. * [ Folic acid supplementation and malaria susceptibility and severity among people taking antifolate antimalarial drugs in endemic areas. ](https://pubmed.ncbi.nlm.nih.gov/36321557/) Crider K, Williams J, Qi YP, Gutman J, Yeung L, Mai C, Finkelstain J, Mehta S, Pons-Duran C, Menéndez C, Moraleda C, Rogers L, Daniels K, Green P.Crider K, et al.Cochrane Database Syst Rev. 2022 Feb 1;2(2022):CD014217. doi: 10.1002/14651858.CD014217.Cochrane Database Syst Rev. 2022.Update in: [Cochrane Database Syst Rev. 2026 Feb 18;2:CD014217. doi: 10.1002/14651858.CD014217.pub2.](https://pubmed.ncbi.nlm.nih.gov/41705996/)PMID: 36321557Free PMC article.Upda
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