{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:49:36Z","timestamp":1782103776153,"version":"3.54.5"},"reference-count":101,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-term use of conventional therapy (CT) for psoriasis vulgaris (PV) is often constrained by adverse effects and costs. While oral plant-derived bioactive compounds show clinical promise as adjunctive treatments, the relative efficacy and safety of these compounds and their combination regimens remain poorly defined due to a lack of head-to-head comparisons. This systematic review and network meta-analysis aimed to compare and rank the efficacy and safety of different oral plant-derived bioactive compounds and their combination regimens for PV.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Randomized controlled trials investigating the effects of plant-derived bioactive compounds, such as compound glycyrrhizin (CG), tripterygium glycosides (TG), and total glucosides of paeony (TGP), on PV were retrieved from Chinese and English databases via computer searches. The main outcome measures included the Psoriasis Area and Severity Index (PASI), CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio, IL-23, IL-17, and TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      . Network meta-analysis was performed using Stata 16.0 software.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 84 randomized controlled trials comprising 7,544 patients across 15 treatment regimens. Most combination therapies significantly outperformed monotherapy in PASI reduction. TG combined with topical therapy (TOP) produced the greatest reduction in PASI scores [mean difference (MD)\u202f=\u202f\u221213.96, 95% confidence interval (CI) (\u221216.88, \u221211.03)], with the highest surface under the cumulative ranking curve (SUCRA) value of 99.80%. Individual compounds showed distinct advantages for specific therapeutic targets. CG\u202f+\u202fTOP proved most effective for reducing IL-23 levels (SUCRA\u202f=\u202f97.30%), while CG\u202f+\u202fNB-UVB achieved the greatest IL-17 reduction (SUCRA\u202f=\u202f91.20%). CG\u202f+\u202fCT best restored CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      ratio balance (SUCRA\u202f=\u202f94.70%), and TGP\u202f+\u202fTOP led all regimens in TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      suppression (SUCRA\u202f=\u202f92.40%). Adverse events were predominantly mild, consisting of gastrointestinal symptoms or skin dryness. No serious or irreversible events were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Combining plant-derived compounds with CT may enhance short-term, outcome-specific efficacy. TG\u202f+\u202fTOP showed the greatest PASI reduction. Immunologically, CG-based regimens optimized IL-23\/IL-17 suppression and CD4\n                      <jats:sup>+<\/jats:sup>\n                      \/CD8\n                      <jats:sup>+<\/jats:sup>\n                      normalization, while TGP\u202f+\u202fTOP maximized TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      inhibition. These distinct profiles inform individualized treatment and warrant long-term confirmation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261304681<\/jats:ext-link>\n                      , identifier (CRD420261304681).\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1844822","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:35:59Z","timestamp":1782102959000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of plant-derived bioactive compounds in the treatment of psoriasis vulgaris: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Yue","family":"Du","sequence":"first","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]},{"name":"Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shouxu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]},{"name":"Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tian","family":"Lv","sequence":"additional","affiliation":[{"name":"Department of Chinese Medicine and Rehabilitation, Beijing Health Vocational College","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoxuan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]},{"name":"Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haomin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]},{"name":"Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangshan","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingling","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Dongzhimen Hospital, Beijing University of Chinese Medicine","place":["Beijing, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"13313","DOI":"10.3390\/ijms241713313","article-title":"Challenges and future trends in the treatment of psoriasis","volume":"24","author":"Lee","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1016\/S0140\u22126736(20)32549\u22126","article-title":"Psoriasis","volume":"397","author":"Griffiths","year":"2021","journal-title":"Psoriasis Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1186\/s12865\u2212021\u221200421\u2212z","article-title":"Glycyrrhizin improves the pathogenesis of psoriasis partially through IL-17A and the SIRT1\u2212STAT3 axis","volume":"22","author":"Qiong","year":"2021","journal-title":"BMC 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psoriasis","volume":"46","author":"Chang","year":"2020","journal-title":"J Lanzhou Univ"},{"key":"ref14","first-page":"435","article-title":"Efficacy observation of compound glycyrrhizin assisted with viaminate in the treatment of psoriasis vulgaris","volume":"21","author":"Chen","year":"2014","journal-title":"Chin J Tradit Med Sci Technol"},{"key":"ref15","first-page":"19\u201321, 24","article-title":"Clinical observation of total glucosides of paeony combined with acitretin and narrow\u2212band ultraviolet B for psoriasis vulgaris","volume":"7","author":"Chen","year":"2014","journal-title":"J Pract Dermatol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"126","DOI":"10.16662\/j.cnki.1674\u22120742.2017.12.126","article-title":"Efficacy and safety analysis of compound glycyrrhizin combined with acitretin capsules in the treatment of plaque psoriasis","volume":"36","author":"Cheng","year":"2017","journal-title":"China Foreign Med Treat"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"79","DOI":"10.19368\/j.cnki.2096\u22121782.2021.23.079","article-title":"Efficacy of compound glycyrrhizin combined with acitretin capsules in the treatment of psoriasis vulgaris and its effect on VEGF levels","volume":"6","author":"Dong","year":"2021","journal-title":"Syst Med"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"92","DOI":"10.13638\/j.issn.1671\u22124040.2017.10.059","article-title":"Immunomodulatory effect and clinical efficacy of compound glycyrrhizin on psoriasis vulgaris","volume":"17","author":"Du","year":"2017","journal-title":"Pract Clin J Integr Tradit Chin West Med"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"8","DOI":"10.14164\/j.cnki.cn11\u22125581\/r.2016.04.004","article-title":"Efficacy analysis of Tripterygium wilfordii polyglycoside tablets combined with tazarotene in the treatment of psoriasis vulgaris","volume":"10","author":"Fan","year":"2016","journal-title":"Chin Mod Drug Appl"},{"key":"ref20","first-page":"138","article-title":"Immunomodulatory effect and clinical efficacy analysis of compound glycyrrhizin on psoriasis vulgaris","volume":"16","author":"Fu","year":"2017","journal-title":"Chin J Dermato Venereol Integr Tradit West Med"},{"key":"ref21","first-page":"1212","article-title":"Efficacy of dual drug regimen assisted by narrow\u2212band ultraviolet B in the treatment of psoriasis vulgaris","volume":"48","author":"Hao","year":"2019","journal-title":"Shaanxi Med J"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"873","DOI":"10.13735\/j.cjdv.1001\u22127089.2014.0873","article-title":"Efficacy analysis of 78 cases of moderate psoriasis vulgaris treated with total glucosides of paeony combined with narrow\u2212band ultraviolet B and calcipotriol","volume":"28","author":"He","year":"2014","journal-title":"Chin J Dermato 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the treatment of psoriasis vulgaris","volume":"27","author":"Jiang","year":"2013","journal-title":"Liaoning Med J"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"115","DOI":"10.3760\/cma.j.issn.1674\u22124756.2017.02.044","article-title":"Effects of compound glycyrrhizin and calcipotriol ointment in the treatment of psoriasis vulgaris and its influence on T helper 17 cells","volume":"44","author":"Jiao","year":"2017","journal-title":"Chin Pract Med J"},{"key":"ref31","first-page":"237","article-title":"Clinical observation on the efficacy of compound glycyrrhizin combined with narrow\u2212band ultraviolet B in the treatment of psoriasis vulgaris","volume":"14","author":"Li","year":"2015","journal-title":"Chin J Dermato\u2212Venereol Integr Tradit West Med"},{"key":"ref32","first-page":"99","article-title":"Compound glycyrrhizin combined with narrow\u2212band ultraviolet B in the treatment of middle\u2212aged and elderly patients with psoriasis vulgaris","volume":"25","author":"Li","year":"2019","journal-title":"J Clin Psychosom Dis"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"1636","DOI":"10.19381\/j.issn.1001\u22127585.2017.11.042","article-title":"Efficacy observation of narrow\u2212band ultraviolet B combined with total glucosides of paeony in the treatment of psoriasis vulgaris","volume":"30","author":"Li","year":"2017","journal-title":"J. Med. Theor. Prac."},{"key":"ref34","first-page":"63","article-title":"Observation on the effect of compound glycyrrhizin combined with narrow\u2212band ultraviolet B irradiation in the treatment of psoriasis vulgaris","volume":"31","author":"Li","year":"2019","journal-title":"Med J Chin People's Health"},{"key":"ref35","first-page":"572","article-title":"Application effect of compound glycyrrhizin combined with acitretin in patients with psoriasis vulgaris","volume":"40","author":"Li","year":"2018","journal-title":"Dermatol. Venereol."},{"key":"ref36","doi-asserted-by":"publisher","first-page":"1959","DOI":"10.19381\/j.issn.1001\u22127585.2017.13.045","article-title":"Efficacy of total glucosides of paeony capsules combined with calcipotriol ointment in the treatment of psoriasis vulgaris and its influence on serum inflammatory factors","volume":"30","author":"Lin","year":"2017","journal-title":"J. Med. Theor. 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Venereol."},{"key":"ref43","first-page":"441","article-title":"Efficacy observation of compound glycyrrhizin combined with acitretin capsules in the treatment of psoriasis vulgaris","volume":"41","author":"Lv","year":"2019","journal-title":"Dermatol Venereol"},{"key":"ref44","first-page":"1414","article-title":"Clinical efficacy of compound glycyrrhizin in psoriasis vulgaris and its influence on IL\u221222","volume":"45","author":"Ma","year":"2021","journal-title":"Guizhou Med J"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"93","DOI":"10.13457\/j.cnki.jncm.2024.17.019","article-title":"Clinical study on Tripterygium wilfordii polyglycoside tablets as adjuvant therapy for psoriasis vulgaris with blood\u2212heat syndrome","volume":"56","author":"Ma","year":"2024","journal-title":"J New Chin Med"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"650","DOI":"10.3969\/j.issn.1006\u22122785.2012.08.025","article-title":"Efficacy observation of total glucosides of paeony combined with narrow\u2212band ultraviolet B irradiation in the treatment of psoriasis vulgaris","volume":"34","author":"Ma","year":"2012","journal-title":"Zhejiang Med J"},{"key":"ref47","first-page":"116","article-title":"Exploration of the efficacy of total glucosides of paeony combined with narrow\u2212band ultraviolet B in the treatment of psoriasis vulgaris","volume":"12","author":"Mao","year":"2013","journal-title":"Chin J Dermato\u2212Venereol Integr Tradit West Med"},{"key":"ref48","doi-asserted-by":"publisher","first-page":"3396","DOI":"10.19381\/j.issn.1001\u22127585.2021.19.039","article-title":"Clinical effect of thalidomide combined with Tripterygium wilfordii in the treatment of psoriasis vulgaris","volume":"34","author":"Peng","year":"2021","journal-title":"J Med Theor Prac"},{"key":"ref49","first-page":"958","article-title":"Efficacy observation of compound glycyrrhizin tablets combined with fluticasone propionate in the treatment of psoriasis vulgaris. 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Postgrad"},{"key":"ref56","first-page":"13","article-title":"Clinical efficacy and adverse reactions of total glucosides of paeony combined with compound flumethasone ointment in the treatment of psoriasis vulgaris","volume":"5","author":"Sun","year":"2015","journal-title":"China Med Pharm"},{"key":"ref57","first-page":"112","article-title":"Analysis of the effect of compound glycyrrhizin combined with Tripterygium wilfordii polyglycosides in the treatment of psoriasis vulgaris","volume":"17","author":"Tan","year":"2019","journal-title":"Contemp Med Symp"},{"key":"ref58","first-page":"2047","article-title":"Clinical effect of calcipotriol combined with compound glycyrrhizin in the treatment of plaque psoriasis","volume":"12","author":"Tan","year":"2015","journal-title":"Lab Med Clin"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"1178","DOI":"10.19381\/j.issn.1001\u22127585.2017.08.049","article-title":"Clinical efficacy observation of Tripterygium wilfordii polyglycosides 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