{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T09:01:57Z","timestamp":1777971717965,"version":"3.51.4"},"reference-count":49,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T00:00:00Z","timestamp":1743379200000},"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. Pharmacol."],"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the efficacy and safety of Tanshinone capsule as a complementary therapy in managing of Acne Vulgaris.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of six databases was conducted to identify relevant randomized controlled trials (RCTs) from each database for nearly 20\u00a0years (from 1 Jan 2004, to 1 June 2024). The Cochrane Handbook was used to evaluate the risk of bias. Meta-analysis was performed using Review Manager 5.4.1, and publication bias was assessed the Stata SE 12.0 software. GRADEpro was used to assess the quality of the evidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 2,969 participants from 28 studies were included. We found that Tanshinone capsules can reduce acne recurrence rates [risk ratio (<jats:italic>RR<\/jats:italic>) 0.44, 95% confidence interval (CI): 0.34 to 0.57, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001]; downregulate levels of necrosis factor-alpha (TNF-\u03b1) [ mean difference (<jats:italic>MD<\/jats:italic>) 0.44, \u221210.18, 95% CI: \u221213.57 to \u22128.04, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001], interleukin (IL) 4 (<jats:italic>MD<\/jats:italic> -6.46, 95%CI: \u22127.14 to \u22125.77, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001), IL-6 (<jats:italic>MD<\/jats:italic> -16.14, 95%CI: \u221230.10 to \u22122.18, <jats:italic>p<\/jats:italic> = 0.02), IL-8 (<jats:italic>MD<\/jats:italic> -4.48, 95%CI: \u22128.30 to \u22120.65, <jats:italic>p<\/jats:italic> = 0.02) and testosterone (<jats:italic>MD<\/jats:italic> -14.50, 95%CI: \u221217.59 to \u221211.40, <jats:italic>p<\/jats:italic> &amp;lt; 0.00001); lower Global Acne Grading System (GAGS) score (<jats:italic>MD<\/jats:italic> -4.71, 95%CI: \u22127.62 to \u22121.80, <jats:italic>p<\/jats:italic> = 0.002); decrease sebum secretion rates (<jats:italic>MD<\/jats:italic> -0.29, 95%CI: \u22120.49 to \u22120.10, <jats:italic>p<\/jats:italic> = 0.003), but the regulation of Luteinizing hormone (LH), Follicle-stimulating hormone (FSH), Estradiol (E<jats:sub>2<\/jats:sub>) is not obvious. In terms of safety, the incidence of adverse events in the experimental group was less than that in the control group (<jats:italic>RR<\/jats:italic> 0.70, 95%CI: 0.56 to 0.87, <jats:italic>p<\/jats:italic> = 0.001). The Begg test and Egger test results indicated no publication bias. Furthermore, the levels of evidence ranged from very low to moderate due to risk of bias and heterogeneity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tanshinone capsules can relieve the symptoms of acne vulgaris, regulate inflammatory cytokines and hormone levels in patients, and reduce recurrence. However, due to the limitations of this study, more multi-center and large-sample studies are needed to confirm these conclusions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42024562320<\/jats:ext-link>, identifier CRD42024562320.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1520039","type":"journal-article","created":{"date-parts":[[2025,3,31]],"date-time":"2025-03-31T05:35:47Z","timestamp":1743399347000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy and safety of Tanshinone capsule in Acne vulgaris: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Yutong","family":"Deng","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruli","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuewen","family":"Ren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengchuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huishang","family":"Feng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuewan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yatong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tangyunni","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingling","family":"Cai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanwen","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"157","DOI":"10.12048\/i.issn.1674-229X.2021.02.018","article-title":"Research on clinical efficacy of tanshinone combined with doxycycline in the treatment of acne vulgaris and its effect on TNF-\u03b1","volume":"31","author":"Cai","year":"2021","journal-title":"Pharm. 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