Abstract
BACKGROUND: Wounds continue to represent a significant public health challenge globally. In recent years, Astragalus mongholicus Bunge, a traditional Chinese botanical drug utilized for wound treatment, has garnered increasing research attention. However, the therapeutic efficacy and safety of this natural botanical drug on wound healing remain poorly understood. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of Astragalus mongholicus Bunge in animal wound models to propel future studies towards definitive preclinical and initial clinical trials. METHODS: A systematic search of seven databases was conducted to identify randomized controlled studies that compared Astragalus mongholicus Bunge to placebo or a "no treatment" arm in animal models of skin wounds. Two authors independently assessed the risk of bias of the included studies using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) tool for preclinical animal studies and extracted relevant information according to a predesigned extraction form. Random effects models were used to estimate the pooled effect and the data were analyzed using R software. RESULTS: Finally, 20 citations (including 21 studies) with 559 animals were included. The meta-analysis revealed that compared to the control group, wounds treated with Astragalus mongholicus Bunge had a higher wound contraction percentage [standardized mean difference 4.18, 95% confidence interval 2.40-5.96, P < 0.0001]. Additionally, the Astragalus mongholicus Bunge treatment group exhibited a positive effect in enhancing angiogenesis, facilitating collagen deposition, and diminishing pro-inflammatory factors. Meantime, no harmful events were reported. CONCLUSION: Astragalus mongholicus Bunge presented positive effects on the process of wound healing in experimental models used, demonstrating the huge potential of this botanical drug for wound treatments. More studies with comparable study protocols should be performed to validate the results of the present systematic review and meta-analysis. SYSTEMATIC REVIEW REGISTRATION: This study was registered in PROSPERO (CRD420250641262).