Background. In the present study, we systematically evaluated the effects of Traditional Chinese Medicine (TCM) on androgenetic alopecia (AGA) in rodent models (rats and mice) to provide potential evidence for the treatment of AGA by TCM. Methods. Previous research papers focusing on the treatment of AGA by TCM were retrieved from various electronic databases (PubMed, Embase, The Cochrane Library, CNKI, Vip, Wanfang data, and CBM) up to October 30, 2021. Screening of the literature was performed independently, and data were extracted and assessed. A meta-analysis was performed using RevMan 5.3 software. Results. When compared with the model groups, a group of C57BL/6 mice treated with TCM showed an increase in the total number of hair follicles (mean difference [MD] = 11.99, 95% confidence interval [CI] [5.94,18.03], P = 0.0001 ), as well as a decrease in serum testosterone (T) level (MD = −1.10, 95% CI [−1.43, −0.78], P < 0.00001 ), skin discoloration time (MD = −2.93, 95% CI [−4.03, −1.84], P < 0.00001 ), and skin hair growth time (MD = −3.16, 95% CI [−4.16, −2.16], P < 0.00001 ). Terminal hair/vellus hair also increased in TCM-treated AGA animals (MD = 3.02, 95% CI [2.05, 3.98], P < 0.00001 ). No significant difference was found in serum estradiol (E2) level, skin tissue E2 level, or skin tissue T level between the TCM-treated group and the model group. Conclusion. TCM can increase the total number of hair follicles and terminal hair/vellus hair ratio, and reduce skin discoloration time and skin hair growth time in AGA animal models. These effects may be related to the reduction of the serum T level in AGA animals. These conclusions need to be verified by high-quality studies as the current analysis may be affected by the number and quality of the studies identified.

Background & aims: Polycystic ovary syndrome (PCOS) is a common endocrine syndrome, and obesity is the most common clinical manifestation of PCOS. Acupuncture therapy has shown great success in the treatment of PCOS, but the mechanism of acupuncture therapy in the treatment of patients with PCOS remains unclear. The biological mechanism of acupuncture therapy is vastly different from western drugs; thus, we aimed to compare the key metabolic pathways, including citric acid and glucose metabolism in acupuncture therapy. Methods Sixty patients with obese polycystic ovary syndrome were randomly distributed into three groups; patients receiving (1) acupuncture treatment alone, (2) conventional western medicine treatment, and (3) acupuncture combined with western medicine treatment. A targeted metabolomics approach was used to identify small molecules and metabolites related to glucose metabolism in the serum of each group, and ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) was used to analyze different metabolic fractions. Results Acupuncture treatment reduced mitochondrial dysfunction and oxidative damage in the liver, and decreased insulin resistance in PCOS patients by reducing the production of many metabolites involved in the tricarboxylic acid cycle (TCA cycle), such as citric acid and succinic acid. Acupuncture therapy also regulated glycolysis and gluconeogenesis pathways upstream of the TCA cycle. Activating the enzymes involved in the key glycolytic pathways and reducing the production of lactate improved the pathological conditions (impaired energy metabolism, insulin resistance, and obesity) in patients with PCOS. Conclusions Acupuncture treatment improved the levels of sex hormones and energy metabolism by downregulating the TCA cycle activity and modulating glycolytic and gluconeogenic pathways. However, the intervention effects on the metabolic pathways were different between patients receiving combination therapy and patients receiving acupuncture therapy alone, suggesting that the dominant modulatory effect of western drugs may largely conceal the efficacy of acupuncture intervention.