Efficacy and mechanisms of Xiangsha Liujunzi Decoction for gastroesophageal reflux disease: A study integrating meta-analysis, network pharmacology and molecular docking.

BACKGROUND: Reflux esophagitis (RE) significantly impairs quality of life. Xiangsha Liujunzi Decoction (XSLJZD) is used in traditional Chinese medicine for RE, but its efficacy and mechanisms remain to be systematically evaluated. PURPOSE: This study integrated meta-analysis, network pharmacology, and molecular docking to evaluate the clinical efficacy of XSLJZD for RE and elucidate its mechanisms of action. METHODS: Randomized controlled trials (RCTs) on XSLJZD for RE were systematically searched. Methodological quality was assessed using the Cochrane Risk of Bias tool, and data were synthesized with RevMan 5.3. Network pharmacology utilizing TCMSP identified active components, targets, and pathways. Molecular docking validated core compound-target interactions. RESULTS: Eight RCTs (n = 646) showed that XSLJZD significantly improved clinical outcomes compared with controls, demonstrating superior overall efficacy and reduced recurrence. Network analysis identified luteolin, baicalin, and β-sitosterol as core components, with AKT1, IL6, and CASP3 as key targets, potentially regulating apoptosis, IL-17, and TNF signaling pathways. Molecular docking confirmed stable binding. CONCLUSION: XSLJZD may improve RE symptoms as an adjunctive therapy, but the evidence is low in certainty. The proposed anti-inflammatory and apoptotic mechanisms are computationally derived. High-quality trials and experimental validation are needed to confirm efficacy and mechanisms of action.