Objective To systematically evaluate the efficacy and safety of Xiangju Capsules in treating chronic rhinosinusitis (CRS).

Methods A computerized search was conducted across CNKI, WanFang Data, VIP, PubMed, Cochrane Library, Embase, and Web of Science databases to identify randomized controlled trials on Xiangju Capsules for CRS from inception to December 31, 2025. Two researchers independently screened studies, extracted data, and assessed risk of bias. Data analysis was performed using RevMan 5.3 software.

Results A total of 25 studies involving 2,862 patients were included. Meta-analysis showed that compared with conventional Western medicine alone, Xiangju Capsules combined with conventional Western medicine or Xiangju Capsules used alone significantly improved the overall clinical effective rate, significantly reduced serum interleukin-6 (IL-6), interleukin-17 (IL-17) levels, and reduced TNF-α and VAS scores (P<0.05). Regarding safety, 12 studies reported adverse events; no significant difference in incidence was observed between the treatment and control groups (P>0.05), and no serious adverse drug reactions were reported.

Conclusion Current evidence suggests that combining Xiangju Capsules with conventional Western medicine is more effective than conventional Western medicine alone in treating CRS. It can reduce serum IL-6, IL-17, and TNF-α levels, improve VAS scores. Existing studies have not reported serious adverse drug reactions. Further large-scale, multicenter randomized controlled trials are needed to confirm these findings.

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