Effects of schisandra extract on muscle atrophy: a systematic review and meta-analysis of preclinical studies

Background Lignans from Schisandra chinensis , such as schisandrin B, possess antioxidant, anti-inflammatory, and protein-regulating properties, suggesting potential against muscle atrophy. However, existing animal evidence is fragmented and lacks quantitative synthesis. Objective This meta-analysis evaluates the effects of S. chinensis on various animal models of muscle atrophy, focusing on muscle structure, function, and oxidative stress. Methods We systematically searched PubMed, Web of Science, Embase, Cochrane Library, and Ovid from inception to April 2025 for relevant animal RCTs, selected via the PICOS framework. Study quality was assessed using the SYRCLE tool. A random-effects meta-analysis was performed on outcomes including muscle weight, fiber cross-sectional area (CSA), catalase (CAT) activity, and grip strength. Results Eleven studies (149 experimental, 149 control animals) were included. S. chinensis significantly increased muscle weight (standardized mean difference = 1.18, 95% CI: 0.19–2.16, P = 0.020) and CAT activity (SMD = 1.77, 95% CI: 0.31–3.23, P = 0.020). cross-sectional area improvement was borderline (SMD = 2.10, 95% CI: −0.02–4.22, P = 0.050). No significant changes occurred in body weight or grip strength. High heterogeneity (I 2 = 80%–95%) was observed, attributable to variations in models and interventions. Conclusion S. chinensis improves muscle structure potentially via enhanced antioxidant defense and reduced protein degradation, though functional benefits remain unconfirmed. Future high-quality, standardized studies are needed to clarify dose-response relationships and translational potential. Systematic Review Registration identifier INPLASY202590030.