Supplementary file 1_Modulation of microbiota by traditional Chinese medicine in chronic inflammatory airway disease: a systematic review and meta-analysis of animal studies.docx

Several pooled estimates showed substantial heterogeneity and sensitivity to individual-study omission. Most included studies reported differences in beta diversity between model and TCM groups. Changes in airway and gut microbial relative abundance were heterogeneous across studies.

High or unclear risk of bias was identified in most SYRCLE domains for the included studies.</p>Conclusion<p>Current preclinical evidence suggests that TCM may be associated with changes in airway and gut microbiota in CIAD animal models. However, the updated quantitative analyses did not demonstrate statistically significant overall effects on the alpha-diversity indices examined, and evidence concerning airway microbiota and microbial relative abundance remains heterogeneous.

These findings should not be interpreted as evidence of microbiota restoration or therapeutic mechanisms. Well-designed studies with more standardized methodologies are warranted to clarify the impact of TCM on lung–gut axis microecology.</p>Systematic Review Registration<p>crd.york.ac.uk/prospero/, identifier PROSPERO CRD420261385384.</p>