Objective To summarize the uric acid-lowering effects and mechanisms of Chinese medicines with medicine-food homology, aiming to provide novel perspectives for the development of new anti-hyperuricemia (HUA) drugs.

Methods Papers on the research of HUA prevention and treatment with medicine-food homology from December 15, 2002 to August 10, 2024 were screened and collected through China National Knowledge Infrastructure (CNKI), PubMed, ScienceDirect, and Google Scholar. Subsequently, the impact of these medications and their extracts, as well as the active compounds on HUA were assessed.

Results A total of 148 relevant papers were collected, including 43 kinds of Chinese medicines and 61 active compounds, all of which have anti-HUA activity. Among them, 41 kinds of Chinese medicines could inhibit the activity of xanthine oxidase, thus leading to the inhibition of uric acid production; and 22 kinds of Chinese medicines could facilitate uric acid excretion, while 15 kinds of Chinese medicines could reduce the inflammation levels in the body and promoting renal protection. Notably, polyphenols and flavonoids are the key active components for the uric acid-lowering effects.

Conclusion This study systematically summarized and analyzed the uric acid-lowering effects and mechanisms of Chinese medicines with medicine-food homology, laying a foundation for their development as HUA agents.