Zifan Wang, Ying Chen, Tiantian Li, Yu Hu, Lingjun Li
Hyperuricemia (HUA) is a metabolic disorder caused by dysregulated uric acid metabolism and constitutes the principal biochemical basis of gout. Persistent elevation of serum uric acid above the saturation threshold promotes monosodium urate crystal deposition in joints, soft tissues, and the kidneys, triggering inflammation and tissue injury. The rising global prevalence of HUA and gout, together with an evident trend toward younger onset, has imposed an increasing public health burden. Traditional Chinese Medicine has been widely used in their management because of its holistic therapeutic approach and favorable safety profile. Among the bioactive constituents derived from Chinese medicinal materials, saponins have attracted particular attention for their multi-target pharmacological actions. Saponin compounds derived from Chinese medicinal materials exert anti-hyperuricemic and anti-gout effects by modulating purine-metabolizing enzymes, regulating urate transporters, restoring gut microbiota homeostasis, and suppressing inflammatory signaling pathways. This review summarizes the pathogenesis of HUA and gout and synthesizes current evidence on the therapeutic mechanisms of saponins derived from Chinese medicinal materials, providing a theoretical basis for the development of novel therapeutic strategies.