This paper reviews the traditional application basis and modern research progress of Kushen (Sophorae Flavescentis Radix), and performs a comprehensive analysis focusing on its chemical constituents, shared common pharmacological mechanisms, and safety profiles, thereby providing a scientific reference for its research and standardized application. Using keywords such as Sophorae Flavescentis Radix, alkaloids, total flavonoids, immune-inflammatory regulation, and safety evaluation, this review collected relevant domestic and foreign relevant literature published in the past decade was retrieved from databases including Wanfang, China National Knowledge Infrastructure, PubMed, and Web of Science. The retrieved studies were systematically analyzed to summarize the traditional medical understanding and modern pharmacological research, with special emphasis on the pharmacodynamic material basis and clinical application mechanisms of Sophorae Flavescentis Radix. Sophorae Flavescentis Radix contains multiple classes of chemical components, predominantly alkaloids, while flavonoids, polysaccharides, and other constituents also contribute to its holistic efficacy. Modern pharmacological studies have revealed that Sophorae Flavescentis Radix exerts its overall effects through immune-inflammatory regulation as the core mechanism, specifically by targeting desmoglein-2 for barrier repair and bidirectionally modulating immune polarization (M1/M2). Its material basis exhibits clear structure-synergy patterns, non-alkaloid components can regulate the toxicity threshold of alkaloids by inhibiting the reactive oxygen species/NOD-like receptor family pyrin domain containing 3 pathway, demonstrating a significant “efficacy-toxicity” balance feature. Meanwhile, adverse reactions related to Sophorae Flavescentis Radix are closely associated with its alkaloid components, dosage, and administration routes, suggesting that the safety risks are manageable to a certain extent. Modern research on Sophorae Flavescentis Radix has, to some extent, validated its traditional efficacy basis. However, critical issues remain, such as unclear relationships among components, insufficient integration of mechanisms, and limited systematic safety evaluations. Future research should strengthen studies on multi-component synergistic mechanisms and safety risk control to promote the rational development and standardized clinical application of Sophorae Flavescentis Radix.

Sophorae Flavescentis Radix  /  multi-target action  /  immune-inflammatory regulation  /  safety evaluation  /  “efficacy-toxicity” balance