Astragalus membranaceus (A. membranaceus), a traditional Chinese medicine, has gained increasing recognition for its potential in treating central nervous system (CNS) disorders. This review aims to systematically integrate the mechanisms of action of A. membranaceus and its bioactive compounds on CNS diseases, with a focus on exploring its therapeutic potential and introducing related health food products. We conducted a comprehensive literature search in PubMed and Web of Science from January 2015 through July 2025. Our analysis reveals that A. membranaceus and its bioactive compounds, particularly A. membranaceus IV (AS-IV) and A. membranaceus polysaccharides (APS), exert multifaceted neuroprotective effects. These effects encompass the mitigation of neuroinflammation, oxidative stress, apoptosis, and ferroptosis, as well as the regulation of autophagy and protection of the blood–brain barrier. The therapeutic potential of A. membranaceus is linked to the modulation of key signaling pathways, such as NF-κB, Nrf2, and PI3K/Akt. Furthermore, based on the concept of “homology of medicine and food,” A. membranaceus is being developed into various health food formulations, offering a promising strategy for the adjuvant treatment and preventive care of CNS diseases. In conclusion, A. membranaceus represents a promising, multi-target pharmacological agent for CNS disorders, yet further high-quality clinical studies are warranted to validate its efficacy and safety in humans.

Rheumatoid arthritis (RA) is a disease of the immune system that leads to continuous synovial inflammation and the progressive breakdown of joints. As essential effector cells in innate immunity, macrophages can become either pro-inflammatory M1 or anti-inflammatory M2 phenotypes, playing a critical role in RA pathogenesis. A marked M1/M2 polarization imbalance exists in the synovial microenvironment of RA, in which excessive activation and accumulation of M1 macrophages serve as a key hub driving persistent inflammation, cartilage degradation, and bone erosion. This review systematically summarizes the polarization mechanisms of macrophages in RA, their core pathological functions, and recent advances in targeting these cells as therapeutic strategies, therefore delivering novel insights and references for RA treatment through targeted changes in macrophage polarization.