Traditional Chinese Medicine Treatment for Pulmonary Nodules: A Systematic Review

With the rising application of chest CT scans, the detection rate of pulmonary nodules (PN) has witnessed a remarkable increase. Traditional Chinese Medicine (TCM) offers a unique method for the treatment and management of PN, with a strong focus on regulation of the body's overall balance and stopping disease progression. This systematic review aimed to identify evidence-based TCM formulae from both clinical research and authorized Chinese invention patents for the management of PN. Built on 69 original PN treatment formulae, the study unveiled the most commonly used TCM types and herbs in these formulae. These are tonic herbs, heat-clearing herbs, phlegm-resolving, cough-relieving and asthma-relieving herbs, as well as blood-activating and stasis-removing herbs. The frequently used herbs include Glycyrrhizae Radix et Rhizoma, Astragali Radix, Pinelliae Rhizoma, Fritillariae thunbergii Bulbus, Citri teticulatae Pericarpium, Platycodonis Radix, Ostreae Concha, and Poria cocos. To sum up and assess the therapeutic effects of TCM on PN, the study employed three indicators: nodule size changes (clinical efficacy), the Traditional Chinese Medicine Syndrome Score Scale (TCMSSS), and the malignancy risk assessment (Mayo Model Score, MMS). Compared to the control group with no pharmacological intervention, the treatment group delivered superior results across all three indicators. The clinical efficacy saw a P-value < 2.2 × 10 −16 and confidence intervals of [0.2873004, 0.3595156], TCMSSS showed a p-value < 2.2 × 10 −16 and confidence intervals of [0.5692573, 0.6422647], and MMS presented Z = -2.929 and a P-value of 0.0034. The overall clinical response rate of the treatment group was 40.43%, and the overall TCMSSS response rate was 76.95%. Additionally, after a comprehensive assessment, Bai Zhengping's Qingfei Sanjie Formula exhibited the most favorable overall therapeutic outcome in the treating of PN.