• Users Online: 1242
  • Print this page
  • Email this page

Table of Contents
Year : 2023  |  Volume : 9  |  Issue : 3  |  Page : 297-306

Lung cancer treatment in traditional chinese medicine: History, current status, and development

1 R & D Department of Special Collection Resources, Institute of Information on Traditional China Medicine, China Academy of Chinese Medical Sciences, Beijing, China
2 Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
3 University of Texas MD Anderson Cancer Center, Houston, TX, USA

Date of Submission14-Jan-2023
Date of Acceptance11-May-2023
Date of Web Publication20-Jul-2023

Correspondence Address:
Dr. Hong-Sheng Lin
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053
Dr. Ying Zhang
Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2311-8571.382025

Rights and Permissions

Objective: This article discusses the following aspects, including the history of traditional Chinese medicine (TCM) in the treatment of lung cancer, the breakthrough in the theory of TCM in treatment of lung cancer, clinical study of TCM in treating lung cancer, microscientific interpretation of TCM treatment for lung cancer and the prospect of TCM in treating lung cancer. Materials and Methods: In this paper, through a systematic search, combing traditional Chinese medicine prevention and treatment of lung cancer ancient books and modern literature. Results: A series of large sample and multi-centered clinical studies have proved that TCM comprehensive treatment significantly improves the clinical efficacy for lung cancer. “TCM treatment system for non-small cell lung cancer” based on staged and standardized integration of TCM and Western medicine has been well developed and popularized in practice. Furthermore, in virtue of the international cooperation platform established by the National Cancer Institute of the United States, the scientific connotation of TCM in the prevention and treatment of lung cancer is systematically and deeply studied, thereby promoting the research and development of new Chinese drugs for lung cancer. Conclusions: Nowadays, TCM has realized a landmark breakthrough in treating lung cancer, bringing benefits to all lung cancer patients.

Keywords: Clinical study, lung cancer, mechanism, non-small cell lung cancer, traditional Chinese medicine

How to cite this article:
Zhang CC, Liu SY, Liu J, Yang PY, Lin HS, Zhang Y. Lung cancer treatment in traditional chinese medicine: History, current status, and development. World J Tradit Chin Med 2023;9:297-306

How to cite this URL:
Zhang CC, Liu SY, Liu J, Yang PY, Lin HS, Zhang Y. Lung cancer treatment in traditional chinese medicine: History, current status, and development. World J Tradit Chin Med [serial online] 2023 [cited 2023 Sep 25];9:297-306. Available from: https://www.wjtcm.net/text.asp?2023/9/3/297/382025

  Introduction Top

The National Cancer Institute (NCI) has recently released the latest Cancer statistics, 2023 on CA. The report revealed that the rate of decline in lung cancer cases among women was half that of men (1.1% vs. 2.6% annually) from 2015 to 2019. This discrepancy can be attributed to the years of dedicated efforts by scholars in clinical and basic research, as well as advancements in early screening, targeted therapy, and immunotherapy specifically applied to lung cancer treatment.[1] In the field of traditional Chinese medicine (TCM), various treatment approaches have been advocated, including protective therapy, loading therapy, consolidation therapy, maintenance therapy, and simple TCM therapy, all based on evidence-based medicine for the treatment of lung cancer.[2],[3],[4],[5] These approaches have benefits for lung cancer patients in terms of preventing lesion enlargement, improving symptoms and overall quality of life, and prolonging survival.[6],[7],[8],[9],[10]

  The History of Traditional Chinese Medicine in the Treatment of Lung Cancer Top

In ancient times, physicians classified lung cancer into categories known as Feiji or Xiben (the accumulation of the lung). Feiji was first recorded in the book Classic of Questioning, stating that “Feiji, also called Xiben, is located in the right hypochondriac region and can grow as large as a cup. If left untreated for a prolonged period, patients may experience symptoms such as chills, fever, asthma, and cough, thereby inducing lung abscess.” These symptoms, such as cough, chest pain, and hemoptysis are similar to those commonly associated with lung cancer. Miraculous Pivot recorded that “patients exhibit signs of weak bones, emaciated muscles, chest fullness, and wheezing,” symptoms that also resemble those seen in advanced stages of lung cancer and the clinical manifestations of malignancy in a qi-exhausted stage. Pulse Classics by Wang Shuhe in the Western Jin Dynasty described that “patients with Feiji usually present symptoms of reversed flow of qi under the hypochondrium, dragging pain in the back, and a floating and superficial pulse,” similar to the symptoms of advanced lung cancer, as well as axillary and supraclavicular lymph node enlargement induced by hepatic and lymphatic metastases or subcutaneous metastasis.

During the Jin and Yuan Dynasties, Liu Wansu greatly influenced future physicians by advocating the use of heat-clearing and detoxifying methods in the treatment of lung cancer. Zhu Danxi expressed the belief that “If healthy qi is nourished, accumulation is spontaneously removed.” In the Ming and Qing Dynasties, Zhang Jingyue emphasized the need for flexible and adaptive therapies based on the varying conditions of patients' constitution, the deficiency or excess of the viscera, and the progression of the disease. Ye Tianshi demonstrated expertise in the use of insect-based drugs during treatment. Wang Qingren believed that promoting blood circulation and removing blood stasis was an effective approach to treatment. Together, these diverse treatment concepts form a comprehensive theoretical system for the treatment of lung cancer, as found in ancient TCM books [Figure 1].
Figure 1: Feiji and Xiben in the Gujin Yitong Daquan

Click here to view

Since the 1970s, TCM oncologists from previous generations, such as Yu Guiqing and Piao Bingkui,[11] have conducted a series of studies based on the theory of “strengthening vital qi and consolidating body resistance.” These studies have verified that drugs with the ability to strengthen vital qi can improve patients' physical condition. As research into TCM treatment for this disease continues to deepen, an increasing number of new theories, treatment strategies, and drugs are emerging.

Yu Rencun[12] suggests that selecting methods to supplement qi and consolidate the root, promote blood circulation, and remove blood stasis is appropriate for treating adverse reactions induced by radiotherapy and chemotherapy in the treatment of lung cancer. Liu Jiaxiang[13] argues that TCM physicians should apply treatment principles of disease differentiation and syndrome differentiation, focusing on strengthening the body's resistance and combining it with anticancer measures based on overall and local patient manifestations. In addition, he emphasizes the importance of a flexible selection of yang-warming drugs. Professor Zhou Daihan[14] insists on the treatment method of “harmonizing by warm-natured medicine,” emphasizing the removal of both qi and phlegm. Professor Zhou Zhongying[15] believes that the main pathogenesis of lung cancer involves phlegm stagnation, blood stasis in the lung, and depletion of qi and yin due to toxicity, with the former being the major pathological factor. The disease initially manifests in the lung and progresses to affect the five viscera at later stages.

  The Breakthrough in the Theory of Traditional Chinese Medicine in Lung Cancer Treatment Top

Extensive studies on the etiology and pathogenesis of lung cancer have revealed that although TCM exhibits lower cytotoxicity towards lung cancer tumor cells, it inhibits the formation of tumors rather than directly killing tumor cells. Thus, it is believed that the concept of “strengthening vital qi and nourishing the root” alone fails to fully encompass the advantages and characteristics of TCM in the treatment of malignant tumors.

Professor Lin Hongsheng[16],[17],[18],[19],[20] found that adhering strictly to the theory of “strengthening vital qi and consolidating body resistance” poses challenges in achieving the goal of prolonging survival time for patients with highly malignant lung cancer. Conversely, administering anti-tumor drugs with functions such as phlegm elimination, mass resolution, toxicity removal, and heat-clearing, tailored to patients' physical conditions, can provide adequate time to strengthen healthy qi and achieve equilibrium between yin and yang. Therefore, she proposes that the theory of “consolidating body resistance and eliminating the source” aligns better with the characteristics of TCM in treating malignancies.

“Consolidating body resistance and eliminating the source” emphasizes the protection of the body's “healthy qi” during TCM treatment, thereby improving the immune microenvironment. In addition, TCM therapies rooted in this theory aim to eliminate the pathogenic factors of lung cancer, preventing the development of tumor “toxicity.” Thus, TCM physicians should adopt a comprehensive approach encompassing both offensive and defensive strategies based on the underlying pathogenesis while incorporating the principles of “consolidating body resistance” and “eliminating the source.” In these studies, Professor Lin Hongsheng emphasized the theory of seed and soil, which focuses on the suppression of tumor cells and the improvement of overall immune function. These studies have been confirmed through nearly two decades of collaboration with the National Cancer Center. The theory of “consolidating the resistance and eliminating the source,” which is widely accepted and applied in modern Chinese medicine, plays a major role in the provision of personalized and precise therapies for the treatment of lung cancer [Figure 2].
Figure 2: The history of lung cancer in traditional Chinese medicine

Click here to view

  Clinical Status of Traditional Chinese Medicine in Treating Lung Cancer Top

Guided by the principle of “consolidating the root and eliminating the source,” the TCM treatment of non-small cell lung cancer (NSCLC) categorizes TCM treatment into five stages: Protective therapy, consolidation therapy, maintenance therapy, loading therapy, and TCM syndrome differentiation therapy, collectively referred to as the “five treatments.” Through full-cycle management, TCM treatment for lung cancer enhances effectiveness and reduces toxicity in various areas, including postoperative therapy, chemoradiotherapy, targeted therapy, immunotherapy, late maintenance therapy, and rehabilitation.

Application of traditional Chinese medicine in perioperative lung cancer treatment

Surgical resection is the preferred treatment option for lung cancer. The theory of TCM holds that radical surgery focusing on the removal of tumor cells can easily harm the qi and blood, leading to internal deficiencies. In contrast, TCM is conducive to creating favorable conditions for patients undergoing surgery by regulating yin and yang, tonifying qi and blood, promoting postoperative recovery, preventing postoperative recurrence, and reducing distant metastasis.

Wang et al. conducted a multicenter prospective cohort study to investigate the application of TCM in patients with NSCLC.[21] They found that high exposure to TCM was associated with better DFS. In a subgroup exploratory analysis, TCM therapy was identified as a protective factor against cancer recurrence and metastasis in NSCLC patients post-surgery, with even longer DFS observed in patients treated with TCM. Su et al. recruited patients (TCM intervention group) who underwent NSCLC surgery.[22] They used modified Shengjiang Decoction as the primary formula based on syndrome differentiation. The results showed significant improvements in item scores, including shortness of breath, cough, expectoration, chest tightness, fatigue, susceptibility to cold, loss of appetite, and insomnia compared to the pretreatment scores (P < 0.05 or P < 0.01).

Application of traditional Chinese medicine in chemotherapy for lung cancer

TCM holds an important position in reducing tumor burden and prolonging the survival time of lung cancer patients. Overall, TCM focuses on supplementing qi and blood while regulating yin and yang. This approach not only improves the quality of life for patients but also plays a vital role in enhancing the effectiveness of radiotherapy and chemotherapy, as well as inhibiting recurrence and metastasis.

Zheng conducted a multicenter prospective randomized controlled trial involving patients with advanced NSCLC.[23] The treatment group followed a standardized treatment based on the NCCN guidelines, combined with a comprehensive program that aimed to invigorate the spleen and stomach, nourish qi and blood, and nourish the liver and kidney. In contrast, the control group received only a single treatment based on NCCN guidelines. The results indicated significant differences between the treatment group and the control group in terms of clinical symptoms such as fatigue, loss of appetite, nausea, and vomiting (P < 0.05). Chen et al. discussed the effects of supplementing Sijunzi Decoction in lung cancer patients with qi and yin deficiency syndrome who experienced chemotherapy-related myelosuppression.[24] The control group received the standard chemotherapy regimen (TP), while the observation group was administered supplemented Sijunzi Decoction in addition to the control group treatment. The results revealed that the observation group showed an increase in the number of neutrophils, hemoglobin, platelets, and white blood cells, as well as a lower TCM symptom score compared to the control group (P < 0.01). Ren et al. used the Xuanfu Daizhe Decoction to treat Chemotherapy-induced nausea and vomiting in lung cancer patients.[25] The control group received conventional Western medicine for antiemesis, while the observation group received Xuanfu Daizhe Decoction as well as the control group treatment. The efficiency of Xuanfu Daizhe Decoction in controlling nausea and vomiting was superior to that of the control group.

Application of traditional Chinese medicine in radiotherapy for lung cancer

Exposure to radiation can easily lead to a deficiency of qi and yin in the body. According to TCM, radiation falls under the categories of “heat evil,” “heat toxin,” or “fire evil.” When heat toxin invades the body, it often results in an internal excess of heat toxin and impairment of Jin fluid. The lungs are tender organs and are unable to endure extreme cold and heat; therefore, lung cancer patients undergoing radiotherapy are more susceptible to manifestations of consumption of lung yin and qi. Radiotherapy can easily trigger adverse reactions, including fatigue, loss of appetite, low fever, suppression of hematopoietic function in the bone marrow, radiation pneumonia, and pulmonary fibrosis, cavity formation caused by cancer necrosis and liquefaction, local skin injury, and other complications.

“Erhuang Decoction” spray (composed of Huanglian, Huangbai, and Huzhang) is a cost-effective and user-friendly treatment option. A large-scale and multi-center randomized controlled clinical trial has demonstrated its remarkable efficiency in relieving pain in radiated skin and alleviating related symptoms (including erythema, skin peeling, and edema) of local skin injury.[26] Furthermore, this decoction has shown promising effects on wound healing, TCM clinical symptoms, KPS score, and quality of life score among patients with malignant tumors suffering from radioactive skin injuries.

Application of traditional Chinese medicine in targeted therapy

Targeted therapy is a cellular and molecular-level treatment that involves binding specifically designed drugs to definite oncogenic sites, resulting in the programmed death of tumor cells while leaving normal cells unaffected. At present, targeted therapy for NSCLC can be classified into the following categories: estimated glomerular filtration rate- tyrosine kinase inhibitors (EGFR-TKIs), anaplastic lymphoma kinase inhibitors, and vascular endothelial growth factor (VEGF) inhibitors. However, this approach has disadvantages such as the development of drug resistance and varying degrees of damage to the skin and cardiovascular system due to long-term use. To overcome these challenges, TCM treatment combined with targeted therapy offers several advantages, including enhanced efficacy, reduced toxicity, and the potential to reverse drug resistance to targeted drugs.

Wang et al. conducted a study to evaluate the efficacy of self-designed Rash Particles (Chishao, Shihu, Baixianpi, Fangfeng, Jinyinhua) in the treatment of EGFR-TKI-related rash.[27] A total of 104 patients who developed rashes after oral administration of EGFR-TKI were randomly assigned to either the treatment group or the control group. The treatment group was given self-designed Rash Particles for oral administration, while the control group received a topical silicone oil emulsion. Both groups experienced an improvement in their skin rash, but the treatment group showed greater improvement and faster remission of the rash compared to the control group (P < 0.05). In another prospective randomized controlled study, Shi recruited 70 patients with NSCLC who experienced diarrhea after receiving targeted drugs.[28] The experimental group was treated with TCM Diarrhea Prescription (Huangqi, Qianshi, Qinpi, and Zhike), while the control group was treated with imontarum. By the 14th day, the diarrhea remission rates of the control group and the experimental group reached 76.67% and 81.82%, respectively, indicating a significant difference between the two groups (P = 0.029).

Application of traditional Chinese medicine in immunotherapy

NSCLC has entered the era of immunotherapy with the widespread use of monoclonal antibody programmed cell death protein-1 (PD-1), such as pembrolizumab, nabuliumab, and camrelizumab, in clinical practice. Although the 5-year survival rate of patients significantly improved,[29] various adverse reactions, such as rash, fatigue, immune hypothyroidism, hyperthyroidism, myocarditis, pneumonia, and hepatitis, are frequently observed during or after treatment. The combination of TCM therapy and immunotherapy improves the aggregation of immune effector cells in NSCLC patients, enhances the depletion of immune cells and bypass activation after immunotherapy, and delays the onset of drug resistance, thereby playing a key role in reducing toxicity and enhancing efficacy.[30]

In a study conducted by Chen,[31] patients with advanced lung cancer were recruited and treated with orally administered Chinese herbs known for replenishing qi and removing phlegm, in combination with PD1/PD-L1 therapy. Out of the 84 cases, disease progression was observed in 55 cases, while the remaining 29 cases showed improvement, with a median optimal therapeutic duration of 9.4 months. A total of 36 patients experienced optimized curative effects and 48 patients were considered as truncated data, with a median optimal curative duration of 9.4 months. Moreover, 63 patients discontinued immunotherapy and 21 were considered truncated data, with a median duration of immunotherapy of 9.2 months. Thus, the oral administration of Chinese herbs with qi-replenishing and phlegm-removing functions, in combination with PD1/PD-L1 therapy, demonstrated more ideal therapeutic efficacy and improved survival outcomes.

Application of traditional Chinese medicine maintenance therapy in advanced lung cancer

TCM maintenance therapy enables us to achieve the following objectives: Relieving symptoms, improving quality of life, increasing disease control rate, and prolonging survival. Compared to chemotherapy and targeted therapy, TCM maintenance therapy demonstrates fewer adverse reactions, greater safety and compliance, and a lower economic impact. Therefore, it is recommended as a preferred choice for treating advanced NSCLC.

Liu et al. reported on the efficacy of Feitai Capsule, which consists of Huangqi, Xianhecao, Tiannanxing, Banzhilian, and other ingredients, in advanced NSCLC patients.[32] The results showed that the median progression-free survival of the experimental group and the observation group were 6.23 months and 4.67 months, respectively (P = 0.048). Shao and Chen randomly divided 100 NSCLC patients with stable disease conditions, who responded well to chemotherapy in stages IIIb to IV, into an observation group (taking Compound Banmao Capsules) and a control group (taking a placebo with supportive treatment) to observe the effect of Compound Banmao Capsules.[33] The results demonstrated that the observation group had a higher effective rate than the control group (56% vs. 38%, P < 0.01). The 2- and 3-year survival rates of the observation group were 22.24% and 13.45%, respectively, which were higher compared to 19.65% and 9.53% of the control group (P < 0.01).

Application of traditional Chinese medicine in rehabilitation of lung cancer

During the rehabilitative period, most patients are prone to various problems, such as psychological disorders, dysfunction, nutritional disorders, physical disabilities, and obstacles to reintegrating into society.

Wang et al. conducted a multicenter, large-sample cohort study. The observation group was treated with a comprehensive treatment plan, including herbal decoction based on syndrome differentiation, exercise and psychological care, diet and functional care, and paste formula.[34] The results showed significant improvements in their anxiety and depression. Furthermore, the study aimed to explore the efficacy of a tonic paste formula known for being “gentle in nature and specific in efficacy.” Patients in the treatment group were orally administered Yifei Qinghua Paste on the basis of conventional Western medicine treatment.[35] The treatment group exhibited significant changes in KPS score, body weight, and immune function compared to the control group (P < 0.05 or P < 0.01).

According to TCM, the concept of the “five treatments and five nourishments” is based on the principles of mutual rooting and interdependence. The purpose of the “five nourishments” is to strengthen patients' constitution, thereby creating favorable physical conditions for the “five treatments.” This approach is beneficial in enhancing patients' endurance during treatment and accelerating the rehabilitation process. The “five nourishments” in TCM encompass psychological cultivation, exercise cultivation, diet cultivation, function cultivation, and paste cultivation. By incorporating these aspects into the entire course of rehabilitative treatment, with the principles of the “five nourishments” and “five treatments” for lung cancer, the overall quality of life can be improved, and the prognosis can be enhanced [Figure 3].
Figure 3: Clinical status of traditional Chinese medicine in treating lung cancer

Click here to view

  Microscientific Interpretation of Traditional Chinese Medicine Treatment for Lung Cancer Top

With the constant advancement of modern medicine, TCM, guided by evidence-based, individualized, and standardized approaches, also endeavors to establish a comprehensive evaluation system for the efficacy of lung cancer treatment. The progress made in immunology, genetics, molecular biology, and other fundamental disciplines have opened up possibilities for in-depth research at the cellular, molecular, and genetic levels. TCM therapies have the ability to regulate immune function, as well as adjust biological processes such as cell differentiation, proliferation, adhesion, morphogenesis, and phenotypic expression, thereby improving the inflammatory environment and hindering the progression from inflammation to cancer. Moreover, they can impede tumor cell proliferation, induce tumor cell apoptosis, inhibit tumor angiogenesis, and promote autophagy through comprehensive regulation of multiple channels and targets [Figure 4].
Figure 4: The mechanism of traditional Chinese medicine treatment of lung cancer

Click here to view

Improvement of the body's immunity

The occurrence and progression of lung cancer are closely correlated with a decline in immune surveillance against tumors. TCM is able to boost immunity by strengthening the healthy qi, thereby achieving anticancer effects through an increase in the number or function of tumor-killer cells.

The main component of cinobufotalin is a refined liposoluble substance extracted from dried toad skin using scientific methods.[36],[37],[38],[39] Cinobufagin, which is the bioactive compound found in cinobufotalin, has been proven to have strong anticancer effects. Patients who underwent chemotherapy in combination with cinobufotalin showed a higher proportion of Th17 cells and a lower proportion of Treg cells compared to the control group. This suggests that cinobufotalin has the ability to upregulate interleukin (IL)-17 and downregulate tumor growth factor-β, thereby promoting the anti-tumor function and reducing the tumor immunosuppressive effects of tumors. Zhang et al. discovered that mice with Lewis lung carcinoma had significantly higher levels of IL-10 in their spleens compared to IL-2, resulting in a Th1/Th2 drift.[40] Qiyu Sanlong Decoction (Huangqi, Yuzhu, Tianlong, Dilong, Longkui, Baihua Sheshecao, Yiyiren, Zexi, Ezhu, Chuanbei) could significantly improve the level of Th1 cells. Fang et al. found that mice with Lewis lung cancer tumors had lower spleen lymphocytes proliferation and an increased ratio of CD4+CD25+Treg cells compared to normal mice.[41] Jianpi Jiedu Formula (Shenghuangqi, Dangshen, Fuling, Gancao, Maidong, Shudi, Xianlingpi, Qiyeyizhihua, and honeycomb) exerts its anti-tumor effects by increasing the proliferation of spleen lymphocytes, reducing the ratio of CD4+CD25+Treg cells, and inhibiting tumor growth to some extent in mice.

Inhibition of tumor cell proliferation

Uncontrollable activation of the cell cycle is a characteristic feature of cell hyperproliferation in cancer cells. Following the M phase, cancer cells either reenter the G1 phase or temporarily arrest in the G0 phase. Chinese drugs have the ability to interfere with the cell cycle of tumor cells, thus inhibiting tumor growth.

Liang et al. conducted a study to investigate the effects of a Chinese herbal formula utilizing flow cytometry and Reverse transcription polymerase chain reaction.[42] They observed that Tiaoqi Xiaoji Decoction (Chaihu, Huangqin, Renshen, Banxia, Zhigancao, Shengjiang, Dazao, Tiandong, Shengmuli, Ezhu, Baihua Sheshe Cao) could block the transition from the S phase to the G2/M phase, reduce the proportion of cells in the mitotic phase, and inhibit cell proliferation. Vermenin capsules were found to inhibit the growth of cancer cells, arresting them in the G0 to G1 phases, thus preventing them from entering the S phase for DNA replication and ultimately inhibiting tumor growth.[43]

Induction of tumor cell apoptosis

Cell apoptosis is a physiological process strictly regulated by multiple genes, including Caspase family, Bcl-2 family, and the tumor suppressor gene P53.

It has been reported that platycodon D exhibits the ability to induce apoptosis in lung cancer by regulating the JNK/PUMA pathway.[44],[45],[46],[47] Elemene has been shown to reduce the division of lung cancer A549 cells, impeding their growth in the S phase and facilitating their apoptosis.[48],[49],[50],[51],[52] Furthermore, some Chinese drugs can induce tumor cell apoptosis by modulating the expression of certain proteins in lung cancer. For instance, Baihua Sheshe Cao (Hedyotis Diffusae Herba) injection has been found to induce apoptosis in human lung cancer SPC-A-1 cells, likely through the upregulation of P53 protein expression and the downregulation of Bcl-2 and NF-k B protein expression.[53],[54],[55]

Inhibition of tumor angiogenesis

The increased expression of angiogenic factors in tumors is one of the causes of abnormal hyperplasia of blood vessels in tumor tissue. Therefore, an important approach to tumor treatment is to inhibit tumor angiogenesis by suppressing VEGF.

Kangaike Injection demonstrates anti-tumor effects by inhibiting angiogenesis, invasion, and metastasis, as well as reducing VEGF levels in advanced NSCLC patients, thereby improving their prognosis.[56] Chen et al. compared the effects of four groups of commonly used Chinese medicines with the ability to supplement qi and strengthen the body's resistance (Shenghuanqi, Nvzhenzi), dispel phlegm and eliminate stagnation (Banxia, Tiannanxing), promote blood circulation and remove blood stasis (Ezhu, Yujin), and clear heat and detoxify (Baihua Sheshe Cao, Banzhilian) against Lewis lung cancer and their mechanisms.[57] All four groups of anti-cancer medicines were found to inhibit tumor angiogenesis by inhibiting VEGF and MMP-2, with the detoxifying group showing the strongest suppression of VEGF expression. The combined group exhibited remarkable advantages in reducing MMP-2 expression levels and improving the expression of ES.


One of the main mechanisms of TCM's anti-tumor action is its regulation of the autophagy process. Autophagy, a process of cellular self-degradation, plays essential homeostatic roles. However, continuous and excessive autophagy inhibits tumor development.[58]

Honokiol can induce autophagy and apoptosis of tumor cells by regulating the AMPK-m TOR signaling pathway.[59],[60],[61],[62],[63] Psoralen has the ability to induce autophagy and inhibit the proliferation of A549 cells by generating reactive oxygen species.[64],[65] Matrine has gained attention in recent years. LC3-II, which is located on the surface of preautophagic vesicles and autophagic vesicles, serves as a specific marker of autophagy vesicles. The use of native compounds of matrine significantly increases the levels of LC3-II protein, thereby inducing autophagy in lung cancer A549 cells [Table 1].[66],[67],[68],[69],[70]
Table 1: The mechanism of traditional Chinese medicine treatment of lung cancer

Click here to view

  Prospect of Traditional Chinese Medicine in Treating Lung Cancer Top

An increasing number of studies has been put forward regarding the theory of TCM in the prevention and treatment of lung cancer.

Li Jie discussed the occurrence, development, and metastasis of tumors using the concept of “yin and yang.”[71] Guided by the theory of “yang transforming qi and yin forming the shape,” it is appropriate to distinguish the waxing and waning of yin and yang in the body and the tumor, dissipating the yin and inhibiting the yang of the tumor. Cheng Haibo proposes three key points of pathogenesis differentiation for cancer toxin.[72] First, it is important to distinguish the pathogenic characteristics of cancer toxin. Second, differentiation of nonspecific pathogenic factors, including depression, wind, cold, heat, dampness, phlegm, and blood stasis is necessary. Finally, he suggests that the basic pathogenesis of malignancy is “the accumulation of evil toxin and deficiency of healthy qi.” Hua Baojin proposes the concept of regulating qi and detoxifying cancer to prevent and treat cancer.[73] He considers that the core pathogenesis of cancer is the disorder of qi activity and the internal accumulation of toxins, and that clinical treatments should follow the principles of syndrome differentiation and disease differentiation in combination.

In terms of clinical practice in the prevention and treatment of lung cancer using TCM, relevant experts, and scholars in this field across China have organized to formulate the Guidelines for TCM Diagnosis and Treatment of Malignant Tumors.[74] These guidelines include a mature, principled, and standardized system for TCM diagnosis and treatment in current clinical practice, along with recommendations for physicians based on international standards for grading evidence in evidence-based medicine.

In 2021, the China Association of Integrated Traditional and Western Medicine released Expert Consensus on the Diagnosis and Treatment of Lung Cancer by Integrated Traditional Chinese and Western Medicine. In recent years, a series of high-level evidence-based medical studies have been conducted on TCM treatment for lung cancer, proving its unique advantages in reducing the toxic and side effects caused by radiotherapy and chemotherapy, relieving clinical symptoms, and enhancing the quality of life. We anticipate the emergence of more large-scale, multi-centered, and high-quality clinical studies on international platforms to establish TCM treatment as an international consensus in this field. Furthermore, the establishment of an internationally recognized evaluation system for the efficacy of TCM in the prevention and treatment of lung cancer is crucial.

In terms of the basic research on the prevention and treatment of lung cancer using TCM, the development of network pharmacology, bioinformatics, and artificial intelligence provides opportunities to elucidate the essence and scope of TCM theory in lung cancer prevention and treatment. This advancement also enables the exploration of the underlying micro-mechanisms of the “inflammation-cancer transformation” chain.[75],[76],[77],[78],[79] By screening large biological samples and studying multiple pathways and targets, we can identify common biological characteristics in the dominant population and regulate the signaling pathway of lung cancer. This contributes to further improvements in the efficacy of TCM in preventing and treating lung cancer.[80],[81],[82],[83],[84]

Moreover, conducting in-depth studies on genomics, proteomics, and metabolomics allows us to observe changes in the type, quantity, and spatial structure of proteins during tumor occurrence and development. These comprehensive, dynamic, and quantitative approaches will also help regulate the homeostasis of the internal environment and differential metabolites. Such studies not only help in revealing the pathogenesis of malignant tumors but also assist in identifying tumor markers for early clinical diagnosis and new therapeutic targets.

  Conclusion Top

Through the dedicated efforts of Chinese physicians across four generations, TCM has made remarkable progress in the field of lung cancer prevention and treatment over the course of 30 years. A series of large-scale, multi-centered clinical studies have demonstrated that TCM comprehensive treatment greatly improves the clinical efficacy of lung cancer treatments. The TCM treatment system for NSCLC, which is based on the staged and standardized integration of TCM and Western medicine, has been well-developed and widely adopted in practice. Before this, no systematic approach for the prevention and treatment of lung cancer had been established as a treatment guideline. Furthermore, through the international cooperation platform established by the NCI of the United States, the scientific connotation of TCM in the prevention and treatment of lung cancer has been systematically and comprehensively studied, thereby promoting the research and development of new Chinese drugs for lung cancer. In addition, TCM, guided by the principles of cultural inheritance and innovation, has gained public recognition and international awareness. Nowadays, TCM is undergoing a process of modernization and has evolved into an evidence-based therapy rather than merely an alternative medicine. It has achieved a major breakthrough in the treatment of lung cancer, benefiting patients with this condition worldwide.

Consent for publication

The authors all consent to the publication of this paper.

Availability of data and materials

All data and materials generated and analyzed during the present study are available from the corresponding author on reasonable request.

Authors' contributions

Chu-Chu Zhang designed the study. Jie Liu performed the review. Hong-Shen Lin provided research guidance. Pei-Ying Yang conducted data analysis. Ying Zhang and Su-Ying Liu contributed to writing assistance and proofreading the manuscript. All authors contributed to the article and approved the submitted version.

Financial support and sponsorship

This work was supported by the Fundamental Research Funds for the Central public welfare research institutes (No. 2020YJSZX-3).

Conflicts of interest

There are no conflicts of interest.

  References Top

Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2023. CA Cancer J Clin 2023;73:17-48.  Back to cited text no. 1
Xu ZY. Evidence-based medicine and treatment of lung cancer. Zhong Xi Yi Jie He Xue Bao 2003;1:151-4.  Back to cited text no. 2
Chen YY, Yu MW, Liu ZS, Zhang Y, Li QW, Yang GW. Effects of traditional Chinese medicine combined with chemotherapy for extensive-stage small-cell lung cancer patients on improving oncologic survival: Study protocol of a multicenter, randomized, single-blind, placebo-controlled trial. Trials 2021;22:437.  Back to cited text no. 3
Li X, Yang GY, Li XX, Zhang Y, Yang JL, Chang J, et al. Traditional Chinese medicine in cancer care: A review of controlled clinical studies published in chinese. PLoS One 2013;8:e60338.  Back to cited text no. 4
Li Y, Xiong C, Qin EQ, Yu Z, Li L, Zhuang GT. Effectiveness of traditional Chinese medicine on chemo-radiotherapy induced leukaemia in patients with lung cancer: A meta-analysis. J Tradit Chin Med 2018;38:661-7.  Back to cited text no. 5
Yang JN, Zhu XM, Yuan PP, Liu JP, Wang B, Wang GQ. Efficacy of traditional Chinese medicine combined with chemotherapy in patients with non-small cell lung cancer (NSCLC): A meta-analysis of randomized clinical trials. Support Care Cancer 2020;28:3571-9.  Back to cited text no. 6
Chen ST, Zhang ZH, Zhang XW, Qi RZ, Jiang JL, Zhang X, et al. TCM therapies combined with chemotherapy for preventing recurrence and metastasis in postoperative II to IIIA NSCLC: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2019;98:e14724.  Back to cited text no. 7
Xu L, Li HG, Xu ZY, Wang ZQ, Liu LS, Tian JH, et al. Multi-center randomized double-blind controlled clinical study of chemotherapy combined with or without traditional Chinese medicine on quality of life of postoperative non-small cell lung cancer patients. BMC Complement Altern Med 2012;12:112.  Back to cited text no. 8
Lin JT, Yang T, Chen WM, Qi XJ, Cao Y, Zheng XT, et al. Zhengyuan capsules for the treatment of chemotherapy-induced cancer-related fatigue in stage IIIB-IV unresectable NSCLC: Study protocol for a randomized, multi-center, double-blind, placebo-controlled clinical trial. J Thorac Dis 2022;14:4560-70.  Back to cited text no. 9
Luo B, Yang M, Han ZX, Que ZJ, Luo TL, Tian JH. Establishment of a nomogram-based prognostic model (LASSO-COX regression) for predicting progression-free survival of primary non-small cell lung cancer patients treated with adjuvant Chinese herbal medicines therapy: A retrospective study of case series. Front Oncol 2022;12:882278.  Back to cited text no. 10
Zheng HG, Hua BJ, Piao BK. Practitioner Piao Bingkui's academic idea on treatment of lung cancer with differentiation of symptoms. Beijing J Tradit Chin Med 2007;05:273-5.  Back to cited text no. 11
Liang SS, Zhang Y, Zhang Q. Professor Yu Renqun's experience in the treatment of non-small cell lung cancer. Acta Chin Med 2018;33:200-3.  Back to cited text no. 12
Sun G. Characteristics of Liu Jiaxiang's differential treatment of lung cancer. J Tradit Chin Med 2000;02:75-6.  Back to cited text no. 13
Wang XW, Lin L, Li PH, He F, Zhou DH. Discussion on Zhou Daihan's TCM academic thought in diagnosis and treatment of tumors. J Guangzhou Univ Tradit Chin Med 2015;32:762-4.  Back to cited text no. 14
Cheng HB, Wu MH. Discussion on academic thought of Professor Zhou Zhong-Ying about cancerous toxin. J Tradit Chin Med 2010;25:866-9.  Back to cited text no. 15
Lin H, Liu J, Zhang Y. Developments in cancer prevention and treatment using traditional Chinese medicine. Front Med 2011;5:127-33.  Back to cited text no. 16
Liu J, Mao JJ, Wang XS, Lin HS. Evaluation of traditional Chinese medicine herbs in oncology clinical trials. Cancer J 2019;25:367-71.  Back to cited text no. 17
Guo QJ, Li J, Lin HS. Effect and molecular mechanisms of traditional Chinese medicine on regulating tumor immunosuppressive microenvironment. Biomed Res Int 2015;2015:261620.  Back to cited text no. 18
Jia LB, Lin HS, Fan HT, Oppenheim J, Howard OM, Li J, Fan H, et al. US national cancer institute-China collaborative studies on Chinese medicine and cancer. J Natl Cancer Inst Monogr 2017;2017:lgx 007.  Back to cited text no. 19
Li J, Lin HS, Hou W, Zhang PT, Hua BJ. Development and current status of national cancer center for Chinese medicine. Chin J Integr Med 2011;17:478-80.  Back to cited text no. 20
Wang XQ, Zhang Y, Hou W, Wang YT, Zheng JB, Li J, et al. Association between Chinese medicine therapy and survival outcomes in postoperative patients with NSCLC: A multicenter, prospective, cohort study. Chin J Integr Med 2019;25:812-9.  Back to cited text no. 21
Su CY, Zhu GH, Li J. The distribution of symptoms in patients with non-small cell lung cancer after surgery and the intervention effect of modified Shengxian decoction. J Tradit Chin Med 2020;61:601-6.  Back to cited text no. 22
Zheng JB. A randomized controlled study of a combination of traditional Chinese medicine combined with chemotherapy in the treatment of advanced non-small cell lung cancer. Beijing University of Chinese Medicine; 2017;26.  Back to cited text no. 23
Chen JJ, Hu LJ, Zhang GY. Effect of Sijunzi decoction on bone marrow suppression of lung cancer in chemotherapy. Chin J Exp Tradit Med Formulae 2018;24:180-5.  Back to cited text no. 24
Renl LP, Lu LS, Hua HJ, Hua Y, Chen WJ. Clinical observation of cyclopedic ochre decoction in the prevention and treatment of nausea and vomiting caused by cisplatin-containing chemotherapy regimen in lung cancer. J Clin Ration Drug Use 2018;11:56-57.  Back to cited text no. 25
Qian HL. Clinical research on the efficacy of Erhuang Decoction in treating radiation-induced skin damage. China Academy of Chinese Medical Sciences; 2015;43.  Back to cited text no. 26
Wang XQ, Zhang Y, Liu J, Liu ZY, Shi H, Zheng JL, et al. A randomized controlled study of self-mimicking rash granules in treating EGFR-TKI associated rashes. World J Integr Tradit West Med 2016;11:1629-32, 49.  Back to cited text no. 27
Shi H. Clinical study of traditional Chinese medicine intervention in targeted therapy associated diarrhea for non-small cell lung cancer. Beijing University of Chinese Medicine; 2016;72.  Back to cited text no. 28
Borghaei H, Gettinger S, Vokes EE, Chow LQ, Burgio MA, de Castro Carpeno J, et al. Five-year outcomes from the randomized, phase III trials checkmate 017 and 057: Nivolumab versus docetaxel in previously treated non-small-cell lung cancer. J Clin Oncol 2021;39:723-33.  Back to cited text no. 29
Yang HX, Lin LZ. Research progress of traditional Chinese medicine in regulating immunotherapy for lung cancer. Her Med 2022;41:853-7.  Back to cited text no. 30
Chen ZQ. Based on literature and real world studies, the study on the clinical efficacy of the traditional Chinese medicine for Yiqi Qutan Prescription combined with PD1/PD-L1 monoclonal antibody in the treatment of advanced lung cancer. Guangzhou University of Chinese Medicine; 2021;97.  Back to cited text no. 31
Liu ZZ, Yu ZY, Ou-Yang XN, Dai XH, Chen X, Zhao ZQ, et al. Effect of maintenance therapy with feitai capsules in patients with advanced non-small cell lung cancer. Chin Clin Oncolol 2009;14:344-6.  Back to cited text no. 32
Shao HY, Chen JF. Prospective study on effect of compound cantharis capsule for maintaining treatment of advanced lung cancer. Chin Arch Tradit Chin Med 2014;32:686-8.  Back to cited text no. 33
Wang XQ, Zheng JB, Guan L, Cheng QW, Yuan JM, Lin HS. Clinical study on intervention of comprehensive treatment of traditional Chinese medicine on quality of life and psychological state of postoperative patients with lung cancer. World Chin Med 2020;15:450-3, 8.  Back to cited text no. 34
Li DR, Hua BJ, Zhang PT, Xiong L, Liu H, Lin HS, et al. Multicenter randomized controlled trial on adjuvant therapy of Yifei Qinghua soft extract in the treatment of postoperative patients with non-small cell lung cancer. J Tradit Chin Med 2016;57:396-400.  Back to cited text no. 35
Gao P, Lu YS, Wu L, Luan Y, Ding MM, Zhang XD, et al. Effect of cinobufotalin on the T helper cells 17 and regulatory T cells and the related factors of patients with lung cancer. Chin J Clin Pharm 2016;32:871-3.  Back to cited text no. 36
Zhang F, Yin Y, Xu T. Cinobufotalin injection combined with chemotherapy for the treatment of advanced NSCLC in China: A PRISMA-compliant meta-analysis of 29 randomized controlled trials. Medicine (Baltimore) 2019;98:e16969.  Back to cited text no. 37
Kai S, Lu JH, Hui PP, Zhao H. Pre-clinical evaluation of cinobufotalin as a potential anti-lung cancer agent. Biochem Biophys Res Commun 2014;452:768-74.  Back to cited text no. 38
Huang JM, Deng CJ, Guo TS, Chen XF, Chen PX, Du SS, et al. Cinobufotalin induces ferroptosis to suppress lung cancer cell growth by lncRNA LINC00597/hsa-miR-367-3p/TFRC pathway via resibufogenin. Anticancer Agents Med Chem 2023;23:717-25.  Back to cited text no. 39
Zhang XX, Tong JB, Yang C, Wang CB, Li ZG. Effect of Qiyu Sanlong decoction on balancing Th1/Th2 drift in mice with lung cancer. Chin J Exp Tradit Med Formulae 2016;22:131-6.  Back to cited text no. 40
Fang MH, Li MH, Li M. Effect of Jianpi Jiedu recipe on immunological regulation of spleen CD4+CD25+treg cells of Lewis lung carcinoma-bearing mice. J Sichuan Tradit Chin Med 2015;33:58-61.  Back to cited text no. 41
Liang LL, Chen SN, Song HY, Zhang B. The effect of tumor-associated genes expression of human lung adenocarcinoma A549 cells treated with Tiaoqixiaoji decoction. J Mod Oncol 2016;24:3345-8.  Back to cited text no. 42
Lou JL, Qiu QY, He XJ, Lin HS, Fei YX, Qi X. Influence of weimaining on the cell cycle of murine Lewis lung carcinoma. J Beijing Univ Tradit Chin Med 2004;02:41-4.  Back to cited text no. 43
Chen ST. Study on the mechanism of non-small cell lung cancer apoptosis induced by bellflower saponin D based on the JNK/PUMA pathway. Beijing University of Chinese Medicine; 2021;56.  Back to cited text no. 44
Li JR, Ma AP, Lan WB, Liu Q. Platycodon D-induced A549 cell apoptosis through RRM1-regulated p53/VEGF/MMP2 pathway. Anticancer Agents Med Chem 2022;22:2458-67.  Back to cited text no. 45
Huang MY, Jiang XM, Xu YL, Yuan LW, Chen YC, Cui G, et al. Platycodin D triggers the extracellular release of programed death Ligand-1 in lung cancer cells. Food Chem Toxicol 2019;131:110537.  Back to cited text no. 46
Seo YS, Kang OH, Kong R, Zhou T, Kim SA, Ryu S, et al. Polygalacin D induces apoptosis and cell cycle arrest via the PI3K/Akt pathway in non-small cell lung cancer. Oncol Rep 2018;39:1702-10.  Back to cited text no. 47
Xu L, Liu D, Yan D, Li HY, Cheng ZZ. A dose- and time-dependent study of the apoptotic effect of elemiene in lung cancer A549 cells. Chin J Mod Drug Appl 2009;3:136-7.  Back to cited text no. 48
Gong Z, Liu ZG, Du KY, Wu JH, Yang N, Malhotra A, et al. Potential of β-elemene induced ferroptosis through Pole2-mediated p53 and PI3K/AKT signaling in lung cancer cells. Chem Biol Interact 2022;365:110088.  Back to cited text no. 49
Zou K, Li ZJ, Zhang Y, Mu L, Chen M, Wang RN, et al. β-Elemene enhances radiosensitivity in non-small-cell lung cancer by inhibiting epithelial-mesenchymal transition and cancer stem cell traits via Prx-1/NF-kB/iNOS signaling pathway. Aging (Albany NY) 2020;13:2575-92.  Back to cited text no. 50
Wu ZB, Wang T, Zhang YM, Zheng ZS, Yu SH, Jing SS, et al. Anticancer effects of β-elemene with hyperthermia in lung cancer cells. Exp Ther Med 2017;13:3153-7.  Back to cited text no. 51
Li JY, Yu J, Liu A, Wang YL. β-Elemene against human lung cancer via up-regulation of P53 protein expression to promote the release of exosome. Lung Cancer. 2014;86:144-50.  Back to cited text no. 52
Wei X, Wang FS, Tu S, Yu LH, Yang XS. Study on apoptosis-inducing effect of Hedyotis diffusa willd (HDI) injection and its molecular mechanism on human lung cancer SPC-A-1 cells. Chin J Gerontol 2007;02:110-2.  Back to cited text no. 53
Su X, Li YP, Jiang M, Zhu JL, Zheng CL, Chen XT, et al. Systems pharmacology uncover the mechanism of anti-non-small cell lung cancer for Hedyotis diffusa Willd. Biomed Pharmacother 2019;109:969-84.  Back to cited text no. 54
Tan JN, Li L, Shi WJ, Sun DD, Xu CL, Miao YJ, et al. Protective effect of 2-hydroxymethyl anthraquinone from Hedyotis diffusa Willd in lipopolysaccharide-induced acute lung injury mediated by TLR4-NF-κB pathway. Inflammation 2018;41:2136-8.  Back to cited text no. 55
Zhang MC, Zhao ZW, Zeng J, Liu ZH. Intervention effects of adjuvant chemotherapy combined with Kang'ai injection on expression of serum VEGF in patients with advanced non-small cell lung cancer. Canc Res Prev Treat 2011;38:545-7.  Back to cited text no. 56
Chen HB. A comparative mechanisms study in Lewis lung carcinoma-bearing micetreated with four sets of frequently-used anti-carcinogenesis TCM. Chinese People's Liberation Army (PLA) Medical School; 2014;23.  Back to cited text no. 57
Huang Z, Zhou L, Chen Z, Nice EC, Huang C. Stress management by autophagy: Implications for chemoresistance. Int J Cancer 2016;139:23-32.  Back to cited text no. 58
Luo LX, Li Y, Liu ZQ, Fan XX, Duan FG, Li RZ, et al. Honokiol induces apoptosis, G1 arrest, and autophagy in KRAS mutant lung cancer cells. Front Pharmacol 2017;8:199.  Back to cited text no. 59
Zhu JF, Xu SN, Gao WL, Feng JY, Zhao GL. Honokiol induces endoplasmic reticulum stress-mediated apoptosis in human lung cancer cells. Life Sci 2019;221:204-11.  Back to cited text no. 60
Qi MM, Chen XJ, Bian LQ, Zhang H, Ma J. Honokiol combined with curcumin sensitizes multidrug-resistant human lung adenocarcinoma A549/DDP cells to cisplatin. Exp Ther Med 2021;22:1301.  Back to cited text no. 61
Pan J, Lee Y, Zhang Q, Xiong DH, Wan TC, Wang Y, et al. Honokiol decreases lung cancer metastasis through inhibition of the STAT3 signaling pathway. Cancer Prev Res (Phila) 2017;10:133-41.  Back to cited text no. 62
Singh T, Katiyar SK. Honokiol inhibits non-small cell lung cancer cell migration by targeting PGE2-mediated activation of β-catenin signaling. PLoS One 2013;8:e60749.  Back to cited text no. 63
Hao WH, Zhang XN, Zhao WW, Chen XP. Psoralidin induces autophagy through ROS generation which inhibits the proliferation of human lung cancer A549 cells. PeerJ 2014;2:e555.  Back to cited text no. 64
Hsieh MJ, Chen MK, Yu YY, Sheu GT, Chiou HL. Psoralen reverses docetaxel-induced multidrug resistance in A549/D16 human lung cancer cells lines. Phytomedicine 2014;21:970-7.  Back to cited text no. 65
Zhou XF, Li F, Fang H, Xu JD, Li YY, Tang XL, et al. Effects of matrine on proliferation and autophagy in human non-small cell lung cancer A549 cells. Chin Archi Tradit Chin Med 2017;35:474-7, 528-9.  Back to cited text no. 66
Zhao B, Hui XD, Wang J, Zeng HR, Yan Y, Hu Q, et al. Matrine suppresses lung cancer metastasis via targeting M2-like tumour-associated-macrophages polarization. Am J Cancer Res 2021;11:4308-28.  Back to cited text no. 67
Yong JP, Wu XY, Lu CZ. Anticancer Advances of Matrine and Its Derivatives. Curr Pharm Des 2015;21:3673-80.  Back to cited text no. 68
Xie W, Lu JJ, Lu QC, Wang X, Long HH, Huang JH, et al. Matrine inhibits the proliferation and migration of lung cancer cells through regulation of the protein kinase B/glycogen synthase kinase-3β signaling pathways. Exp Ther Med 2018;16:723-9.  Back to cited text no. 69
Zhu H, Lu Q, Lu Q, Shen X, Yu L. Matrine regulates proliferation, apoptosis, cell cycle, migration, and invasion of non-small cell lung cancer cells through the circFUT8/miR-944/YES1 Axis. Cancer Manag Res 2021;13:3429-42.  Back to cited text no. 70
Xu BW, Li J, Gao RK, Zhu GH, Wu J. On the treatment of tumor in traditional Chinese medicine based on the theory of yang transforming Qi, Yin shaping up body. J Tradit Chin Med 2020;61:315-8.  Back to cited text no. 71
Cheng HB, Li L, Sheng WX, Wang JY, Wu MH, Zhou ZY. System construction for the syndrome differentiation and treatment of cancer toxin. J Nanjing Univ Tradit Chin Med 2022,38:559-4.  Back to cited text no. 72
Zheng HG, Hou W, Hua BJ. The academic connotation of regulating Qi and resolving toxins method and its application in prevention and treatment of tumors. J Tradit Chin Med 2022;63:2023-8, 36.  Back to cited text no. 73
Lin HS, Liu J, Zhang Y. The connotation and significance of guidelines for TCM diagnosis and treatment of malignant tumors. Chin J Clin Oncol Rehab 2016;23:257-60.  Back to cited text no. 74
Lv JY, Liu JG, Chao GQ, Zhang S. PARs in the inflammation-cancer transformation of CRC. Clin Transl Oncol 2023;25:1242-51.  Back to cited text no. 75
Sohrab SS, Raj R, Nagar A, Hawthorne S, Paiva-Santos AC, Kamal MA, et al. Chronic Inflammation's Transformation to Cancer: A Nanotherapeutic Paradigm. Molecules 2023;28:4413.  Back to cited text no. 76
Whitehouse S, Chen PL, Greenshields AL, Nightingale M, Hoskin DW, Bedard K. Resveratrol, piperine and apigenin differ in their NADPH-oxidase inhibitory and reactive oxygen species-scavenging properties. Phytomedicine 2016;23:1494-503.  Back to cited text no. 77
Olaru AV, Selaru FM, Mori Y, Vazquez C, David S, Paun B, et al. Dynamic changes in the expression of MicroRNA-31 during inflammatory bowel disease-associated neoplastic transformation. Inflamm Bowel Dis 2011;17:221-31.  Back to cited text no. 78
Liao WH, Wen YQ, Wang J, Zhao MY, Lv SB, Chen NZ, et al. Gallic acid alleviates gastric precancerous lesions through inhibition of epithelial mesenchymal transition via Wnt/β-catenin signaling pathway. J Ethnopharmacol 2023;302:115885.  Back to cited text no. 79
Yang YD, An R, Feng T, Qin XF, Zhang J, Bo YL, et al. Skullcapflavone I suppresses proliferation of human lung cancer cells via down-regulating microRNA-21. Exp Mol Pathol 2019;110:104285.  Back to cited text no. 80
Wang M, Tang WH, Gong NJ, Liu PJ. Sodium Danshensu inhibits the progression of lung cancer by regulating PI3K/Akt signaling pathway. Drug Dev Res 2022;83:88-96.  Back to cited text no. 81
Zhang T, Li SM, Li YN, Cao JL, Xue H, Wang C, et al. Atractylodin induces apoptosis and inhibits the migration of A549 lung cancer cells by regulating ROS-mediated signaling pathways. Molecules 2022;27:2946.  Back to cited text no. 82
Zhang SL, Liu N, Ma MX, Huang H, Handley M, Bai XL, et al. Methionine enkephalin (MENK) suppresses lung cancer by regulating the Bcl-2/Bax/caspase-3 signaling pathway and enhancing natural killer cell-driven tumor immunity. Int Immunopharmacol 2021;98:107837.  Back to cited text no. 83
Cao B, Lin JZ, Wu ZF, Liu HM, Zhang DK, Xu H, et al. Mechanisms exploration of Xiaojin pills on lung cancer based on metabolomics and network pharmacology. J Pharm Pharmacol 2021;73:1071-9.  Back to cited text no. 84


  [Figure 1], [Figure 2], [Figure 3], [Figure 4]

  [Table 1]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
The History of T...
The Breakthrough...
Clinical Status ...
Microscientific ...
Prospect of Trad...
Article Figures
Article Tables

 Article Access Statistics
    PDF Downloaded31    
    Comments [Add]    

Recommend this journal