Advances in Research on Subsolid Pulmonary Nodules in Traditional Chinese and Western Medicine

近几年的肺结节检出率因影像学技术的提高和国民健康意识的提高而快速增长，现代医学对肺结节的治病遵循随访观察、外科手术的原则，而亚实性肺结节恶性风险高但进展缓慢，受到越来越多的重视，影像学随访频繁，可能使患者焦虑加重，导致诊疗过度，而根治性手术的过早实施，也可能会造成介入过度。在此临床决策困境下，中医药散结展现出独特的临床优势，患者趋向于中医疗法。在中医治疗肺结节方面，各家都有多年的临床经验和独到的见解，亚实性肺结节通常被认为是以正气亏虚为本虚，以气滞、痰凝、血瘀、毒聚等为其标实，在治疗上需要根据证型辨证论治标本兼治，以化痰散结、活血通络、行气祛湿、通阳散结等治其标实，在扶助正气治疗本虚的基础上治疗肺结节。In recent years, the detection rate of pulmonary nodules has surged significantly due to advancements in imaging technology and heightened public health awareness. Modern medicine typically manages pulmonary nodules through follow-up observation and surgical intervention. However, subsolid pulmonary nodules, which carry a high malignant risk yet progress slowly, have garnered increasing attention. Frequent imaging follow-ups may exacerbate patient anxiety, leading to overdiagnosis, while premature radical surgery risks excessive intervention. Amidst this clinical dilemma, Traditional Chinese Medicine has demonstrated unique advantages in nodule-resolving therapies, with growing patient preference for TCM approaches. In TCM practice, subsolid pulmonary nodules are generally conceptualized as rooted in deficiency of vital Qi, with surface manifestations such as Qi stagnation, phlegm coagulation, blood stasis, and toxin accumulation. Treatment emphasizes syndrome differentiation and holistic management, targeting both the root (reinforcing vital Qi) and the manifestations (resolving phlegm, dispelling stasis, regulating Qi, eliminating dampness, and dispersing nodules). Therapies like phlegm-dissolving, stasis-removing, Qi-activating, and Yang-unblocking methods are employed to address surface pathologies, while concurrently strengthening the body’s foundational vitality to treat pulmonary nodules comprehensively.