肺结节发病机制及中医药治疗研究进展

肺结节（PN）发病机制复杂，当前基础已经取得一定进展，本文从炎症与感染修复、肿瘤发生、免疫应答，以及遗传与环境交互四大机制层面展开综述，重点对PN发生与癌变机制展开分析，介绍当前比较热点的研究方向与成果，如Ninj1抑制、缺氧微环境、代谢重编程等。从常见治法角度，系统性总结了中药复方治疗PN疗效，以及可能涉及的靶点和与其所对应的分子、通路，为临床不同情境下的应用提供参考。通过以上综述得出结论，中医药能够有效改善PN患者症状，降低PN恶性概率，作用途径可能通过PI3K/AKT、MAPK、HIF-1、NF-κB、JAK/STAT等通路发挥抗炎、抑制血管生成、阻抑细胞增殖与促进凋亡的多靶作用，体现出复方整体调节的优势。根据当今研究成果与不足，文章也提出了一些建设性发展意见，未来还需更多的努力揭示PN发生机制和中医药治疗PN可解释的作用机制，推动中医药在PN全程管理中的规范化应用，从而降低肺癌发生率并改善患者预后与生活质量。

The pathogenesis of pulmonary nodules (PN) is complex, with current foundational research having achieved certain progress. This review examines four key mechanisms: inflammation and infection repair, tumourigenesis, immune responses, and genetic-environmental interactions. It focuses on analysing the mechanisms underlying PN development and malignant transformation, introducing prominent research directions and findings such as Ninj1 inhibition, hypoxic microenvironments, and metabolic reprogramming. From the perspective of common therapeutic approaches, this review systematically summarises the efficacy of traditional Chinese medicine (TCM) compound formulations in treating PN, along with potential target molecules and pathways involved. This provides reference for clinical application in diverse scenarios. The review concludes that TCM effectively alleviates symptoms in PN patients and reduces malignant progression probability. Its mechanisms likely involve multi-target effects through pathways including PI3K/AKT, MAPK, HIF-1, NF-κB, and JAK/STAT, exerting anti-inflammatory, anti-angiogenic, anti-proliferative, and pro-apoptotic actions. This demonstrates the holistic regulatory advantages of TCM formulas. Given current research achievements and limitations, the article proposes constructive developmental suggestions. Future endeavours should focus on elucidating the pathogenesis of PN and the action mechanisms underlying TCM treatment for PN. This will advance the standardised application of TCM throughout the PN management continuum, thereby reducing lung cancer incidence and improving patient prognosis and quality of life.