Comprehensive evidence from the Shanghai University of Traditional Chinese Medicine demonstrates that integrative protocols combining acupuncture and multi-herbal therapy with chemotherapy significantly improve survival quality, immune modulation, and tumor control in patients with non-small-cell lung cancer (NSCLC).[1] A meta-analysis of randomized trials revealed consistent increases in objective response rate (ORR), Karnofsky Performance Status (KPS), and T-cell ratios when traditional Chinese medicine (TCM) modalities supplemented standard oncologic regimens.[1–3]
Among oral preparations, Jin Fu Kang (金复康) is one of the most studied for the Qi–Yin deficiency pattern common in advanced NSCLC.[4] It contains Huáng Qí (黄芪 Astragalus membranaceus), Běi Shā Shēn (北沙参 Glehnia littoralis), Tiān Dōng (天冬 Asparagus cochinchinensis), Nǚ Zhēn Zǐ (女贞子 Ligustrum lucidum), Juǎn Bǎi (卷柏 Selaginella tamariscina), Chóng Lóu (重楼 Paris polyphylla), Yín Yáng Huò (淫羊藿 Epimedium brevicornum), Jiǎo Gǔ Lán (绞股蓝 Gynostemma pentaphyllum), Shān Zhū Yú (山茱萸 Cornus officinalis), Shí Jiàn Chuān (石见穿 Salvia chinensis), Mài Dōng (麦冬 Ophiopogon japonicus), and Hú Lú Bā (葫芦巴 Trigonella foenum-graecum).[5] It is administered orally (20 mL twice daily for six weeks) to improve fatigue, appetite, and respiratory function. Biomolecular analysis showed activation of caspase-3 and p53 pathways, inhibition of VEGF and HIF-1α, and normalization of cytokines (↑ IL-2, IFN-γ; ↓ IL-10, TGF-β₁), correlating with reduced angiogenesis and enhanced apoptosis.[6] In clinical cohorts, Jin Fu Kang reduced leukopenia incidence and improved mean KPS by >10 points compared with chemotherapy alone.[7]
Yi Qi Qing Du Fang (益气清毒方, Codonopsis-based formula) combines Dǎng Shēn (党参 Codonopsis pilosula), Bái Zhú (白术 Atractylodes macrocephala), Fú Líng (茯苓 Poria cocos), Huáng Qí (黄芪 Astragalus membranaceus), Bàn Zhī Lián (半枝莲 Scutellaria barbata), Bái Huā Shé Shé Cǎo (白花蛇舌草 Hedyotis diffusa), and Chóng Lóu (Paris polyphylla).[8] Administered as a 200 mL decoction twice daily for 90 days, it elevates Th1 cytokines (IL-2, IFN-γ), suppresses TGF-β₁ and IL-10, and promotes tumor-cell apoptosis through Bax/Bcl-2 modulation.[9] Clinically, this formula reduced inflammatory C-reactive protein and improved median survival time. The therapeutic principle (益气解毒 yì qì jiě dú – augment Qi and eliminate toxicity) targets Qi deficiency with internal toxin accumulation typical of advanced disease.[10]
Fei Yan Ning (肺炎宁, composite immune-restorative formula), developed at Longhua Hospital (SUTCM), integrates Huáng Qí (Astragalus membranaceus), Líng Zhī (Ganoderma lucidum), Huáng Jīng (黄精 Polygonatum sibiricum), Nǚ Zhēn Zǐ (Ligustrum lucidum), Yín Yáng Huò (Epimedium brevicornum), Shān Zhū Yú (Cornus officinalis), and Shí Jiàn Chuān (Salvia chinensis).[11] Taken as granules three times daily for six weeks, this formula suppresses PI3K/AKT signaling and MMP-2/9 expression while restoring mitochondrial cytochrome-c and caspase activity.[12] CT follow-up showed measurable tumor-volume reduction, and patients reported improved appetite, reduced dyspnea, and higher KPS scores.[13]
The herbal therapies are frequently integrated with standardized acupuncture prescriptions designed to regulate Lung Qi, enhance immunity, and mitigate chemotherapy-induced fatigue.[14] Commonly used acupoints include BL13 (Fèi Shū 肺俞), LU1 (Zhōng Fǔ 中府), LU9 (Tài Yuān 太渊), LU7 (Liè Quē 列缺), ST36 (Zú Sān Lǐ 足三里), and CV17 (Shān Zhōng 膻中). The research reveals the following common applications of acupoints:
Treatments are administered three times per week throughout six- to eight-week chemotherapy cycles.[16] Electroacupuncture at ST36 and LU7 improves neutrophil recovery and reduces emesis via hypothalamic regulation of IL-1β and TNF-α.[17] Manual reinforcing at BL13 and LU9 enhances alveolar oxygen exchange and reduces radiation-induced pneumonitis.[18] The protocol harmonizes Lung and Spleen Qi, stabilizes immune homeostasis, and reduces chemotherapy toxicity.[19]
Mechanistic research from Shanghai shows that these combined therapies activate multi-pathway tumor-suppressive processes: apoptosis through Bax/Bcl-2 and caspase-3/9 activation, autophagy via LC3 and Beclin-1, pyroptosis by gasdermin-D cleavage, and ferroptosis through GPX4 inhibition and lipid ROS accumulation.[20] Angiogenesis is suppressed by reducing VEGF and HIF-1α, while E-cadherin increases and vimentin decreases, demonstrating epithelial-mesenchymal transition reversal.[21] These mechanisms align with clinical improvements in progression-free survival when TCM therapy accompanies EGFR-targeted agents.[22]
Clinical practice at Shanghai’s affiliated hospitals employs six-week integrated cycles, repeated up to three times annually. Each cycle combines acupuncture and individualized herbal therapy with evaluation via CT and serum markers (VEGF, IL-6, TGF-β). As patterns shift from Qi deficiency (qì xū) to Yin deficiency (yīn xū), physicians prescribe Mài Mén Dōng Tāng (麦门冬汤 Ophiopogon decoction) for Yin support; persistent Qi deficiency is treated with Bǔ Zhōng Yì Qì Tāng (补中益气汤 Astragalus-Atractylodes decoction) to strengthen Spleen Qi.[23]
The review also details the role of herbal injectables used for patients unable to tolerate oral therapy.[24] Ai Di (艾迪 injection) combines Bān Máo (Mylabris phalerata), Huáng Qí (Astragalus membranaceus), Rén Shēn (Panax ginseng), and Cì Wǔ Jiā (Acanthopanax senticosus). When co-administered with cisplatin and gemcitabine, Ai Di achieved a 79 percent ORR versus 11.5 percent for chemotherapy alone.[25] Shen Fu (参附 injection) composed of Rén Shēn and Fù Zǐ (Aconitum carmichaelii praeparata) increased CD3⁺ and CD4⁺ lymphocytes, raised CD4⁺/CD8⁺ ratios, and improved KPS while reducing myelosuppression.[26] Kang Ai (康艾 injection) and Kang Lai Te (康莱特 injection), formulated from Huáng Qí (Astragalus membranaceus), Rén Shēn (Panax ginseng), and Yì Yǐ Rén (Coix lachryma-jobi), suppressed NF-κB and MAPK pathways, enhancing cisplatin sensitivity and reducing chemotherapy inflammation.[27] A network meta-analysis of 7,728 patients confirmed that these four injectables significantly improved clinical response and reduced grade III/IV toxicity.[28]
The injectables share mechanistic similarities with the oral formulas: inducing apoptosis, suppressing angiogenesis, and enhancing immunity through Th1 cytokine up-regulation. Ai Di and Kang Ai notably reduced PD-L1 expression and enhanced CD8⁺ T-cell infiltration in tumor microenvironments, thereby potentiating immune-checkpoint therapy.[29] These preparations are commonly administered intravenously during chemotherapy intervals with close monitoring of hepatic and renal indices.[30]
Collectively, the data confirm that acupuncture combined with targeted herbal decoctions and standardized injectables produces measurable biomedical effects—activation of apoptotic and immunologic pathways, suppression of pro-tumor cytokines, and stabilization of systemic Qi dynamics. Patients experience enhanced quality of life, reduced chemotoxicity, and improved tumor-response rates. This integrated model unites classical TCM theory with molecular oncology, establishing a clinically validated framework for evidence-based TCM lung-cancer care.[31]
In nations such as China and Taiwan, the integration of acupuncture and herbal medicine with pharmacologic chemotherapy has become a standard component of oncology care and is fully reimbursed under national health insurance systems. In the United States and many other countries, acupuncture is now routinely provided within hospital oncology departments and private clinics to manage pain, nausea, fatigue, and other cancer-related symptoms. However, substantial regulatory barriers persist for the broader implementation of Chinese herbal medicine, particularly for injectable preparations. These herbal injectables—widely utilized in East Asian hospitals—remain without U.S. Food and Drug Administration (FDA) approval, limiting their adoption in integrative cancer protocols despite extensive clinical documentation of efficacy and safety abroad.
Looking forward, the development of internationally standardized quality-control systems, rigorous pharmacovigilance data, and coordinated regulatory pathways could enable phased clinical evaluation of these injectables in Western oncology settings. Such measures would allow future evidence-based approval of herbal formulations while ensuring patient safety and alignment with modern pharmaceutical standards, potentially ushering in a new era of fully integrative cancer care.
References:
[1] Xi Z., Dai R., Ze Y., Jiang X., Liu M., Xu H. Traditional Chinese Medicine in Lung Cancer Treatment. Molecular Cancer 2025; 24:57 .
[2–31] Ibid., pp. 2–6 and Tables 1–2 (Clinical and Mechanistic Sections on Jin Fu Kang, Yi Qi Qing Du Fang, Fei Yan Ning, Ai Di, Shen Fu, Kang Ai, Kang Lai Te; cytokine and apoptotic data).
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