1.Molecular Mechanism of Programmed Cell Death in Chronic Obstructive Pulmonary Disease and Traditional Chinese Medicine Intervention: A Review
Xin PENG ; Yunhui LI ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Haotian XU ; Ziming DANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):304-313
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that poses a significant threat to global health, exhibiting high morbidity, disability and mortality rate, with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex, and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death (PCD) is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine (TCM) is characterized by holistic regulation. In recent years, extensive research has been conducted in the TCM field focusing on modulating apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis for the treatment of COPD, yielding remarkable achievements. Therefore, this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD, aiming to provide insights and references for the clinical prevention, treatment and in-depth research of COPD.
2.Molecular Mechanism of Programmed Cell Death in Chronic Obstructive Pulmonary Disease and Traditional Chinese Medicine Intervention: A Review
Xin PENG ; Yunhui LI ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Haotian XU ; Ziming DANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(3):304-313
Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease that poses a significant threat to global health, exhibiting high morbidity, disability and mortality rate, with its prevention and treatment situation becoming increasingly critical. The pathogenesis of COPD is complex, and the underlying cellular and molecular biological mechanisms remain incompletely elucidated. Programmed cell death (PCD) is the process wherein cells actively undergo demise to maintain internal environmental stability in response to certain signals or specific stimuli. Contemporary medical research indicates that the dysregulation of PCD patterns such as apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis is closely related to the onset and progression of COPD. Clarifying the molecular mechanisms of PCD in COPD may provide novel perspectives for in-depth understanding and prevention of the disease. Traditional Chinese medicine (TCM) is characterized by holistic regulation. In recent years, extensive research has been conducted in the TCM field focusing on modulating apoptosis, necroptosis, pyroptosis, autophagy, and ferroptosis for the treatment of COPD, yielding remarkable achievements. Therefore, this study systematically explored the molecular mechanism of PCD in COPD and reviewed the potential mechanisms and intervention status of TCM targeting PCD in COPD, aiming to provide insights and references for the clinical prevention, treatment and in-depth research of COPD.
3.Discussion on Scientific Connotation of Vital Qi Strengthening for Detoxification Therapy in Treatment of Community-acquired Pneumonia Based on Theory of "Vital Qi Deficiency and Toxic Stasis"
Hanxiao WANG ; Zheyu LUAN ; Haotian XU ; Xin PENG ; Ziming DANG ; Kun YANG ; Qianqian WANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(4):226-234
Community-acquired pneumonia (CAP) refers to an infectious inflammation of the lung parenchyma (including the alveolar wall,that is,the broad pulmonary interstitium) acquired outside the hospital. Its common pathogens include streptococcus pneumoniae,respiratory viruses, mycoplasma pneumoniae, and so on. The related factors for the occurrence and development of CAP include patient characteristics (immune function,mucus production and clearance function,coagulation function,physical condition, and comorbidity) and pathogen characteristics (susceptibility,virulence,and antibiotic resistance). The pathogenesis of CAP lies in immune deficiency,pathogen invasion,inflammatory response disorder,mucus production and clearance disorder, coagulation disorder, and so on. The pathogenesis of CAP in traditional Chinese medicine can be described as "vital Qi deficiency and toxic stasis". Vital Qi deficiency (lack of immunity) is the potential pathogenesis of the disease and easy to be invaded by external pathogens (respiratory pathogens). Toxic stasis (inflammatory disorder,mucus production and clearance disorder,and coagulation dysfunction) is the key pathogenic factor. Vital Qi deficiency and toxic stasis are intermingled in a state of deficiency and excess,which suggests that the treatment of CAP lies in strengthening vital Qi and eliminating pathogenic factors. This involves strengthening vital Qi in the whole process to consolidate body resistance and nourish promordial Qi. It also involves clearing heat,eliminating phlegm,removing dampness,and dispelling stasis to dispel pathogenic toxins based on the syndrome differentiation. Its action mechanism is to regulate immune and inflammatory responses,resist pathogens,and improve mucus production and clearance, as well as coagulation disorders. Starting from the key pathogenesis of CAP,"vital Qi deficiency and toxic stasis", this paper discussed the pathogenesis of CAP and summarized the action mechanism of vital Qi strengthening for detoxification in its treatment. It is intended to complement the theoretical system by identifying "vital Qi deficiency and toxic stasis" as the key pathogenesis underlying CAP and the scientific connotation of treating CAP with vital Qi strengthening for detoxification,thereby providing insights for its clinical application.
4.Immunity-inflammation Mechanism of Viral Pneumonia and Traditional Chinese Medicine Treatment Based on Theory of Healthy Qi and Pathogenic Qi
Zheyu LUAN ; Hanxiao WANG ; Xin PENG ; Yihao ZHANG ; Yunhui LI ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):239-247
Viral pneumonia is an infectious disease caused by virus invading the lung parenchyma and interstitial tissue and causing lung inflammation, with the incidence rising year by year. Traditional Chinese medicine (TCM) can treat viral pneumonia in a multi-component, multi-target, and holistic manner by targeting the core pathogenesis of pneumonia caused by different respiratory viruses, demonstrating minimal side effects and significant advantages. According to the theory of healthy Qi and pathogenic Qi in TCM, the struggle between healthy Qi and pathogenic Qi and the imbalance between immunity and inflammation run through the entire process of viral pneumonia, and the immunity-inflammation status at different stages of the disease reflects different relationships between healthy Qi and pathogenic Qi. Immune dysfunction leads to the deficiency of healthy Qi, causing viral infections. The struggle between healthy Qi and pathogenic Qi causes immunity-inflammation imbalance, leading to the onset of viral pneumonia. Inflammatory damage causes persistent accumulation of phlegm and stasis, leading to the progression of viral pneumonia. The cytokine storm causes immunodepletion, leading to the excess of pathogenic Qi and diminution of healthy Qi and the deterioration of viral pneumonia. After the recovery from viral pneumonia, there is a long-term imbalance between immunity and micro-inflammation, which results in healthy Qi deficiency and pathogenic Qi lingering. Healthy Qi deficiency and pathogenic Qi excess act as common core causes of pneumonia caused by different respiratory viruses. Clinical treatment should emphasize both replenishing healthy Qi and eliminating pathogenic Qi, helping to restore the balance between healthy Qi and pathogenic Qi as well as between immunity and inflammation, thus promoting the recovery of patients from viral pneumonia. According to the TCM theory of healthy Qi and pathogenic Qi, this article summarizes the immunity-inflammation mechanisms at different stages of viral pneumonia, and explores the application of the method of replenishing healthy Qi and eliminating pathogenic Qi in viral pneumonia. The aim is to probe into the scientific connotation of the TCM theory of healthy Qi and pathogenic Qi in viral pneumonia and provide ideas for the clinical application of the method of replenishing healthy Qi and eliminating pathogenic Qi to assist in the treatment of viral pneumonia.
5.Thoughts of Syndrome Differentiation and Treatment and Effect Mechanism of Haoqin Qingdantang in Treating Viral Pneumonia Based on Theory of Treating Different Diseases with Same Therapy
Xin PENG ; Haotian XU ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Yihao ZHANG ; Kun YANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):209-217
The principle of treating different diseases with the same therapy is the essence of syndrome differentiation and treatment in traditional Chinese medicine (TCM). It means that when the same pathogenic changes or the same symptoms appear in the development of different diseases, the same principles or methods can be used for treatment. Due to the complexity and high variability of viral pathogenicity, the precise and effective treatment of different types of viral pneumonia (VP) has always been a research focus and difficulty in modern medicine. VP belongs to the category of external-contraction febrile disease, warm disease, and epidemic in TCM. Haoqin Qingdantang (HQQDD) is a representative formula for clearing heat and dispelling dampness in warm diseases, and its intervention in VP caused by various viral infections has significant effects. This study, guided by the theory of treating different diseases with the same therapy, links the related studies on using HQQDD to treat different types of VP and finds that influenza virus pneumonia (IVP), severe acute respiratory syndrome (SARS), and COVID-19 all have a common pathogenic mechanism of dampness-heat at different stages of respective diseases. When these diseases are dominated by damp-heat factors, the use of HQQDD yields remarkable therapeutic effects. Modern pharmacological studies have confirmed that HQQDD can inhibit virus replication, reduce fever reactions, inhibit the expression of inflammatory mediators, and regulate immune balance. Moreover, the sovereign medicine in this formula has excellent antiviral activity, and the formula reflects rich scientific connotations of treating VP. According to the theory of treating different diseases with the same therapy and based on the effective treatment practice and modern pharmacological research of HQQDD for different types of VP, this paper mines the underlying TCM theory of treatment with the same therapy, explores the syndrome differentiation and treatment strategy and effect mechanism of this formula for different types of VP, and analyzes the treatment mechanism and characteristics, with the aim of providing evidence and reference for the clinical application and modern research of HQQDD.
6.Role of Traditional Chinese Medicine in Regulating Immune Inflammation and Microvascular Damage in Preventing Recurrence of Pneumonia During Recovery Based on Combination of Pathogenic Factors
Xin PENG ; Haotian XU ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Kun YANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):249-258
Pneumonia is an infectious disease with high morbidity and mortality worldwide, and its damage to the body is not limited to the acute phase. The theory of combination of pathogenic factors emphasizes that the combination of new pathogens and residual pathogens in the body leads to the occurrence of diseases, which generalizes the causes of recurrence during pneumonia recovery. During the recovery stage of pneumonia, pathological changes such as disturbance of immune homeostasis, persistent low-grade inflammation, and microvascular damage continue to affect the body function, impair the health and quality of life of patients, and increase the risk of secondary infection. According to the theory of traditional Chinese medicine (TCM), pneumonia is caused by deficiency, and Qi deficiency and blood stasis is the core pathogenesis in the recovery stage. At this time, the body is not full of healthy qi and still has residual pathogens, and thus it is susceptible to external pathogenic factors that lead to disease recurrence. As an important part of the TCM philosophy of treating disease before its onset, prevention of recurrence after recovery emphasizes the need for aftercare in the recovery stage to prevent disease recurrence. Based on the pathogenesis theory of combination of pathogenic factors and the pathogenesis of Qi deficiency and blood stasis, this paper discusses the effect and connotation of TCM in regulating immune inflammation and microvascular damage in preventing recurrence of pneumonia during the recovery stage, aiming to develop new ideas for effective prevention and treatment of pneumonia at this stage.
7.Research progress in the mechanism of Chinese materia medica in the treatment of viral pneumonia based on signaling pathway
Jiaqi SHANG ; Xin PENG ; Zheyu LUAN ; Yunfan WANG ; Yihao ZHANG ; Jihong FENG
International Journal of Traditional Chinese Medicine 2025;47(9):1332-1336
The research on the mechanism of Chinese materia medica in the treatment of viral pneumonia (VP) is mainly based on the monomer components of Chinese materia medica and TCM compounds. Among them, the monomer components are mainly polyphenols, flavonoids and anthraquinones, which have anti-inflammatory, antiviral, immunomodulatory and antioxidant pharmacological effects. The efficacy of TCM compounds is mainly based on clearing heat, and it has the functions of removing phlegm, removing blood stasis, removing dampness, moistening lung and so on. The intervention of Chinese materia medica in VP mainly involves NF-κB, MAPK, JAK/STAT, PI3K/Akt and other signaling pathways. The mechanism includes regulating oxidative stress, apoptosis, regulating immune function, inhibiting inflammatory response, etc., which can reduce the pathological damage of inflammatory cell infiltration and edema in lung tissue, and achieve the protective effect on lung tissue. The current research models exhibit unclear patterns of syndrome differentiation, and the mechanisms of Chinese materia medica involving multiple targets and pathways are poorly understood. Future research should integrate disease-syndrome combination models to further explore the mechanisms by which TCM regulates multiple targets and pathways, thereby providing insights and methodologies for the treatment of viral pneumonia with Chinese materia medica.
8.Discussion on Traditional Chinese Medicine Theory and Pharmacological Mechanism of Xuanfei Baidu Prescription in Treatment of Viral Pneumonia
Yihao ZHANG ; Xin PENG ; Zheyu LUAN ; Yunfan WANG ; Jiaqi SHANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(19):214-224
Viral pneumonia (VP) is an inflammatory disease caused by one or more viruses that infect the upper respiratory tract and spread downward. Causing varying degrees of pulmonary parenchymal damage, VP poses a serious threat to the society and public health. The treatment of VP now faces the dilemma of drug shortage, since Western medicine can only alleviate symptoms and lacks specific treatment methods. In traditional Chinese medicine (TCM), VP is assigned as an epidemic disease, with the etiology attributed to epidemic toxin and six excesses and the pathological factors of dampness, heat, toxin, deficiency, and stasis. The basic pathogenesis of VP is Yin-Yang imbalance, dysfunction of Zang-Fu organs, and healthy Qi deficiency. Accordingly, the treatment should follow the principle of replenishing healthy Qi and expelling pathogen. The treatment method of VP is mainly developed based on syndrome differentiation of six meridians, defense-Qi-nutrient-blood, and triple energizer. Xuanfei Baidu prescription (XFBD) is an effective prescription developed by Academician ZHANG Boli and Professor LIU Qingquan by literature research and selection of multi-component Chinese medicine. It is the product of modern research combined with TCM. XFBD is modified from Maxing Shigantang, Maxing Yigantang, Tingli Dazao Xiefeitang, Qianjin Weijingtang, and Buhuanjin Zhengqisan. It is mainly used to treat epidemic diseases with the syndrome of dampness toxin stagnating in the lung, with the effects of ventilating lung and resolving dampness, clearing heat and expelling pathogen, purging lung, and removing toxin, demonstrating the potential for the prevention and treatment of VP. This paper reviews the research progress of XFBD in combating VP in terms of the prescription composition, compatibility ideas, indications, and clinical new applications, as well as the pharmacological mechanisms of inhibiting virus, reducing inflammation, regulating immune system, ameliorating pulmonary fibrosis, and modulating intestinal flora. In addition, we put forward our thoughts and suggestions on the problems in the research, with a view to informing the clinical use of drugs and the basic research on the treatment of VP including COVID-19.
9.Role of Supplementing Qi and Activating Blood in Preventing Relapse After Recovery of Community-acquired Pneumonia with Syndrome of Lung Deficiency and Collateral Stasis
Hanxiao WANG ; Zheyu LUAN ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):232-239
Community-acquired pneumonia (CAP) is a respiratory infection which takes a long time to fully recover after clinical symptoms are alleviated in the short term. It affects the physical health and quality of life of the patients in the long term and can occur repeatedly, which is related to inflammation, immunity, and the coagulation function. Lung Qi deficiency and collateral stasis are the key pathogenesis of CAP at the recovery stage. The development of CAP is accompanied by the decreased production and the increased consumption of Qi, which results in lung Qi deficiency. At the same time, heat pathogen forces the blood to move improperly, which depletes Qi and damages fluid, resulting in lung collateral stasis. Lung Qi deficiency and collateral stasis are causal and influence each other. The patients at the recovery stage of CAP generally present deficient lung Qi and healthy Qi, impaired immune function, and weakened defense function. However, pathogenic Qi, coagulation function changes, and thrombosis exist, and some coagulation factors are associated with the prognosis of CAP. The Chinese medicines for tonifying lung and supplementing Qi can help replenish healthy Qi, consolidate the body foundation, and regulate the inflammation. The Chinese medicines for activating blood and resolving stasis can dredge the lung collaterals, clear the pathogenic Qi, improve the microvascular circulation, and inhibit the inflammatory response. The Chinese medicines for supplementing Qi and activating blood can replenish healthy Qi and dispel pathogen to regulate immunity, inhibit inflammation, and alleviate the clinical symptoms, thus promoting the recovery from pneumonia. From lung Qi deficiency and collateral stasis, this paper summarizes the application and explains the scientific connotation of supplementing Qi and activating blood in preventing relapse after recovery of CAP, providing ideas for using this method to assist in preventing relapse after recovery of CAP.
10.Connotation of Traditional Chinese Medicine in Treatment of Chronic Obstructive Pulmonary Disease by Regulating Gut Microbiota Based on "Lung and Large Intestine Being Interior-exterior Related"
Hanxiao WANG ; Zheyu LUAN ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(3):169-177
Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition characterized by persistent and often progressive airflow obstruction, including airway abnormalities (e.g., bronchitis and bronchiolitis) and chronic respiratory symptoms (e.g., dyspnea, cough, and expectoration). It is one of the leading causes of death worldwide. According to the theory of traditional Chinese medicine (TCM), the lung and large intestine are interior-exterior related. Therefore, COPD can be treated from both the lung and intestine by the methods of tonifying and invigorating lung, spleen, and kidney, dispelling phlegm, and expelling stasis. Gut microbiota plays a key role in human immunity, nerve, and metabolism and may act on COPD by affecting the structures and functions of lung and intestine tissue and regulating lung inflammation and immunity. TCM can restore the balance of gut microbiota, which is conducive to the recovery from COPD. For example, the treatment method of tonifying lung and invigorating kidney can regulate gut microbiota, alleviate pulmonary and intestinal injuries, and improve lung immunity. The treatment methods of dispelling phlegm and expelling stasis can regulate gut microbiota and reduce pulmonary inflammation. According to the TCM theory of lung and large intestine being interior-exterior related, this review elaborates on the connotation of TCM in the treatment of COPD by regulating gut microbiota, aiming to provide new ideas for the clinical treatment of COPD via gut microbiota.

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