Moxibustion Therapy for Pulmonary Nodules
Pulmonary Nodules
Overview
Since the pandemic, detection rates of pulmonary nodules in China have climbed sharply, approaching 60%. Modern medicine defines a pulmonary nodule as a focal, roughly round area of increased density on imaging, with a diameter of 3 cm or less. These nodules may be solid or subsolid, singular or multiple, and are not accompanied by lung collapse, enlarged hilar lymph nodes, or pleural effusion. Based on size, they are classified as micro‑nodules (< 5 mm), small nodules (5 – 10 mm), and nodules (10 – 30 mm). A ground‑glass nodule refers specifically to a hazy, “ground‑glass” shadow on CT, representing a particular subtype of pulmonary nodule.
Western studies show that larger nodules carry a higher risk of malignancy, while those under 6 mm have a malignancy probability below 1%. By density, nodules are divided into solid and subsolid types: solid nodules have the lowest malignancy rate (about 7%); among subsolid nodules, pure ground‑glass nodules have a moderate malignancy rate (about 18%); mixed (part‑solid) nodules show the highest risk, around 63%.
TCM Context
Traditional Chinese medicine did not historically recognize “pulmonary nodules” as a named disease; they have emerged only with advances in imaging technology. Most nodules are discovered incidentally during health screenings or examinations for other conditions, often in patients without symptoms. In TCM, imaging can be seen as an extension of Wàng (望, visual inspection).
Pulmonary nodules fall under the category of Fèi Jī—one of the “five accumulations” described in the Nàn Jīng (“Classic of Difficulties,” chapter 56): “Accumulation in the Lung, called Xī Bèi (息贲),” meaning pathogenic qi remains and congeals in the lung.
Pathogenesis
The fundamental mechanism is yù—stagnation and congealing. Whether due to external invasion of wind‑heat or wind‑cold, or internal injury from the seven emotions, the first hit is always to the body’s qi mechanism. When qi stagnates, blood and body fluids fail to circulate properly, leading to phlegm and blood stasis that block the lung’s channels. In essence, nodules form from the congealing of phlegm and stasis.
Although the nodules appear in the lung, the root lies in the Spleen–Stomach’s production of phlegm: “The Lung is the vessel that stores phlegm; the Spleen and Stomach are the source that generates phlegm.” When the lung’s function is compromised, patients may also experience facial acne, constipation, urticaria, weakened digestion, shortness of breath, and fatigue. Yin‑deficiency with exuberant fire often underlies most nodular disorders.
Recommended Acupuncture–Moxibustion Points
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Group A: Zhì Yáng (至阳), Fèi Shū (肺俞), Huán Tiào (环跳), Yǒng Quán (涌泉)
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Group B: Qū Chí (曲池), Qī Mén (期门), Zhōng Wǎn (中脘), Fēng Lóng (丰隆)
These point combinations are offered for reference only. Please perform moxibustion under the guidance of a qualified practitioner with extensive clinical experience.
In our practice, combining these moxibustion protocols with manual techniques often prompts patients to expectorate phlegm on their own, leading to notably favorable outcomes.