A Comprehensive Exploration of Thyroid Nodules Diagnosis, Epidemiology and Pathophysiology with Emphasis on the Role of Traditional Chinese Medicine Treatment.

Thyroid nodules are a prevalent endocrine disease with rising global incidence. Modern clinical management relies on standardized workflows stratified by nodule size, TI-RADS ultrasound risk grading, fine-needle aspiration biopsy (FNA) indications, cytological results, thyroid function and malignant risk, including active surveillance, thermal ablation and surgical resection as definitive interventions. While western medicine achieves precise diagnosis and radical treatment, it still faces limitations such as recurrent benign nodules, postoperative complications and long-term hormone side effects. Traditional Chinese Medicine (TCM), as a complementary and adjuvant therapy rather than a replacement for definitive western treatment, has accumulated mature clinical experience for auxiliary intervention of thyroid nodules. This review firstly systematically sorts out modern diagnostic techniques, epidemiological characteristics, genetic susceptibility and core pathophysiological mechanisms of thyroid nodules, and fully summarizes guideline-based standardized western medical treatment paradigms. Then we systematically expound the TCM etiology, pathogenesis, syndrome differentiation theory, classical compound preparations (Xiaojin Capsule, Neixiao Tablet, external Jie Jian gel), single herbal medicines and isolated active monomers (diosgenin), and clarify their respective applicable scenarios including preoperative conditioning, perioperative support, postoperative rehabilitation and symptomatic relief after ablation. We further stratify all cited research evidence by study type (preclinical experiments, observational trials, randomized controlled trials and meta-analyses) to avoid overstating clinical efficacy based solely on animal and cell experiments. Meanwhile, we summarize integrated Chinese-Western combined regimens and current research advances in TCM mechanism research. Finally, we independently discuss the controversies, safety risks, standardization defects and clinical research limitations of TCM intervention, and put forward future research directions. This review aims to clarify the auxiliary positioning of TCM in the overall thyroid nodule treatment system, provide comprehensive integrated Chinese-Western clinical reference, and promote standardized and translational research of TCM for thyroid nodules.