Traditional Chinese Medicine in Cushing’s Syndrome: A Narrative Review of Pathophysiology and Potential Therapeutic Effects

This article employs a narrative review approach to systematically elucidate the pathophysiological mechanisms of Cushing Syndrome (CS), with a particular focus on exploring the theoretical foundations, clinical applications, and future directions of Traditional Chinese Medicine (TCM) in its treatment. CS is an endocrine disorder caused by chronic excessive cortisol secretion, with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis at its core. The article first outlines the epidemiological characteristics, pathophysiological mechanisms (including abnormalities in the cAMP/PKA signaling pathway and autocrine/paracrine dysregulation), and genetic basis (such as mutations in ARMC5, PRKACA, and other genes) of CS. Regarding diagnosis, it reviews the application of clinical symptom evaluation, biochemical tests (eg, dexamethasone suppression tests), and imaging techniques (eg, MRI, CT). The core of this review lies in its systematic evaluation of TCM's comprehensive strategies in treating CS. It provides a detailed analysis of the clinical application of TCM, including herbal formulations (eg, Buzhong Yiqi Decoction, Xiaoyao Powder variations), non-pharmacological therapies (eg, acupuncture, tuina), and integrated approaches, while summarizing potential evidence of their efficacy in alleviating symptoms, modulating immunity, and improving quality of life. Concurrently, it points out that the field currently lacks high-quality clinical research support, and that the mechanisms of action and standardized treatment protocols require further investigation. Finally, the article looks forward to the prospects of integrating TCM with modern medicine in treating CS, as well as future directions in basic research, clinical trials, and international collaboration. The aim is to provide a theoretical basis and practical reference for the treatment of CS with TCM.