In recent years, in addition to the remarkable progress of molecularly targeted drugs in the treatment of non-small cell lung cancer (NSCLC), immunotherapy for NSCLC has also gradually become a hot spot of attention with the in-depth understanding of the relationship between tumors and the immune system, mainly focusing on the discovery of specific tumor antigens and the development of related immune adjuvants and vectors, i.e. various vaccines (cancer For example, the study of MAGE-A3 (melanoma-associated antigen A3) found that adjuvant therapy with MAGE-A3 vaccine in early stage NSCLC patients could reduce tumor recurrence, and other studies such as Belagenpumatucel-L, CIMAvax, Mucin 1, etc. have entered phase II. and others, such as Belagenpumatucel-L, CIMAvax, and Mucin 1, are in phase II clinical trials. [1][2] Therefore, immunotherapy is becoming a hot spot to prevent postoperative recurrence and improve the efficacy of NSCLC. Therefore, in the perioperative period of NSCLC patients, can the adjuvant treatment with traditional Chinese medicine, can it also improve the immune status of the body, play the role of immunotherapy, reduce postoperative recurrence and improve the efficacy? This is a topic worthy of in-depth study. As a thoracic surgery department of a large general Chinese hospital, our specialty has a large number of surgical treatment cases of lung cancer every year, and we can simultaneously take advantage of our Chinese medicine advantage to carry out perioperative treatment with Chinese medicine and observe that Chinese medicine treatment has a positive effect on the immune status of patients. First of all, the occurrence and development of tumor has a very close relationship with the immune function of the body. Molecular immunology shows that cellular immunity is the main mode of the body’s anti-tumor immunity. In controlling the growth of immunogenic tumor cells, the T cell-mediated immune response plays an important role. The CD system antigens exist on the surface of normal T cells, of which CD3+ are all mature T cells, two subpopulations CD4+ are helper T lymphocytes and CD8+ are suppressor T lymphocytes, and their ratio is constant in the human body. To maintain the optimal balance, NK cells (Nature killer cells) and T cell subsets play an important role in tumor immunosurveillance. CD4+, which can secrete IL-2 and IFN-r, has a significant synergistic effect with NK cells. CD8+, which is the opposite of CD4 cells, can inhibit the killing activity of NK cells and can lead to the suppression of immune response. NK cells are natural killer cells, which can kill tumor cells directly or by secreting cytotoxic factors without the participation of antibodies, complement or sensitized lymphocytes, which can reflect the anti-tumor ability of the body. Its reduced activity is often an important cause of tumor development and distant metastasis. Patients with lung cancer all have different degrees of cellular immune impairment, and this immune dysfunction is dominated by cellular immunity, mainly manifested as (1) decreased CD4+ T cells, unchanged or increased CD8+ T cells, and inverted CD4+/CD8+ ratio; (2) significantly decreased NK cell activity, but not due to decreased number of NK cells; (3) decreased lymphocyte transformation rate (LTT); (4) decreased levels of serum slL-2R, IL-2, IgG, IgA, etc. The mechanism of low immune status in lung cancer patients, especially in advanced lung cancer, may be related to the secretion of soluble immunosuppressive factors by tumor cells, as well as the influence of immunosuppressive factors activated in splenocytes under the stimulation of tumor antigens, resulting in the decrease of immune function in lung cancer patients. As the disease progresses and the tumor size increases, immune function may be progressively suppressed, which is tumor-derived and affects immune function by directly inhibiting the activity of NK cells in the organism and also by activating pre-existing suppressor cell precursors in the spleen. [7] There are no significant differences in the immune status of patients with different types of lung cancer, regardless of the malignancy of their tumor cells. Secondly, surgery has a dual role in tumor immunity: on the one hand, surgery can remove tumor lesions, lift tumor-derived immunosuppression, and improve patients’ cellular immune function; on the other hand, surgical treatment and its accompanying anesthesia, drugs, and blood transfusion can aggravate patients’ original immune function damage. Clinical observation revealed that the preoperative NK cell activity as well as CD3+, CD4+, CD4+/CD8+ were lower in lung cancer patients than in the normal group, while CD8+ was higher than in the control group, indicating that the cellular immune function of lung cancer patients was in an immunosuppressed state and the patients’ ability to recognize and kill mutated cells was reduced; 2 to 7 days after lung cancer patients, their NK cell activity decreased, CD3+, CD4+ This is related to surgical trauma, blood transfusion, anesthesia and related drugs, and various other stress reactions; 2 to 4 weeks after surgery, because the tumor load is lifted and the immunosuppression brought about by the tumor is alleviated, the above indicators gradually rebound or approach normal. It has been shown that whether patients underwent lobectomy, total pneumonectomy or palliative resection, the peripheral blood NK cell activity and CD4+/CD8+ increased significantly after surgery compared with the preoperative period, while CD8+ cells decreased significantly compared with the preoperative period, and there was no significant difference in the rebound of immune function between the lobectomy and palliative resection groups. It indicates that this tumor-derived suppressor starts to decline immediately after tumor resection, while the immune function of patients with unresectable tumors did not change significantly compared with that before surgery. The results suggest that for lung cancer treatment, lobectomy or total lung resection (including resection of metastases) should be pursued; for some advanced patients, palliative resection of local lesions should be strived for to remove or reduce the tumor load and the suppressive factors produced by it. Recent studies have found that many patients with malignant solid tumors have a certain number of tumor cells in bone marrow, lymph nodes and peripheral blood, i.e. micro-metastases. The number of peripheral blood cancer cells rises therefore, the low level of immune function after surgery increases the chance for early metastasis of tumor to some extent, thus immune support therapy should be given in the early postoperative period. In order to prevent the rapid growth of microscopic lung cancer metastases existing in the body due to the further decline of immune function, it is beneficial to improve the long-term survival rate of patients. Therefore, perioperative treatment methods to improve the immune function of the body may improve surgical efficacy, reduce surgical recurrence and metastasis, and improve long-term survival rate. Currently applied methods, including biological response modulators, such as thymidine and cytokines; [14] there are also a few reports about the application of Chinese medicine, including ginseng injection, Edhi injection, Kanglet injection, and acupuncture methods, but the studies are less abbreviated. [15][16][17] For example, Kangai injection is a widely used and representative anti-tumor Chinese medicinal preparation in clinical practice, and its formula reflects both the law of supporting and fighting cancer. The active ingredients of astragalus and ginseng have been proved to improve the phagocytic activity of T-cell subsets and NK cells, promote hematopoiesis, and enhance the phagocytosis of tumor cells; and bitter ginseng has a stable inhibitory effect on the proliferation of vascular endothelial cells induced by tumor cells. Then what kind of effect does this effect of supporting and fighting cancer have on the immune function of tumor patients? Some studies have shown that while reducing the adverse effects of radiotherapy and chemotherapy, Kangai injection can also enhance the immune function of the body and improve the quality of life of patients, thus improving the effect of tumor treatment. [18][19] Xu Hongyan and other clinical observations found that the combination of Kangai injection and chemotherapy in the treatment of non-small cell lung cancer patients had a significant protective effect on the immune function suppression caused by chemotherapy. [20] also reported that its combination with radiotherapy in the treatment of non-small cell lung cancer could not only reduce the adverse effects of radiotherapy, but also inhibit the growth of cancer cells and improve the immune status of patients with non-small cell lung cancer treated with radiotherapy. [21] It has also been reported that it can significantly improve the cellular immune function of patients treated with radiotherapy for esophageal cancer. In our clinical application, we observed that most lung cancer patients have lung spleen qi deficiency, and the treatment of Chinese herbal medicine to tonify the lung, strengthen the spleen and benefit qi and nourish yin can significantly improve the perioperative immune status of patients undergoing radical surgery for non-small cell lung cancer, increase patients’ tolerance for surgery, promote postoperative recovery, alleviate postoperative pain, poor nausea and susceptibility, improve patients’ quality of life and consolidate the surgical effect.