Beyond Conventional Treatment: Herbal Medicine and Nutraceuticals as Complementary Therapies for COPD and Asthma

Chronic obstructive pulmonary disease (COPD) and asthma remain among the most prevalent respiratory disorders worldwide, characterized by chronic inflammation, oxidative stress, and impaired quality of life. Although there has been significant advancement in the pharmacologic therapies, complementary strategies that can potentially target the underlying mechanisms and complement the conventional treatment are growing in interest among numerous patients and providers. This narrative review used systematic search methods in PubMed, Google Scholar, and ScienceDirect to select herbal medicines and nutraceuticals that were studied for COPD and asthma, with a specific selection using objective pulmonary functionality parameters (FEV1, FVC, FEV1/FVC). Analysis of evidence identified multiple interventions with a clinically significant effect, such as Astragalus membranaceus, Rhodiola rosea, nanocurcumin, Bufei granule, and Wuqinxi breathing exercises, most of which have anti-inflammatory, antioxidant, and immunomodulatory effects. The other agents, including Withania somnifera, Maxingshigan decoction, and L-carnitine, exhibited significant but inconsistent efficacy, whereas compounds like N-acetylcysteine, resveratrol, and cannabis had little effect. Mechanistic research indicates NF-kB, MAPK, Nrf2, and cytokine signaling pathways as typical therapeutic targets. Despite the limitations of methodological heterogeneity, the results indicate the judicious use of the choice of herbal and nutraceutical interventions in comprehensive respiratory care. Such supportive interventions can be patient-centered, enhance medication compliance, and offer an added effect in combination with evidence-based pharmacologic therapies. The quality of therapeutic application of the drug needs to be established through further high-quality therapeutic trials in order to determine the safety, dosing, and long-term outcomes.