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The most fundamental gap remains the acute need for rigorously designed, large-sample, multicenter, placebo-controlled randomized controlled trials (RCTs) dedicated to evaluating the efficacy (using primary endpoints such as 6-minute walk distance [6MWD] and time to clinical worsening) and long-term safety profiles of specific TCM interventions (whether monocomponent agents or standardized complex formulas) within well-defined HPH populations, characterized by precise inclusion criteria reflecting underlying lung disease etiology and PH severity alongside standardized treatment protocols

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