[Clinical strategies of classical formulae in treatment of chronic obstructive pulmonary disease]

Chronic obstructive pulmonary disease(COPD) is one of the top three leading causes of death worldwide and can be divided into acute exacerbation and stable phases. Acute exacerbation of COPD(AECOPD) is the main trigger of disease progression and mortality in COPD patients, while the stable phase is a chronic and continuous stage of the disease. With continuous updates to relevant guidelines, modern medicine has achieved certain therapeutic effects in the treatment of COPD. However, long-term use of antibiotics and glucocorticoid drugs tends to drug resistance and may cause adverse reactions. Traditional Chinese medicine(TCM) attaches great importance to syndrome differentiation and has unique advantages in the treatment of lung diseases, following the principle of "treating the symptoms in acute conditions and the root in chronic ones". According to TCM theory, the pathological location of COPD is the lungs and is related to the spleen and kidneys. The disease is characterized by deficiency in origin and excess in manifestations, with phlegm and deficiency as the main pathogenesis factors. During the acute exacerbation phase, phlegm is the predominant factor, running through the disease course, and often mixed with heat, dampness(turbidity), cold, or blood stasis. These may appear in various combinations, leading to syndromes such as phlegm-heat obstructing the lungs, phlegm-turbidity blocking the lungs, external cold with internal fluid retention, and phlegm-blood stasis blocking the lungs. In the stable phase, deficiency is predominant, commonly involving deficiencies of the lungs, spleen, and kidneys. This article explored the clinical strategies of classical formulae in the treatment of COPD in recent years based on COPD staging and pathogenic factors and presented two medical cases for peer reference and discussion.