慢性阻塞性肺病（chronic obstructive pulmonary disease，COPD）是全球第3大致死原因，有效治疗COPD已成为亟需解决的医疗问题。中药多糖因其具有免疫调节、抗炎和抗氧化等多种生物活性，在COPD治疗方面备受关注。通过系统检索PubMed、中国知网（CNKI）及Web of Science等数据库，对近20年来中药多糖抗COPD的临床试验和临床前实验研究进行汇总、归纳和总结。中药多糖如黄芪多糖、香菇多糖及石斛多糖等能够显著改善COPD患者的临床症状和呼吸功能，增强免疫能力，降低炎症水平。其作用机制主要涉及减轻氧化应激损伤、调节免疫炎症应答、抑制气道重塑及调节肠道菌群等方面。中药多糖在COPD治疗中展现出巨大的开发潜力和应用前景，不仅拓宽了中药多糖在传统医学中的应用价值，同时也为促进中药多糖资源的开发利用和COPD的新药研发提供了重要的参考价值。

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, making the effective treatment of this condition is an urgent medical challenge. Polysaccharides derived from traditional Chinese medicine (TCM) have gained significant attention in COPD therapy due to their immunomodulatory, anti-inflammatory, and antioxidant properties. This study conducted a systematic search of databases, including PubMed, CNKI, and Web of Science, to summarize, categorize, and synthesize clinical trials and preclinical research on the use of these polysaccharides for the treatment of COPD over the past two decades. The analysis indicated that TCM polysaccharides, such as astragalus polysaccharides, lentinan and polysaccharide of Shihu (Dendrobii Caulis), can significantly improve clinical symptoms and respiratory function in COPD patients. These polysaccharides could enhance immune capacity and reduce inflammation levels. The mechanisms of action primarily involve alleviating oxidative stress, modulating immune-inflammatory responses, inhibiting airway remodeling, and regulating gut microbiota. The TCM polysaccharides in the treatment of COPD demonstrates substantial development potential and promising prospects. This not only broadens the application value of polysaccharides in traditional medicine but also provides a significant reference for the development and utilization of TCM polysaccharide resources and the discovery of new drugs for COPD.

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国家自然科学基金项目（81872959，81373920，30801522）；四川省青年科技创新团队项目：（19CXTD0055）；成都中医药大学“杏林学者”学科人才科研提升计划项目（ZYTS2019022）