目的 基于真实世界数据，探究中药治疗慢性阻塞性肺疾病（chronic obstructive pulmonary disease，COPD）稳定期的临床特征及用药规律，为临床辨证选药及中药新药研发提供科学依据。方法 收集2019年1月—2025年1月广西中医药大学第一附属医院、柳州市中医医院、梧州市中医医院门诊6 240例COPD稳定期患者的电子病历资料，通过古今医案云平台，运用频数统计、关联规则和层次聚类分析方法，系统总结病症特点和中药配伍规律。结果 COPD稳定期患者以肺肾两虚证和肺脾气虚证为主要证型，核心症状为咳嗽、咳痰、喘息气促和胸胀。常用药物包括甘草、半夏、陈皮、白术和黄芪等；重要药物组合包括甘草-半夏、黄芪-党参等；药物以温性为主，甘、辛、苦味并重，多归肺、脾、肾3经。结论 明确COPD稳定期以肺肾及肺脾气虚证为主，治疗需补益肺脾肾、温阳化痰、活血化瘀，揭示的核心药组为临床精准辨证施治及未来临床验证、新药开发提供重要参考。

Objective To investigate the clinical characteristics and medication patterns of traditional Chinese medicine (TCM) in the treatment of stable chronic obstructive pulmonary disease (COPD) based on real-world data and provide a scientific basis for syndrome differentiation-based medication selection and the development of new TCM therapies. Methods Electronic medical records of 6 240 outpatients with stable COPD treated at the First Affiliated Hospital of Guangxi University of Chinese Medicine, Liuzhou Hospital of Traditional Chinese Medicine, and Wuzhou Hospital of Traditional Chinese Medicine between January 2019 and January 2025 were retrospectively collected. Disease characteristics and TCM prescription compatibility patterns were systematically analyzed using the Ancient and Modern Medical Record Cloud Platform through frequency analysis, association rule mining, and hierarchical cluster analysis. Results The predominant syndrome types in patients with stable COPD were lung-kidney deficiency syndrome and lung-spleen qi deficiency syndrome. The core symptoms were cough, sputum production, shortness of breath, and chest distension. Commonly used herbs included Gancao (Glycyrrhizae Radix et Rhizoma), Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), and Huangqi (Astragali Radix). Important herb combinations included Glycyrrhizae Radix et Rhizoma-Pinelliae Rhizoma and Astragali Radix-Dangshen (Codonopsis Radix). These herbs were predominantly warm in nature and sweet, pungent, and bitter in flavor, and were mainly associated with the lung, spleen, and kidney meridians. Conclusion This study suggests that the stable stage of COPD is primarily characterized by lung-kidney deficiency syndrome and lung-spleen qi deficiency syndrome. Therapeutic strategies should focus on tonifying the lung, spleen, and kidney, warming yang, resolving phlegm, activating blood, and resolving stasis. The identified core herb combinations may provide an important reference for precise syndrome differentiation and treatment, future clinical validation, and the development of new TCM-based therapies.

R285.64

2020年度广西中药药效研究重点实验室运行补助项目（2006538）；广西道地药材药效物质基础及其活性成分快速检测创新研究人才团队引进（KJT23015）；农作物废弃物药用研究创新团队（04B23008A5）