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.

chronic obstructive pulmonary disease  /  real-world data  /  data mining  /  medication patterns  /  Glycyrrhizae Radix et Rhizoma- Pinelliae Rhizoma  /  Astragali Radix-Codonopsis Radix