Abstract: Objective To observe the clinical effect of eliminating phlegm and supplementing deficiency on acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods Collect the diagnosis and treatment data of AECOPD patients with phlegm obstructing lung type in the Department of Pulmonary Disease, Conghua District Traditional Chinese Medicine Hospital, Guangzhou from January 1, 2015 to December 31, 2023, and screen the data according to the inclusion and exclusion criteria. The included data were divided into an observation group and a control group based on whether the basic formula for resolving phlegm and tonifying deficiency was used for treatment. Two groups were matched using propensity score matching (PSM) to achieve baseline balance and comparability. The inflammation immune indicators, ventilation function (blood gas analysis), glucocorticoid use (inhaled and intravenous glucocorticoids), and quantitative scores of traditional Chinese medicine clinical symptoms (cough, expectoration, sputum quality, sputum color, wheezing, fever) were compared between the two groups before and after treatment to evaluate the clinical efficacy of the method of resolving phlegm and supplementing deficiency in AECOPD patients. Results A total of 401 patient data were included, including 256 in the observation group and 145 in the control group. Using SPSS 26.0 for propensity score matching, 135 cases were successfully matched to the observation group and 135 cases to the control group. Due to the inconsistent timing of efficacy evaluation among different cases, after successful matching, the generalized estimation equation (GEE) was used to compare the changes in TCM syndrome scores and test indicators between the two groups of cases before and after treatment. It was found that the trend of TCM syndrome score decline in the observation group was more significant and statistically significant difference than that in the control group(P<0.05). The rising and falling trends of the inspection indicators are not consistent, but the changing trends of these inspection indicators were not statistically significant difference(P>0.05). Conclusion In this study, the method of resolving phlegm and supplementing deficiency had a significant symptom relief effect on AECOPD patients with phlegm turbidity obstructing lung type, but did not significantly improve inflammatory and blood gas analysis indicators, which may be related to sample size.

Key words: propensity score matching, chronic obstructive pulmonary disease, acute exacerbation stage, eliminating phlegm and tonifying deficiency