Over the past 25 years, both inter national and Chinese guidelines for chronic obstructive pulmonary disease (COPD) have undergone numerous updates and revisions that have continuously focused and optimized therapeutic targets, evaluation systems, and treatment strategies. We have reviewed and summarized the changes in the relevant contents of COPD guidelines, with a focus on their relevance to clinical practice. In recent years, COPD treatment has focused on two therapeutic targets: symptom relief and reduction of acute exacerbation risk. There is an increasing emphasis on individualized care, incorporating the concept of closed-loop management in upgrading/downgrading and initial/subsequent treatment to ensure dynamic adjustment of follow-up care. In addition, the emergence of new treatment options based on different pathogenesis mechanisms has provided new breakthroughs in COPD management. Chinese guidelines for COPD are also being continuously updated to provide more guidance for patients, such as early screening and diagnosis, comprehensive and self-management, and the prevention and treatment of acute exacerbations, thereby continuously improving the precision of decision-making and scientific management in the clinical practice of COPD diagnosis and treatment.
慢性阻塞性肺疾病(简称慢阻肺病)的国内外指南在25年内经过持续更新与修订,在治疗目标、评估体系和治疗策略方面不断聚焦与优化。本文总结了慢性阻塞性肺疾病指南的相关内容的变迁,重点探讨其对临床实践的指导意义。近年来,慢阻肺病的治疗方案以缓解症状和降低未来急性加重风险两大治疗目标为核心,越来越强调个体化治疗,同时融入了升级/降级和初始/后续治疗的闭环管理理念,以确保随访治疗的动态调整。此外,基于不同发病机制的新治疗方案的出现,也为慢阻肺病的管理提供了新的突破。我国慢阻肺病指南也不断更新,针对早期筛查诊断、全程和自我管理、急性加重防治等方面提供更加全面的指导,不断提高慢阻肺病诊治临床实践中的精准决策与科学管理。.