ArticleFrontiers in medicine2026
Clinical outcomes associated with Shenling Bufei Tongluo Decoction as add-on therapy in stable COPD patients with a frequent-exacerbator phenotype: a retrospective real-world cohort study.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Acute exacerbations accelerate disease progression and increase mortality in chronic obstructive pulmonary disease (COPD). Patients with a frequent-exacerbator phenotype remain at persistently high risk despite conventional therapies, highlighting the need for effective adjunctive strategies. Shenling Bufei Tongluo Decoction (SLBTD) is used in routine clinical practice, but real-world evidence regarding its clinical outcomes in this high-risk population remains limited. Methods: This retrospective real-world cohort study evaluated SLBTD add-on therapy in stable COPD patients with a frequent-exacerbator phenotype. Patients receiving SLBTD plus conventional management were compared with those receiving conventional management alone. Propensity score weighting was applied to balance baseline covariates. The primary outcome was first moderate-to-severe COPD exacerbation during a 1-year post-index observation period. Secondary outcomes included annualized exacerbation rates, hospitalization, symptoms, pulmonary function, traditional Chinese medicine (TCM) syndrome score, and recorded safety outcomes. Results: Among 528 eligible patients (176 SLBTD, 352 comparator), stabilized weighting achieved excellent covariate balance. Patients receiving SLBTD add-on therapy had a lower observed risk of first moderate-to-severe exacerbation [hazard ratio (HR), 0.68; 95% confidence interval (CI), 0.53-0.87; Conclusion: In routine clinical practice, patients receiving SLBTD add-on therapy had a lower recorded exacerbation burden and more favorable symptom-related outcomes than those receiving conventional management alone, without an observed increase in recorded safety events. These findings should be interpreted as observational associations rather than evidence of causal efficacy.
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