[Transformations and optimizations: updates in the global and domestic guidelines for chronic obstructive pulmonary disease over 25 years].

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.