Objective To explore the effect of acupuncture combined with traditional Chinese medicine on EOS and CRP of chronic obstructive pulmonary disease in the real world based on "three discrimination, three phases and three adjustments". Methods Based on the HIS system database of Yunnan provincial hospital of traditional Chinese medicine, a retrospective cohort study was conducted to collect 3 357 patients diagnosed as chronic obstructive pulmonary disease patients in the period of illness and serious illness from August 2019 to August 2022. According to whether or not to receive ATCM treatment, 1 696 cases were divided into traditional Chinese medicine group and 1 661 cases were divided into traditional Chinese medicine treatment group. The effects of EOS and CRP in the two groups were analyzed by propensity score (PS) (Logistic regression, PS matching, PS adjustment, PS stratification, PS weighting). Results The total effective rate of the ATCM group was significantly better than that of the traditional Chinese medicine group before and after PS treatment (P<0.05). Conclusion The traditional Chinese medicine based on "three discrimination, three phases and three adjustments" can significantly reduce the EOS and CRP levels of patients with COPD in the disease stage, onset stage and severe disease stage, which is better than that of traditional Chinese medicine alone.