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Guilou Tongluo Formula (GLTLF) is a traditional Chinese herbal prescription designed for the treatment of chronic obstructive pulmonary disease (COPD) complicated by pulmonary hypertension (PH). This multi-component formula consists of nine herbal ingredients, including *Trichosanthis Fructus*, *Cinnamomi Ramulus*, *Astragali Radix*, and *Salviae Miltiorrhizae Radix*, which synergistically target pulmonary vascular remodeling and inflammation. Clinical research, including prospective multicenter randomized controlled trials, suggests that GLTLF exerts its therapeutic effects via the gut-lung axis by modulating gut microbiota composition and plasma metabolite profiles. This systemic regulation helps alleviate the clinical symptoms and hemodynamic impairment associated with COPD-PH, an area recently highlighted as a critical therapeutic gap in the GOLD 2025 guidelines.
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