Objective: To evaluate the efficacy of structured peri-discharge intensive interventions on pulmonary function, exercise capacity, and dyspnea severity in patients with chronic obstructive pulmonary disease (COPD). Methods: A randomized controlled trial was conducted involving 60 COPD patients eligible for discharge from our department between January 2022 and December 2023. Participants were allocated equally to a control group (routine discharge guidance) or an observation group (routine guidance plus intensive intervention). Both cohorts were monitored for 3 months. Assessments included spirometry (FVC, FEV₁, FEV₁/FVC), modified Medical Research Council (mMRC) dyspnea scores, 6-minute walk distance (6MWD), and 1-year rehospitalization frequency, evaluated at discharge (baseline), 1 month, and 3 months post-enrollment. Results: Repeated-measures ANOVA indicated significant group-by-time interactions for pulmonary function parameters (F = 7.82–14.35), mMRC scores (F = 8.24), and 6MWD (F = 9.76) (all p < 0.01). The observation group demonstrated superior improvements in FVC (2.08 ± 0.30 L vs. 2.29 ± 0.35 L), FEV₁ (0.79 ± 0.19 L vs. 0.95 ± 0.25 L), and FEV₁/FVC ratio (37.98 ± 4.51% vs. 41.48 ± 5.03%) at 1 and 3 months compared to controls (all p < 0.01), with progressive gains over time (within-group p < 0.01). At 3 months, the observation group also exhibited lower mMRC scores (2.05 ± 0.31 vs. 2.41 ± 0.35) and longer 6MWD distances (282.72 ± 36.25 m vs. 243.21 ± 31.12 m) (both p < 0.01). Over the 12-month follow-up, the rehospitalization rate was significantly reduced in the observation group (10.00% vs. 30.00%; RR = 0.33, p = 0.039). Conclusion: Peri-discharge intensive intervention for COPD patients significantly enhances pulmonary function, exercise tolerance, and dyspnea management, while reducing rehospitalization risk.