Abstract： Objective： To observe the clinical effect of Tongfu Xuanfei tang combined with noninvasive ventilation for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods： A total of 84 cases of inpatients with AECOPD were selected as the study subjects and randomly divided into two groups， 42 cases in each group. The control group was treated with routine western medicine treatment including noninvasive ventilation，and the observation group was additionally treated with Tongfu Xuanfei tang based on the treatment of the control group. The clinical effect， C- reactive protein(CRP)，arterial oxygen partial pressure(PaO2)，arterial carbon dioxide partial pressure(PaCO2) and abdominal distention in the two groups were compared. Results：The total clinical effective rate was 90.48% in the observation group and 80.95% in the control group，the difference being significant(P＜0.05). After treatment，the values of CRP，PaO2 and PaCO2 in the two groups compared with those before treatment， differences being significant(P＜0.05)； and the above values in the observation group were better than those in the control group，differences being significant(P＜0.05). After treatment，the incidence of abdominal distension in the observation group was significantly fewer than that in the control group， the difference being significant(P＜0.05). During treatment，no obvious adverse reaction occurred in the two groups. Conclusion： The therapy of Tongfu Xuanfei tang combined with noninvasive ventilation has significant effect in treating AECOPD，which can effectively improve symptoms and blood gas analysis，and significantly reduce abdominal distension.