Abstract： Objective： To observe the clinical effect of Xuanfei Decoction combined with point application with Chinese herbal medicine for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with respiratory failure. Methods：A total of 100 cases of AECOPD complicated with respiratory failure were selected and divided into the observation group and the control group according to the random number table method，with 50 cases in each group. The control group was treated with routine western medicine group， and the observation group was treated with Xuanfei Decoction and point application with Chinese herbal medicine based on the treatment of the control group. Both groups were treated for seven days. The clinical effects and incidence of adverse reactions were compared between the two groups. The changes in scores of modified Medical Research Council (mMRC) questionnaire， forced expiratory volume in one second (FEV1)， ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC)， partial pressure of oxygen (PaO2)， partial pressure of carbon dioxide (PaCO2)， and scores of clinical symptoms were compared before and after treatment. Results：The total effective effect was 92.00% in the observation group and 74.00% in the control group，the difference being significant (P＜ 0.05). After treatment，the mMRC scores in the two groups were decreased when compared with those before treatment (P＜0.05)， and FEV1 and FEV1/FVC levels were increased when compared with those during treatment (P＜0.05)；mMRC score in the observation group was lower than that in the control group (P＜0.05)， and FEV1 and FEV1/FVC levels were higher than those in the control group (P＜0.05). After treatment，PaO2 levels in the two groups were increased when compared with those before treatment (P＜ 0.05)， and PaCO2 level was decreased when compared with that before treatment (P＜0.05). After treatment， the symptom scores of cough， expectoration， and wheezing in the two groups were decreased when compared with those before treatment (P＜0.05)，and the above scores in the observation group were lower than those in the control group (P＜0.05). During treatment， there was no serious adverse reaction in the two groups. Conclusion： Xuanfei Decoction combined with point application with Chinese herbal medicine has a significant effect on patients with AECOPD complicated with respiratory failure，which can effectively improve clinical symptoms，lung function and blood gas indexes，and is safe and reliable.