Abstract： Objective： To observe the clinical efficacy of hot compress with Chinese medicine and patting back along the meridian with vibration expectoration device in the treatment of patients with severe pneumonia of phlegmturbidity accumulating in the lung type. Methods：A total of 132 patients with severe pneumonia of phlegm-turbidity accumulating in the lung type admitted to the Intensive Care Unit （ICU） of Hangzhou TCM Hospital of Zhejiang Chinese Medical University from January to December 2024 were selected. They were randomly divided into the blank control group，intervention group A，intervention group B，and intervention group C using the random number table method， with 33 cases in each group. The four groups received the following treatments， respectively： conventional therapy alone； conventional therapy combined with patting back along the meridian using a vibration expectoration device； conventional therapy combined with Chinese medicine hot compress；and conventional therapy combined with Chinese medicine hot compress and patting back along the meridian using the vibration expectoration device. Observation continued until the patients in the four groups were discharged from the ICU. Blood gas parameters [oxygenation index （PaO2/FiO2）， arterial oxygen saturation （SaO2）， partial pressure of carbon dioxide （PaCO2）] and levels of inflammatory factors [C-reactive protein（ CRP），tumor necrosis factor-α（ TNF-α），interleukin-6（ IL-6）] before and after treatment，total sputum volume expelled within 48 hours，duration of clinical symptoms （time to fever resolution， time to disappearance of lung rales），duration of invasive mechanical ventilation，length of ICU stay，and mortality rate were compared among the four groups. Results：PaO₂/FiO₂ and SaO₂ in the four groups showed an increasing trend over time，while PaCO₂ showed a decreasing trend over time. There were significant differences in PaO2/FiO2，SaO2， and PaCO2 among the four groups before treatment，after 7 and 14 days of treatment （P＜0.05）. After 7 and 14 days of treatment， PaO2/FiO2 and SaO2 increased in all four groups compared to before treatment， while PaCO2 decreased， with significant differences （P＜0.05）. After 14 days of treatment， PaO2/FiO2 and SaO2 increased compared with those after 7 days of treatment， and PaCO₂ decreased compared with that after 7 days of treatment， with significant differences （P＜0.05）. Before treatment， there were no statistically significant differences in PaO2/FiO2， SaO2， and PaCO2 among the four groups （P＞0.05）. After 7 and 14 days of treatment，intervention groups A，B，and C showed higher PaO2/FiO2 and SaO2 and lower PaCO2 compared to the blank control group， with significant differences （P＜ 0.05）. Intervention group C showed higher PaO2/FiO2 and SaO2 and lower PaCO₂ compared to intervention groups A and B at 7 and 14 days after treatment， with significant differences （P＜0.05）. There were no statistically significant differences in PaO2/FiO2，SaO2，and PaCO2 between intervention group A and intervention group B after 7 and 14 days of treatment（ P＞0.05）. Intervention groups A，B，and C had greater total sputum volume expelled within 48 hours and shorter time to fever resolution and time to disappearance of lung rales compared to the blank control group， with significant differences（ P＜0.05）. Intervention group C showed greater total sputum volume expelled within 48 hours and shorter time to fever resolution and time to disappearance of lung rales compared to intervention groups A and B，with significant differences （P＜0.05）.There were no significant differences in total sputum volume expelled within 48 hours， time to fever resolution， or time to disappearance of lung rales between intervention group A and intervention group B （P＞0.05）. Intervention group C had shorter duration of invasive mechanical ventilation and length of ICU stay compared to the blank control group and intervention groups A and B （P＜0.05）. There were no significant differences in duration of invasive mechanical ventilation or length of ICU stay among intervention group A， intervention group B， and the blank control group （P＞0.05）. After 7 days of treatment， CRP， TNF-α， and IL-6 levels decreased in all four groups compared to before treatment （P＜0.05）. Intervention groups A，B，and C showed lower CRP，TNF-α， and IL-6 levels than the blank control group（ P＜0.05），and intervention group C showed lower levels of CRP，TNF-α， and IL-6 than intervention groups A and B （P＜0.05）. There were no significant differences in CRP，TNF-α，or IL-6 levels between intervention group A and intervention group B （P＞0.05）. No significant difference was found in mortality rate among the four groups （P＞0.05）. Conclusion： Adding hot compress with Chinese medicine combined with patting back along the meridian using a vibration expectoration device to conventional therapy for patients with severe pneumonia of phlegm-turbidity accumulating in the lung type can effectively promote sputum expectoration and resolution of clinical symptoms， improve pulmonary ventilation， reduce inflammatory responses， and shorten the duration of mechanical ventilation and length of ICU stay.