Abstract： Objective： To observe the clinical value of Bufei Yiqi Pingchuan tang combined with positive pressure ventilation for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with severe type II respiratory failure(RF) of the lung- kidney deficiency and phlegm- heat obstructing the lung type，and its effect on the lung function. Methods：A total of 72 cases of patients with AECOPD complicated with severe RF of the lung-kidney deficiency and phlegm- heat obstructing the lung type were divided into two groups，36 cases in each group. The routine group was treated with routine positive pressure ventilation， and the combination group was treated with Bufei Yiqi Pingchuan tang combined with positive pressure ventilation. Changes in inflammatory markers in serum， arterial blood gas indexes and indexes of the lung function were compared between the two groups. Results： When compared with those in the same group before treatment，levels of C-reactive protein(CRP) and procalcitonin(PCT) in serum in the two groups were decreased after treatment(P＜0.05)； levels of partial carbon dioxide pressure(PaCO2) were decreased(P＜0.05)， and levels of partial aiterial oxygen pressure(PaO2) were increased(P＜0.05). After seven-day treatment，airway resistance(R) and positive endexpiratory pressure(PEEPi) in the two groups were decreased when compared with those before treatment in the same group (P＜0.05)，and levels of static lung compliance(CST) were increased(P＜0.05). After three- day treatment，when compared with those in the routine group，levels of CRP and PCT in serum in the combination group were decreased(P＜0.05)；level of PaCO2 was decreased(P＜0.05)，and level of PaO2 was increased(P＜0.05)；levels of R and PEEPi were decreased(P＜0.05)， and level of CST was increased(P＜0.05). After seven- day treatment， when compared with those in the routine group， levels of CRP and PCT in serum in the combination group were decreased(P＜0.05)；level of PaCO2 was decreased(P＜0.05)， and level of PaO2 was increased(P＜0.05)；levels of R and PEEPi were decreased(P＜0.05)， and level of CST was increased (P＜0.05). After treatment，the total effective rate was 86.11% in the combination group，higher than that of 63.89% in the routine group(P＜0.05). Conclusion： For patients with AECOPD complicated with severe RF， Bufei Yiqi Pingchuan tang combined with positive pressure ventilation can effectively improve the CST and condition of airway as well as enhance clinical effect.