Abstract：Objective：To observe the clinical effect of acupuncture combined with point injection at Zusanli(ST 36） with neostigmine for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD) complicated with gastrointestinal dysfunction and undergoing mechanical ventilation(MV). Methods： A total of 92 cases of AECOPD patients complicated with gastrointestinal dysfunction and undergoing MV treatment were selected，and were divided into the control group and the experiment group according to the random number table method，46 cases in each group.Both groups were give routine basic treatment of western medicine；the control group was additionally given point injection at Zusanli(ST 36) with neostigmine，and the experiment group was additionally given acupuncture based on the treatment of the control group. Both groups were treated for seven days.The clinical effect， the scores of gastrointestinal symptoms， the incidence of adverse reactions，as well as levels of motilin(MTL)，substance P(SP)，and vasoactive intestinal peptide(VIP) in plasma were compared between the two groups. Results：The total effective rate was 91.11% in the experiment group，higher than that of 68.18% in the control group(P＜0.05). Three days and seven days after treatment， scores of the bowel sound， abdominal distension， defecation， and gastric retention in the two groups were decreased when compared with those before treatment(P＜0.05)，and the four scores above in the experiment group were lower than those in the control group at the same period(P＜0.05).Three days and seven days after treatment，levels of MTL and SP in plasma in the two groups were increased when compared with those before treatment(P＜0.05)，and levels of VIP in plasma were decreased(P＜0.05). Three days and seven days after treatment，levels of MTL and SP in plasma in the experiment group were higher than those in the control group at the same period(P＜0.05)，and the level of VIP in plasma was lower than that in the control group at the same period(P＜0.05). The incidence of adverse reactions was 4.44% in the experiment group， and 9.09% in the control group； there was no significant difference being found in the comparison of the incidence between the two groups(P＞0.05). Conclusion： In the treatment of AECOPD patients complicated with gastrointestinal dysfunction and undergoing MV treatment， the therapy of acupuncture combined with point injection at Zusanli(ST 36) with neostigmine can significantly improve their clinical symptoms and regulate the level of gastrointestinal hormones.