Abstract：Objective：To observe the clinical effect of therapy of Qingfei Huatan Prescription combined with non- invasion positive pressure ventilation on type Ⅱ respiratory failure (RF) in senile patients and its effect on the cognitive function. Methods： A total of 80 RF senile patients were selected and randomly divided into the control group and the observation group，with 40 cases in each group. The control group was given non-invasion positive pressure ventilation for treatment，and the observation group was treated with therapy of Qingfei Huatan Prescription combined with non- invasion positive pressure ventilation. The clinical effects， disappearance time of clinical symptoms， including the recovery time of normal respiration and body temperature， disappearance time of expectoration and cough and hospitalization time，syndrome scores，indexes of blood gas，including partial pressure of carbon dioxide in arterial blood (PaCO2)，oxygen saturation (SO2)，partial pressure of oxygen in arterial blood (PaO2) and oxygenation index (OI)， indexes of lung function， including forced vital capacity (FVC)， forced expiratory volume in one second (FEV1) and FEV1/FVC and scores of Montreal Cognitive Assessment (MoCA) in Chinese version were compared between the two groups. Results：The total effective rate was 92.50% in the observation group and 72.50% in the control group，the difference being significant (P＜0.05). After treatment，the recovery time of normal respiration and body temperature， disappearance time of expectoration and cough and hospitalization time in the observation group were less than those in the control group，differences being significant (P＜0.05). After treatment，the syndrome scores of expectoration，cough，asthma shortness of breath，palpitation in both groups were decreased when compared with those before treatment (P＜0.05)， and the above five scores in the observation group were lower than those in the control group (P＜0.05). After treatment， the PaCO2 levels in the two groups were decreased when compared with those before treatment (P＜0.05)， and the levels of SaO2， PaO2 and OI were increased when compared with those before treatment (P＜0.05)； the PaCO2 level in the observation group was lower than that in the control group (P＜0.05)， and the levels of SaO2， PaO2 and OI were higher than those in the control group (P＜ 0.05). After treatment， the levels of FVC， FEV1 and FEV1/FVC in the two groups were increased when compared with those before treatment (P＜0.05)，and the above three levels in the observation group were significantly higher than those in the control group (P＜0.05). After treatment， the MoCA scores in both groups were increased when compared with those before treatment (P＜0.05)，and the MoCA score in the observation group was obviously higher than that in the control group (P＜0.05). Conclusion：The therapy of Qingfei Huatan Prescription combined with non- invasion positive pressure ventilation can effectively enhance the cognitive function and lung function of type Ⅱ RF senile patients，and improve the indexes of blood gas and clinical symptoms with a good curative effect.