Abstract： Objective： To observe the clinical effect of ion introduction with Xiaoqinglong Decoction combined with western medicine atomization for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of exterior cold with interior fluid retention type. Methods： A total of 78 cases of AECOPD patients of exterior cold with interior fluid retention type were selected and divided into the control group and the observation group according to the random envelope method，with 39 cases in each group. The control group was treated with Budesonide Suspension，Compound Ipratropium Bromide Solution for Inhalation， and Piperacillin Tazobactam Sodium for Injection， and the observation group was additionally treated with ion introduction with Xiaoqinglong Decoction based on the treatment of the control group. Syndrome scores，white blood cell count (WBC)，C-reactive protein (CRP)，procalcitonin (PCT)，fractional exhaled nitric oxide (FeNO)，lung function indicators [forced vital capacity (FVC)，forced expiratory volume in one second (FEV1) and FEV1/FVC]， blood gas analysis indicators [arterial oxygen partial pressure (PaO2) and arterial carbon dioxide partial pressure (PaCO2)]，scores of COPD Assessment Test (CAT)，and scores of modified Medical Research Council (mMRC) Dyspnoea Scale before and after treatment as well as the clinical effect and safety were compared between the two groups. Results： The total effective rate was 94.9% in the observation group and 79.5% in the control group，the inter group comparison showed that the difference being significant (P＜0.05). After treatment， the scores of wheezing， coughing， expectoration， and total scores 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). After treatment， the levels of FEV1 and FVC in the two groups were increased when compared with those before treatment (P＜0.05)，and the FVC level in the observation group was higher than that in the control group (P＜0.05)；there was no significant difference being found in the comparison of FEV1 levels between the two groups (P＞0.05). There was no significant difference being found in the comparison of FEV1/FVC levels between the two groups before and after treatment (P＞0.05). After treatment，the levels of WBC，CRP，PCT，and FeNO in the two groups were decreased when compared with those before treatment (P＜0.05)，and the levels of CRP，PCT，and FeNO in the observation group were lower than those in the control group (P＜0.05)；there was no significant difference being found in the comparison of WBC levels between the two groups (P＞0.05). After treatment，the PaO2 levels in the two groups were increased when compared with those before treatment (P＜0.05)，and the PaCO2 levels were decreased when compared with those before treatment (P＜0.05)；the PaO2 level in the observation group was higher than that in the control group (P＜0.05)，and the PaCO2 level was lower than that in the control group (P＜0.05). After treatment， the CAT and mMRC scores in the two groups were decreased when compared with those before treatment (P＜0.05)，and the CAT and mMRC scores in the observation group were lower than those in the control group (P＜0.05). During the treatment process， there were no abnormality in blood routine， urine routine， liver and kidney function， and electrocardiogram in the two groups. In the observation group， there was one case of mild local skin itching. Conclusion： Ion introduction with Xiaoqinglong Decoction combined with western medicine atomization for AECOPD of exterior cold with interior fluid retention type can effectively improve clinical symptoms，lung function，and blood gas status of patients，reduce inflammatory reactions，and have acceptable safety.