Objective To observe the efficacy and safety of TCM treatment combined with western medicine therapy for acute exacerbations and respiratory failure in chronic obstructive pulmonary disease （COPD）.Methods A total of 104 patients with acute exacerbations and respiratory failure in COPD were randomized into the treatment group and control group

with 52 in each.The conventional western treatment was given to both groups and TCM treatment was added in the treatment group.The treatment lasted for 14 days.The symptom scores

sign scores

dyspnea scores

acute physiology and chronic health evaluation Ⅱ （APACHEⅡ） were assessed before treatment and on the 4th

7th and 14th day of treatment.The blood gas analysis

mortality and adverse reactions were observed and recorded as well.Results The symptom scores

sign scores

dyspnea scores and APACHEⅡ scores were significantly decreased in both groups on the 14th day of treatment （P<0.05）

especially in the treatment group （P<0.05）.The partial pressure of oxygen in arterial blood （PaO2） was significantly increased but the partial pressure of carbon dioxide in arterial blood （PaCO2） was significantly decreased in both groups on the 14th day of treatment （P<0.05）

especially PaO2 in the treatment group （P<0.05）.The mortality of the treatment group and control group was 3.85% and 5.77% respectively

with no significant difference between groups （P>0.05）.Two mild adverse events occurred in each group.Conclusion TCM treatment combined with western medicine therapy is effective for acute exacerbations and respiratory failure in COPD

especially in relieving clinical symptoms

increasing PaO2 and alleviating dyspnea.