OBJECTIVE: To probe into the clinical efficacy of heat-clearing and bowel-relaxing decoction in the treatment of acute exacerbation of chronic obstructive pulmonary disease （AECOPD） of phlegm-heat and lungobstruction accomplicated with gastrointestinal dysfunction in elderly patients. METHODS: 96 patients with AECOPD of phlegm-heat and lung-obstruction admitted into Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from Sept. 2017 to May 2019 were selected and divided into control group （48 cases

treated with conventional western medicine

with the course of treatment was 10 days） and treatment group （48 cases

given heat-clearing and bowelrelaxing decoction based on the control group

with the course of treatment was 10 days）. Scores of TCM symptom scores

serum inflammatory factor [interleukin-6 （IL-6）

interleukin-8 （IL-8）

tumor necrosis factor-α （TNF-α） and C-reactive protein （CRP） ]

pulmonary function indicators [forced expiratory volume in 1 s （FEV

1

）

proportion of FEV

1

accounted for forced vital capacity （FEV

1

/FVC） ]and blood gas indicators [arterial partial pressure of oxygen （PaO

2

） and partial pressure of carbon dioxide （PaCO

2

） ] levels of both groups before and after treatment were evaluated

clinical efficacy and hospital stays were recorded. RESULTS: After treatment

the total effective rate of treatment group was 95. 83% （46/48）

which was significantly higher than that of the control group （72. 92%

35/48）

with statistically significant difference （P

<

0. 05）. Improvements of cough

expectoration

shortness of breath

fever

constipation and total symptom scores of treatment were significantly better than those of the control group

with statistically significant differences （P

<

0. 05）; of which the constipation had been greatly improved

which had extremely significant differences in comparison with the control group （P

<

0. 001）. The IL-6

IL-8

TNF-α and CRP levels of both groups had been significantly decreased

and those of the treatment group were significantly lower than the control group

with statistically significant differences （P

<

0. 05）. After treatment

the FEV

1

and FEV

1

/FVC levels of treatment group were significantly higher than those of before treatment and the control group

with statistically significant differences （P

<

0. 05）. After treatment

the PaO

2

level of treatment group was significantly higher than that of before treatment and the control group

while the PaCO

2

level was significantly lower

with statistically significant differences （P

<

0. 05）. The average hospital stay of treatment group was （11. 83±0. 95） days

which was significantly shorter than that of the control group （15. 15 ± 1. 43） days

with statistically significant difference （P

<

0. 05）.CONCLUSIONS: The efficacy of heat-clearing and bowel-relaxing decoction in the treatment of AECOPD of phlegmheat and lung-obstruction accomplicated with gastrointestinal dysfunction in elderly patients is remarkable

which can significantly improve clinical symptoms and gastrointestinal function

effectively correct airway inflammation reaction and promote pulmonary function

with high safety.