OBJECTIVE: To probe into the regulating effects of Zhichuanling injection combined with tiotropium bromide powder for inhalation on T cell 17（Th17） and regulatory T cell（Treg） balance in patients with acute exacerbation chronic obstructive pulmonary disease（AECOPD）（phlegm obstructing lung syndrome）. METHODS: A total of 100 patients with AECOPD（phlegm obstructing lung syndrome）admitted into this hospital from Jun. 2018 to Jun. 2020 were divided into the control group and the observation group via the random envelope method

with 50 cases in each group. Both groups were given conventional treatment

on that basis

the control group was given tiotropium bromide powder for inhalation

18 μg/times for once a day. The observation group was given intramuscular injection of 2 mL Zhichuanling injection for twice a day on the basis of the control group. Both groups were treated for 14 d. The clinical efficacy

TCM symptom integral

pulmonary function

changes of Th17/Treg related factors

St. George’s respiratory questionnaire and incidence of adverse drug reactions were compared between two groups. RESULTS: The total effective rate of treatment group was 96.00%（48/50）

significantly higher than 84.00%（42/50） of control group

with statistically significant difference（P<0.05）. After treatment

totally 8 items of TCM symptom integral in the observation group were significantly low than those of the control group

the percentage of forced expiratory volume in 1 s accounted for the expected value was significantly higher in the observation group than the control group

the percentage of forced expiratory volume in 1 s accounted for the forced vital capacity was significantly lower in the observation group than the control group

the serum IL-10 level and Th17/Treg ratio were significantly higher in the observation group than the control group

and the serum IL-17 level was significantly lower in the observation group than the control group

with statistically significant differences（P<0.05）. After treatment

the scores of all dimensions（symptoms

activities

influences） of St. George’s respiratory questionnaire in the observation group were significantly lower than those of the control group

with statistically significant differences（P<0.05）. The incidences of adverse drug reactions of control group and observation group were respectively 6.00%（3/50） and 4.00%（2/50）

the difference was not statistically significant（χ~2=0.21

P=0.65）. CONCLUSIONS: The efficacy of Zhichuanling injection combined with tiotropium bromide powder for inhalation in the treatment of AECOPD（phlegm obstructing lung syndrome）is remarkable

which can obviously improve the clinical symptoms and pulmonary function of patients

correct the immune imbalance of Th17/Treg and promote quality of life.