Abstract: OBJECTIVE To study the clinical efficacy and economy of tanreqing injection with intravenous combined with inhalation compared to intravenous or inhalation alone treatment on moderate and severe acute exacerbation of chronic obstructive pulmonary disease(AECOPD). METHODS All of 120 patients of AECOPD from May of 2014 to May 2015 were randomly divided into control group, intravenous group, inhalation intravenous group and combined group. Control group was given oxygen, cough, asthma, anti-infection, correction of electrolyte and acid-base imbalance and other conventional treatment. On the basis of the control group, intravenous group was given Tanreqing injection(20 mL, ivgtt, qd); inhalation group was given Tanreqing injection(10 mL, whxr, qd); and combined group was given Tanreqing injection with intravenous combined with inhalation. The observation time were all 7~14 d. Comparison the difference of each group in clinical efficacy, the change of lung function and quality of life before and after treatment, length of stay hosptial, total cost of treatment and the rate of adverse drug reactions(ADR). And used cost-effectiveness analysis(CAE) to analyze economic. RESULTS After treatment, the clinical efficacy , improvement in lung function and quality of life were significant higher in the combined group than those of the control group, intravenous intravenous groupnd inhalation group(P<0.05), the days of hospitalization and the total cost of treatment were significant lower in the combined group than those of the control group, intravenous group and inhalation group , all the difference were statistically significant (P<0.05). On the cost-effectiveness analysis (CEA), C/E of control group was maximum(99.56) and combined group was minimum(42.62) among the four groups. CONCLUSION Intravenous combined with inhalation of Tanreqing injection for AECOPD is good clinical efficacy, safety and economy, worthy of promotion in the future.