To observe the effect of Chinese medicine intestine adjusting therapy (IAT) on patients with respiratory failure caused by acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and undergoing noninvasive ventilation, their immune function, ventilation indices and incidence of complication.Patients matched with the inclusive criteria were randomized into two groups, 30 in each group. All received bi-level positive airway pressure ventilation and conventional drug therapy, but to patients in the treatment group, IAT was applied additionally by electro-acupuncturing (EA) acupoints Zusanli (ST36), Shangjuxu (ST37), Fenglong (ST40), and Quchi (LI11), also the retention enema with Xuanbai Dachengqi Decoction. The nutritional indicators, including serum total protein (TP), serum albumin (ALB) and hemoglobin (HGB); immune indices, including immuno-globulins (IgG, IgA, IgM), complements, and T-lymphocyte subsets; and the incidence of ventilation complications in the two groups were dynamically observed and compared.After treatment, the nutritional indicators went down in both groups (P < 0.05, P < 0.01), but the lowering in the treatment group were lesser. Moreover, the treatment group showed a higher TP level (P < 0.05) and lower depressive amplitude of ALB (P < 0.01) than those in the control group. Immune indices, excepting IgM, increased significantly in both groups (P < 0.05 or P < 0. 01), but the increments in the treatment group were higher, so significant difference was shown between groups (P < 0.05 or P < 0.01). As for comparison in ventilation complication, the incidence of abdominal distension (which was extensively occurred in the control group), belching and error aspiration in the treatment were significantly fewer (P < 0.05, P < 0.01). Besides, the maximum PS and PEEP, and the mechanical ventilation time were significantly reduced in the treatment group (P < 0.05).IAT of Chinese medicine is facilitated to improve the nutritional status of AECOPD patients with respiratory failure undergoing noninvasive ventilation, enhance their immune function, improve the ventilatory efficiency, reduce the duration of mechanical ventilation and the occurrence of complications.