〔Abstract〕 Objective To analyze the effects of Modified Maxing Shigan Ersan Decoction combined with salbutamol sulfate injection on pulmonary function and blood gas indicators in patients with chronic obstructive pulmonary disease (COPD) during acute exacerbation. Methods A total of 94 patients with acute exacerbation of COPD admitted to Jiaozuo Hospital of Traditional Chinese Medicine from January 1, 2022 to June 30, 2023 were selected and divided into a control group and an observation group by lottery, with 47 cases in each group. They were treated with salbutamol sulfate alone or in combination with Modified Maxing Shigan Ersan Decoction, respectively. The treatment effects, pulmonary function indicators [forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), FEV1/FVC], blood gas indicators [partial pressure of oxygen (PaO₂), partial pressure of carbon dioxide (PaCO₂)], and safety were compared. Results The total effective rate of the observation group was higher than that of the control group; the levels of FVC, FEV1, PEF, and FEV1/FVC in the observation group were higher than those in the control group after treatment; The PaO₂ in the observation group was higher than that in the control group, while PaCO₂ was lower than that in the control group after treatment, with statistically significant differences (P < 0.05). There was no statistically significant difference in the incidence of adverse drug reactions between the two groups (P > 0.05). Conclusion For patients with acute exacerbation of COPD, the treatment with Modified Maxing Shigan Ersan Decoction combined with salbutamol sulfate injection has better efficacy, can also improve pulmonary function and blood gas indicators, and has high safety.