Abstract： Objective To investigate the clinical effects of tiotropium bromide and montelukast combined with budesonide formoterol in the treatment of acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Methods Eighty patients with AECOPD admitted to The First Affliated Hospital of Gannan Medical University from June 2020 to November 2022 were selected and divided into a control group(n=40)and a combination therapy group(n=40)by randomized numerical table method.The control group was treated with tiotropium bromide and budesonide formoterol,and the combination therapy group was treated with montelukast on this basis.Lung function,inflammatory factor and drug safety were compared between the two groups.Results Lung function indexes increased in both groups after treatment,the level of inflammatory factor decreased,and the changes were more obvious in the combination treatment group,the differences were statistically significant(P<0.05).No significant adverse reactions occurred during the treatment of both groups.Conclusion On the basis of tiotropium bromide combined with budesonide formoterol treatment,the addition of montelukast in AECOPD patients can enhance the efficacy of the treatment,so that the patients'lung function can be significantly improved,reduce the body's inflammatory response,and promote the patient's transition,which is worthy of wide clinical application.