Objective To explore the application effect of respiratory training and sputum removal intervention strategies in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). undergoing high-intensity non-invasive positive pressure ventilation (NIPPV) intervention Methods A total of 116 patients with acute exacerbation of COPD admitted to Zhengzhou Central Hospital Affiliated to Zhengzhou University from June 2022 to June 2024 were selected as research subjects and divided into conventional group (physical sputum removal) and combination group (respiratory training combined with physical sputum removal) according to different intervention schemes, with 58 cases in each group. The lung function, blood gas analysis indicators, exercise endurance, timerelated indicators, and quality of life of the two groups were compared. Results After 14 days of intervention, the forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) levels in both groups increased, and the modified medical research council (mMRC) scores decreased (P <0.05), the FEV1 and FVC levels in the combination group were higher than those in the conventional group, and the mMRC score was lower than that in the conventional group (P <0.05). The partial pressure of oxygen (PaO2) and peripheral oxygen saturation (SpO2) levels in both groups increased, and partial pressure of carbon dioxide in arterial blood (PaCO2) levels decreased (P <0.05), the PaO2 and SpO2 levels in the combination group were higher than those in the conventional group, and the PaCO2 was lower than that in the conventional group (P<0.05). The 6-minute walk test (6MWT) in both groups increased, and the Borg scale scores decreased (P<0.05), the 6MWT in the combination group was higher than that in the conventional group, and the Borg scale score was lower than that in the conventional group (P<0.05). The disappearance time of rales, mechanical ventilation time, and hospitalization time in the combination group were shorter than those in the conventional group (P<0.05). The COPD Assessment Test (CAT) Questionnaire scores of both groups decreased (P<0.05), and the scores of the combination group were lower than those of the conventional group (P<0.05). Conclusion Respiratory training and sputum removal intervention strategies can effectively improve the pulmonary function and blood acid-base balance of patients with acute exacerbation of COPD undergoing high-intensity NIPPV, improve exercise tolerance and quality of life, and promote patient recovery, with good results.