Background. COPD is a chronic respiratory disease with a long course and recurrent characteristics. According to relevant statistics, the global incidence of COPD is more than 30%, which seriously affects the life of patients and endangers their health. Objective. To observe the curative effect of Xiyanping in elderly patients with COPD and its influence on the expressions of growth differentiation GDF-15 and HIF-1α in serum. Methods. From August 2019 to December 2021, 86 elderly patients with acute exacerbation of COPD were admitted to our hospital. As the research objects, they were divided into the control group () and the observation group () randomly. The control group received the conventional treatment, while the observation group got Xiyanping on the basis of the control group. The differences in the duration of antibiotic use, expectoration, hospital stays, adverse reactions and serum-related factors, blood routine, pulmonary function, airway hyperreactivity index, COPD assessment test (CAT) score, and Borg score were made a comparison between them. Results. On the 3rd and 7th days after being treated, the sputum excretion in them was higher than before, but on the 3rd day of treatment, the sputum excretion in the observation group was higher than that in the control group, while on the 7th day of treatment, the sputum excretion was lower than that in the control group with statistically significant differences (). Before treatment, the serum-related factors and blood routine indexes between them were similar (). After treatment, GDF-15, HIF-1α, CXCL12, TNF-α, IL-8, TGF-β, WBC, and NEU in them were significantly lower than before, and the values in the observation group were significantly lower than those in the control group with statistically significant differences (). There was no difference in the related indexes of pulmonary function and airway hyperreactivity between them before treatment. After being treated, FEV1, FVC, and FEV1/FVC in them were significantly higher than those before treatment. The airway resistance and lung compliance of the two groups at exhalation and inspiration were significantly lower than before, and the values in the observation group were significantly lower than those in the control group (). There was no difference in CAT and Borg scores between them before treatment. After treatment, the CAT score and Borg score of these patients were significantly lower than those before treatment, and the value of the observation group was significantly lower than that of the control group (). The duration of antibiotic use and length of stay in the observation group were significantly shorter than those of the control group, while the incidence of adverse reactions was not statistically significantly different compared with the control group (). Conclusion. Xiyanping can improve pulmonary function of elderly patients with acute exacerbation of COPD, reduce the response of airway hyperreactivity, and promote the excretion of sputum.