Clinical Effect of Inhaled Budesonide/Formoterol and Tiotropium Bromide for Very Severe Chronic Obstructive Pulmonary Disease Patients at Stable Stage

Objective To explore the clinical effect of budesonide / formoterol and tiotropium bromide for combined inhalation in the treatment of very severe chronic obstructive pulmonary disease(COPD) patients at stable stage. Methods 210 patients with very severe COPD admitted to our hospital from October 2012 to April 2013 were selected and randomly divided into three groups equally. Patients in group A were given inhaled budesonide and formoterol(Symbicort Turbuhaler, 80 μg/4.5 μg, twice-daily), patients in group B were given inhaled tiotropium bromide(Spiriva, 18 μg, twice-daily), while patients in group C were given inhaled budesonide/formoterol(1 ~ 2times/day) and tiotropium bromide(twice-daily). All patients were given maintenance therapy for 6 months. The lung functions before and after therapy, curative effects and adverse reactions of three groups were observed. Results The total effective rates of group A, group B and group C were 84.3%, 58.6% and 94.3%, respectively, and the difference among three groups was statistically significant(P 0.05). The group C was superior to the group A and group B in the improvement of lung function, dyspnea scores and quality of life score(P 0.05).The IL-8 level and TNF-α level of group C after treatment were(0.32 ± 0.15) pg/m L and(63.21 ± 7.17) pg/m L, significantly lower than those before treatment(P 0.05), and those of group A and group B after treatment(P 0.05). There was no statistically significant difference among three group in the incidence of drug-related adverse reactions(P 0.05). Conclusions Combined inhalation with budesonide /formoterol and tiotropium bromide for very severe COPD patients at stable stage has significant effect, which can obviously reduce patients' serum inflammatory factors levels, improve patients' lung function, and improve patients' quality of life.