Effect of tiotropium bromide combined with inhaled glucocorticoids on lung function, FeNO and immune function in patients with asthma-COPD overlap syndrome

HU Haitao; ZENG Lijuan; QU Lei; GONG Chuanming

Abstract：Objective To observe the effect of tiotropium bromide combined with inhaled glucocorticoids on lung function, FeNO and immune function in patients with asthma-chronic obstructive pulmonary disease (ACOS) overlap syndrome.Methods One hundred and eighteen patients with ACOS were selected as subjects and were equally divided into the observation group and control group by the random number table method. Both groups were treated with budesonide powder inhalation, but the observation group was additionally treated with tiotropium bromide dry powder capsules. The clinical effect, pulmonary function indexes [forced vital capacity (FVC), forced expiratory volume in one second (FEV1), the percentage of forced expiratory volume in forced vital capacity (FEV1/FVC), FeNO], serum inflammatory factors [interleukin (IL-6), tumor necrosis factor alpha (TNF-α), immune function indexes (Th1 and Th2 cell subsets) and scores of asthma symptom (ACT) and chronic obstructive pulmonary disease symptoms (CAT) before and after treatment were compared between the two groups.Results The total effective rate in the observation group was significantly higher than that in the control group (P<0.05). After treatment, the improvement of FVC, FEV1, FEV1/FVC and FeNO in the observation group was more significant than that in the control group (t=9.785, 7.537, 11.045 and 3.037, P<0.05). The expression levels of IL-6 and TNF-α in the observation group were significantly lower than those in the control group (t=4.568 and 2.835,P<0.05). The immune indexes (Th1, Th2, Th1/Th2) and improvement of CAT and ACT scores in the observation group were significantly better than those in control (t=14.192, 2.222, 12.692 and 8.565, 7.863, P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (χ2=0.778,P<0.05).Conclusion Tiotropium bromide combined with inhaled glucocorticoids can significantly relieve the clinical symptoms of patients with ACOS and improve lung function and immune function in patients. This approach is more effective than inhalation of glucocorticoids alone, without increasing adverse reactions.