Effect of tiotropium bromide combined with salmeterol/fluticasone inhalation on lung function, sleep quality and heart rate variability in patients with asthma-chronic obstructive pulmonary disease overlap syndrome

Fu Yu; Wu Shaomin; Zeng Zhaofan

doi:10.3760/j.issn.1673-4777.2019.09.013

Abstract：Objective To explore the effect of tiotropium bromide combined with salmeterol/fluticasone inhalation on lung function,sleep quality and heart rate variability in patients with asthma-chronic obstructive pulmonary disease overlap syndrome (ACOS).Methods A total of 94 patients with ACOS admitted to Hainan General Hospital from October 2015 to June 2018 were randomly divided into control group(n =47) and observation group (n =47).The control group was treated with salmeterol/fluticasone inhalation on the basis of routine treatment.The observation group was treated with tiotropium bromide on the basis of control group.Pulmonary function indexes[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),percentage of predicted FEV1 (FEV1％ pre)],sleep condition [Pittsburgh Sleep Quality Index (PSQI) and sleeping time per night],heart rate variability[standard deviation of 24 h normal RR intervals(SDNN),root mean square of successive differences(RMSSD),percentage of adjacent RR intervals with difference of duration greater than 50 ms (PNN50)],therapeutic efficacy and adverse reactions were analyzed.Results After treatment,FVC,FEV1,FEV1 ％ pre,SDNN,RMSSD and PN50 significantly increased and the indexes in observation group were higher than those in control group [(2.88 ± 0.23) L vs (2.61 ± 0.27) L,(2.49 ± 0.21) L vs (2.04 ± 0.22) L,(47 ±5)％ vs(41±6)％,(139±24)ms vs (123±26)ms,(54±12)ms vs (48±11)ms,(16.0±2.0)％ vs (15.0 ±2.0)％] (all P ＜ 0.05).PSQI score significantly decreased and sleeping time per night significantly increased in both groups;PSQI score in observation group was lower[(4.7 ± 1.8) vs (7.7 ± 1.9)] and sleeping time per night was longer [(7.3 ± 1.1) h vs (6.8 ± 1.1) h] (all P ＜ 0.05) than those in control group (all P ＜0.05).The therapeutic effect in observation group was significantly better than that in control group(P ＜ 0.05).There was no significant difference in the incidences of xerostomia,nausea,dizziness and tachycardia between groups(all P ＞0.05).Conclusion Combined tiotropium bromide with salmeterol/fluticasone inhalation treating ACOS can effectively improve lung function,improve sleep quality and reduce heart rate variability.