Effect of budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with theophylline sustained-release tablets on dyspnea severity and small airway function in patients with bronchiectasis complicated with severe chronic obstructive pulmonary disease

Nan Guangri; Wang Manrui

doi:10.3760/j.issn.1673-4777.2026.04.004

Abstract：Objective To observe the clinical efficacy of budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with theophylline sustained-release tablets in the treatment of patients with bronchiectasis complicated with severe chronic obstructive pulmonary disease(BCOS),and to explore its effect on improving dyspnea and small airway function in BCOS patients.Methods A total of 90 BCOS patients admitted to Hainan Hospital of Chinese PLA General Hospital from January 2023 to January 2024 were enrolled as research subjects.According to different treatment regimens,the patients were divided into the control group(45 cases,budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol alone)and the observation group(45 cases,budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with theophylline sustained-release tablets).The clinical data and therapeutic efficacy were compared between the two groups.A difference-in-differences model was established to evaluate the changes in comprehensive scores before and after treatment in the two groups.Repeated measures analysis of variance was used to analyze the changes in maximal expiratory flow at 25％of forced vital capacity(MEF25)and maximal expiratory flow at 50％of forced vital capacity(MEF50).The effects of MEF25 and MEF50 on therapeutic efficacy during treatment were analyzed.Results There were no statistically significant differences in clinical data between the two groups(all P＞0.05).After treatment,the scores of chronic obstructive pulmonary disease assessment test(CAT),St.George's respiratory questionnaire(SGRQ)and modified medical research council dyspnea scale(mMRC)in both groups were significantly lower than those before treatment,and the scores in the observation group were significantly lower than those in the control group(all P＜0.05).The results of the difference-in-differences model showed that the CAT,SGRQ and mMRC scores decreased by 9.782,5.462 and 8.102 on average after treatment.The interac-tion coefficient of group × time had a significant effect on the comprehensive scores.The reduction amplitude of comprehensive scores in the observation group after treatment was higher than that in the control group,with an increase of 7.631,3.019 and 6.932 respectively.There were statistically significant differences in the inter-group effect,time effect and interaction effect of MEF25 and MEF50 levels in patients(all P＜0.05).The total effective rate of treatment in the observation group was significantly higher than that in the control group[95.6％(43/45)vs 82.2％(37/45)](x2=6.133,P=0.047).The results of stratified analysis showed that at each stratified level of MEF25 and MEF50 at 12 weeks of treatment,the therapeutic effect of the observation group was stronger than that of the control group(both P＜0.001).Conclusion Budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol combined with theophylline sustained-release tablets can improve the clinical efficacy of BCOS patients,alleviate dyspnea and improve small airway function.