Control Study Of Different Treatment Protocol In Patients With Severe Chronic Obstructive Pulmonary Disease In Stable Phase

background： chronic obstructive pulmonary disease (COPD) is a diseasethat is preventable and treatable and characterized by airflow obstructionthat is not fully reversible. The treatment for COPD including drugtreatment and daily functional exercise.bronchodilators with or withoutinhaled corticosteroid had been proved to be effective treatment protocolfor severe COPD in stable phase.objectives：to evaluate the efficacy and tolerability of tiotropium andsalmeterol/fluticasone and theophylline treatment for severe COPDpatient in stable phase， and their influence on patient’s lungfunction,aiway inflammation factor and other index.methods：after4weeks run-in treatment period,137COPD patients whommatching the requirements were randomized to three groups and accept24weeks treatment with theophylline0.2BID or salmeterol/fluticasone50/250ug twice daily fix dose or tiotropium18ug QD respectively.FinishedPulmonary function test,six minute walking test,dyspnea questionnaire,BODEindex,ECG, sputum cell count and sputum VEGF and LTB4measurement at thebeginning,4weeks,12weeks and at the end of the experiment.Result：in the three groups of patients with sever COPD in stablephase,40patients finished treatment in group treating with theophylline and40patients finished treatment in group treating with salmeterol/fluticasone50/250ug twice daily fix dose，other42patients finishedtreatment in group of treating with tiotropium18ug QD fix dose，all patients show significance improvement in measurement of Pulmonaryfunction,6minute walk test,dyspnea questionnaire,BODE index. Tiotropiumand salmeterol/fluticasone is more effective than theophylline inimproving these experiment results. Tiotropium and salmeterol/fluticasone had show no significant difference when compare with eachother except for6minute walk test. The three treatment can decrease the sputumVEGF and LTB4，and the Tiotropium treatment group shows notable difference.Conclusion：tiotropium and salmeterol/fluticasone theophylline all showefficacy in improve copd patient’s life，the tiotropium and salmeterol/fluticasone is more efficient than theophylline. Tiotropium maybe willdelayed the airway remolding.