The Efficacy Of ICS+LABA In The Treatment Of COPD And The Relationship With FeNo,Peripheral Blood Eosinophils

Objective:To study the relationship between the efficacy of ICS+LABA in the treatment of COPD patients and FeNO and peripheral blood eosinophils.Methods:40 cases of newly diagnosed COPD patients included in the respiratory department from January 2018 to January 2019 were selected as research objects,and FeNO and EOS levels of all patients were slightly higher than the normal high limit(FeNO > 25 ppb,EOS > 5.0%).According to the numerical table method,20 patients were randomly divided into two groups,among which group A was treated with salmeterol-fluticasone powder inhalation and group B was treated with tiotropium bromide powder inhalation,and the treatment results of the two groups were compared.According to FeNO level of patients in group A,the patients in this group were further divided into 25 ppb < FeNO < 50 ppb subgroup(n=7)and FeNO 50 ppb subgroup(n=13)to observe the EOS level of patients with different concentrations of FeNO.Results:1.Treatment effective rate: the total effective rate of group A was 90.00%,significantly higher than that of group B(75.00%)(P < 0.05).2.Changes in lung function indicators after treatment: there was no difference in the levels of FEV1,FEV1%,FVC,and FEV1/FVC% between the two groups before treatment(P>0.05),and the levels of various indicators in the two groups after treatment were significantly improved(P < 0.05),but the improvement degree in group A was better than that in group B(P < 0.05).3.Changes in FeNO and EOS after treatment: there was no difference in FeNO and EOS levels between the two groups before treatment(P>0.05).After treatment,FeNO levels in group A were significantly lower than those in group B,suggesting improved airway inflammation(P < 0.05),but there was no statistically significant difference in blood EOS levels between the two groups after treatment(P>0.05).After dividing group A into two subgroups,it was found that EOS level of patients in the 25 ppb < FeNO < 50 ppb group was lower than that in the FeNO 50 ppb group before treatment(P < 0.05),and EOS level of patients in the25 ppb < FeNO < 50 ppb group was higher than that in the FeNO 50 ppb group after treatment(P < 0.05).4.Changes in clinical symptom score after treatment: there was no difference in the symptom score of cough,expectoration and shortness of breath between the two groups before treatment(P>0.05),and all scores in the two groups were significantly improved after treatment(P < 0.05),but the improvement degree in group A was better than that in group B(P < 0.05).5.CAT and 6MWT changes after treatment: there was no difference in CAT score and 6MWT between the two groups before treatment(P>0.05),and all indexes in the two groups were significantly improved after treatment(P < 0.05),but the improvement degree in group A was better than that in group B(P < 0.05).After correlation analysis,it was found that FeNO level was positively correlated with EOS level(P < 0.05),and negatively correlated with lung function indicators of FEV1,FEV1%,FVC,FEV1/FVC%(P <0.05).6.Adverse reactions: the incidence of adverse reactions in group A was 10.00%,which was not different from that in group B(15.00%)(P>0.05)Conclusion:1.In terms of treatment effectiveness,for patients with increased FeNO and EOS,COPD patients with phenotype of eosinophilic inflammation,the treatment regimen of ICS+LABA may be superior to LAMA treatment in terms of alleviating symptoms,improving lung function and quality of life.2.In terms of treatment safety,ICS+LABA does not significantly increase the incidence of adverse reactions compared with LAMA.