CLINICAL OBSERVATION OF TIOTROPIUM BROMIDE POWDER INHALATION COMBINED WITH ROXITHROMYCIN ORAL TREATMENT FOR PATIENTS WITH STABLE BRONCHIECTASIS

Biyu Chen^#, Chenglin Wu^#, Meifang Wang^*

Department of Respiratory Medicine, Taihe Hospital, Shiyan 442000, Hubei Province, China

Objective: To observe the clinical efficacy of tiotropium bromide powder combined with roxithromycin in the treatment of patients with stable bronchiectasis. 

Methods: A total of 120 patients with stable bronchiectasis were selected. Patients in the control group took 0.15 g of roxithromycin capsules orally once a day. In addition to the same roxithromycin capsules, patients in the treatment group also inhaled 18 μg of tiotropium bromide once a day. The course of treatment was three months. Clinical symptoms, dyspnea score, number of acute exacerbations, arterial blood gas and pulmonary function response indices, and cell classification of alveolar lavage fluid were observed. 

Results: Compared to before treatment, the clinical symptom score and dyspnea score of the treatment group were significantly decreased after treatment (P < 0.05), as was the dyspnea score in the control group (P<0.05). The clinical symptom score, dyspnea score, and number of exacerbations in the treatment group were significantly lower than those of the control group (P<0.05). After treatment, values for the arterial partial pressure of oxygen, forced expiratory volume in one second, and six-minute walk test were significantly increased in both the control and treatment groups, but these increases were significantly greater in the treatment group than in the control group (P<0.05). There were no significant changes in partial pressure of carbon dioxide, forced vital capacity, or peak expiratory flow rate (P>0.05). Following treatment, the proportion of neutrophils in both groups decreased significantly and the proportion of macrophages increased significantly (P<0.05) in comparison to pre-treatment levels, but the proportion of lymphocytes did not change significantly. The inflammation in patients with bronchiectasis may be related to collagenase secreted by neutrophils, which suggests that both treatments may have significant effects on tracheal inflammation – although the proportions of neutrophils and macrophages differed between the two groups, all changes following treatment were statistically significant (P<0.05). 

Conclusion: Tiotropium bromide powder combined with roxithromycin can significantly improve the symptoms of patients with bronchiectasis.