Effects of Tiotropium Combined with Theophylline on Stable COPD Patients of Group B, D and its Impact on Small Airway Function: A Randomized Controlled Trial

Theophylline for the management of respiratory disorders in adults in the 21st century: A scoping review from the American College of Clinical Pharmacy Pulmonary Practice and Research Network

Theophylline is an oral methylxanthine bronchodilator recommended as alternate therapy for the treatment of asthma and chronic obstructive pulmonary disease (COPD). However, it is not generally recommended for the treatment of other respiratory disorders such as obstructive sleep apnea (OSA) or hypoxia. Most clinical practice guidelines rely on evidence published prior to the year 2000 to make these recommendations. This scoping review aimed to gather and characterize evidence describing theophylline for the management of respiratory disorders in adults between January 1, 2000 and December 31, 2020. Databases searched included Ovid MEDLINE, Embase, CINAHL Complete, Scopus, and International Pharmaceutical Abstracts. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews. Studies were included if they were published in English, theophylline was used for any respiratory disorder, and the study outcomes were disease- or patient-oriented. After removal of duplicates, 841 studies were screened and 55 studies were included. Results aligned with current clinical guideline recommendations relegating theophylline as an alternative therapy for the treatment of respiratory disorders, in favor of inhaled corticosteroids and inhaled bronchodilators. This scoping review identified the need for future research including: theophylline versus other medications deemed alternative therapies for asthma and COPD, meta-analyses of low-dose theophylline, and studies evaluating evidence-based patient-oriented outcomes for OSA, hypoxia, ventilator-induced diaphragmatic dysfunction, and spinal cord injury-related pulmonary function.

Effect of Yifei-Huoxue Decoction Combined with Tiotropium on Inflammatory Cytokine Levels, Pulmonary Function, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Objective

The main objective is to investigate the effect of Yifei-Huoxue decoction combined with tiotropium on the inflammatory cytokine levels, pulmonary function, and quality of life in patients with chronic obstructive pulmonary disease (COPD).

Methods

Ninety-eight COPD patients who were treated in our hospital from January 2021 to January 2022 were selected as the research objects, and they were divided into reference group (routine treatment) and study group (Yifei-Huoxue decoction combined with tiotropium), with 49 cases in each group. The patients' clinical indexes were compared between the two groups, and the clinical efficacy in the two groups was analyzed.

Results

Compared with the reference group, the study group had remarkably lower inflammatory cytokine levels (including tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-6 (IL-6)) after treatment (P > 0.05). In terms of the patients' pulmonary function indexes after treatment, the study group achieved lower forced vital capacity (FVC), forced expiratory volume in 1s (FEV1), and FEV1/FVC levels compared with the reference group (P < 0.05). Both groups had a lower erythrocyte sedimentation rate (ESR) after treatment compared with that before treatment. However, the intergroup difference in the ESRs after treatment was remarkable, and the study group had a much lower ESR compared with the reference group (P < 0.05). Compared with the reference group, the study group achieved much higher 36-item short form health survey (SF-36) scores in dimensions of general health, physical functioning, social functioning, and mental health after treatment (P < 0.05).

Conclusion

Yifei-Huoxue decoction combined with tiotropium not only enhances the COPD patients' pulmonary function but also decreases their inflammatory levels. Therefore, this treatment is conducive to promoting the COPD patients' recovery and exerts positive effect on improving their quality of life.

Relationship of Nutritional Status and Spirometric Parameters in Children with Bronchial Asthma

The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma.

Chronic Obstructive Pulmonary Disease Treatment and Pharmacist-Led Medication Management

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death across the globe. Its repeated exacerbation will seriously worsen the quality of life, aggravate the patients’ symptoms, and bring a heavy burden on the patients and the society. Understanding the current status of drug therapy and the role of pharmaceutical care is essential for the management of COPD. In addition to the drugs already on the market, recent clinical trials also show that emerging novel drugs for treating COPD are being developed to prevent the symptoms, reduce the frequency of acute exacerbation, and improve the quality of life. Recent progress in new drug research should lead to novel treatment options for COPD patients in future clinical practice. The pharmaceutical care has shown significantly favourable impacts on addressing drug-related problems, supporting its vital role in the management of COPD, especially when there are a wide range of therapeutic agents. This review not only provides an overview of current treatment strategies but also further underlines the importance of new drug development and pharmaceutical care for patients with COPD.