Comparative Study on the Efficacy of Tiotropium Bromide Inhalation and Oral Doxofylline Treatment of Moderate to Severe Stable Chronic Obstructive Pulmonary Disease

This study compared the efficacy and safety of tiotropium bromide inhalation powder （spiriva） and doxofylline oral tablet （doxofylline） in the treatment of chronic obstructive pulmonary disease （COPD）. A multi-center, randomized, double-blind, double-dummy, parallel-controlled study involved 127 eligible stable moderate to severe COPD patients treated with inhaled tiotropium dry powder （18 μg/day） or oral doxofylline tablets （0.2 g/time, 2 times a day） for 12 and 24 weeks. Before and after treatment for 12 weeks and 24 weeks, respectively, pulmonary function, 6-min walking distance and dyspnea index were recorded. The results showed that in both tiotropium group and doxofylline groups, after 12-week treatment, FEV1, FEV1/FVC% and 6-min walk distance were sig-nificantly higher than those before the medication, while dyspnea index decreased as compared with that before treatment. After 24-week treatment, a slight improvement in the measures was observed as compared with that of 12-weeks treatment, but the difference was not statistically significant. With both 12-week and 24-week treatment, the effect of tiotropium was slightly better than that of doxofylline tablets, with the difference being statistically insignificant. The major adverse events in the tiotropium group and doxofylline group were observed in 9 cases （9.9%） and 12 cases （12.9%）, respectively, and no statistically significant difference was found between them. We are led to conclude that both tiotropium at 18 μg a day and doxofylline tablets at 0.2 g/day （two times a day） are effective and safe for the treatment of COPD.

Effects of doxofylline combined with Dingzhang Decoction on AECOPD and its influence on NLRP3 mRNA and TLR4-MyD88 pathway

Objective: To investigate the effect of doxofylline combined with Dingzhang Decoction on acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and its effect on NLRP3 mRNA and TLR4MyD88 pathway. Methods: 120 patients with AECOPD from May 2017 to June 2018 were randomly divided into two groups (n=60). The control group was treated with doxofylline, and the observation group was treated with Dingzhang Tangdingzhang in the control group. Blood gas index and lung function index were compared between the two groups. Serum interleukin-1 (IL-1), interleukin-18 (IL-18) and peripheral blood lymphocyte NLRP3 mRNA and TLR4MyD88 pathway were detected and compared. Protein expression level. Results: The effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the blood gas indexes of both groups were significantly improved (P<0.05). PaO2 in the observation group was higher than that in the control group and PaCO2 was significantly lower than the control group (P<0.05). After treatment, the lung function indexes of both groups were significantly increased (P<0.05). FEV1 and PEF in the observation group were significantly higher than the control group (P<0.05). After treatment, IL-1 and IL-18 were significantly decreased (P<0.05). IL-1 and IL-18 in the observation group were significantly lower than the control group (P<0.05). There was no significant difference in NLRP3 mRNA levels between the two groups before treatment (P>0.05), and it was significantly decreased after treatment (P<0.05). The level of NLRP3 mRNA in peripheral blood lymphocytes of the observation group was significantly lower than that of the control group (P<0.05). There was no significant difference in TLR4 and MyD88 protein levels between the two groups before treatment (P>0.05), and significantly decreased after treatment (P<0.05). The levels of TLR4 and MyD88 in peripheral blood lymphocytes of the observation group were significantly lower than those of the control group (P<0.05). Conclusion: Dingzhang Decoction combined with doxofylline has a better clinical effect on AECOPD patients, which can better improve blood gas index and lung function. Dingzhangtang significantly inhibited the TLR4-MyD88 pathway in lymphocytes and down-regulated the level of NLRP3 mRNA.

Clinical study on doxofylline combined with inhalant treatment of acute attack of bronchial asthma

Objective:To study the effect of doxofylline combined with inhalant on inflammation and immune response in acute attack of bronchial asthma.Methods: Patients with acute attack of bronchial asthma who were treated in Ganquan People's Hospital in Yan'an Shaanxi Province between May 2015 and October 2017 were chosen as the research subjects and randomly divided into the observation group who received doxofylline combined with inhalant treatment and the control group who received conventional inhalant treatment. The contents of inflammatory mediators and protease molecules in serum as well as the contents of immune cells in peripheral blood were measured before treatment and 3 d after treatment.Results:3 d after treatment, Eotaxin, YKL40, LTB4, TGF-β1, POSTN, ADAM8, ADAM33 and MMP9 contents in serum as well as Th2, Th9 and Th17 contents in peripheral blood of both groups of patients were lower than those before treatment whereas TIMP1 contents in serum as well as Th1 and Treg contents in peripheral blood were higher than those before treatment, and Eotaxin, YKL40, LTB4, TGF-β1, POSTN, ADAM8, ADAM33 and MMP9 contents in serum as well as Th2, Th9 and Th17 contents in peripheral blood of observation group of patients were lower than those of control group whereas TIMP1 content in serum as well as Th1 and Treg contents in peripheral blood was higher than those of control group.Conclusion:Doxofylline combined with inhalant treatment of acute attack of bronchial asthma can more effectively inhibit the activation of inflammatory response and improve the immune response mediated by Th cells.