Discussion
chronic respiratory tract inflammatory disease, malignant arrhythmia, death, dyspnea, inflammation, wheezing, respiratory adverse, fibrosis, emphysema, cough, asthma, phlegm, BT-related adverse reactions, COPD, shortness of breath
ADVERSE EVENTS, INFLAMMATION, FIBROSIS, EMPHYSEMA, COPD, ASTHMA, INFLAMMATORY DISEASE
COPD is a chronic airway inflammatory disease characterized by incompletely reversible airflow limitation, whose symptoms include small airway mucus formation, airway wall fibrosis, and emphysema [Bronchodilator agents are the cornerstone of COPD treatment, but they cannot completely reverse airway remodeling. As a new interventional technique, BT is effective on improving airway remodeling and lung function and relieving COPD [This study compared the difference in the efficacy between combined BT treatment and conventional medical treatment. As a result, both treatments improved FVC, FEVMoreover, FEVLung functional changes do not accurately reflect the life quality of patients. Poor lung function does not necessarily influence on patient life quality. Conversely, some patients with good lung function develop severe clinical symptoms that significantly affect their life quality. Assessing patient life quality and exercise tolerance is important to determine the effectiveness of combined BT treatment for COPD.The 6-min walk test is closely related to lung function parameters in COPD patients, with longer 6-min walking distance indicating better pulmonary ventilation function [mMRC assesses dyspnea level based on the shortness of breath symptom at the corresponding exercise intensity. Combined BT treatment significantly reduced mMRC and improved dyspnea. Considering the relatively one-sided assessment of mMRC, CAT assessment was conducted. CAT is a questionnaire based on SGRQ, reflecting life quality in COPD patients. Compared with assessing COPD life quality based on FEVCOPD acute exacerbation indicates an acute exacerbation of a patient’s respiratory symptoms and the need for additional treatment. After an exacerbation, about 20% of COPD patients do not return to their previous state. Declined lung function induces persistently severe COPD and reduces the life quality [Using long-acting anticholinergic drugs (LAMAs) is found to effectively improve lung function and reduce acute exacerbations in asthma and COPD patients [COPD is a chronic respiratory tract inflammatory disease. Studies have found that persistent and low-grade systemic inflammation is a factor for frequency-sensitive exacerbations [For safety, respiratory adverse events in both groups mostly included cough, phlegm, and short-term wheezing, which were effectively controlled in a short time. No serious adverse events such as malignant arrhythmia or death were observed in both groups within 1 year post-treatment. Therefore, BT treatment is safe and feasible for COPD patients.Combined BT treatment better improve lung function of COPD patients than conventional medical treatment, significantly improve life quality and reduce COPD acute exacerbation. BT-related adverse reactions are controllable in the short term, without serious adverse events. However, there are some limitations of this study. First, this study did not set the sham-operation group, which might have a certain effect on the results. Therefore, clinical studies with more perfect clinical design should be conducted. Second, this work enrolled patients with moderate to severe COPD, and the severity of emphysema also varied, which might lead to the difference in BT therapeutic effect. In addition, no subgroup analysis was conducted in this work, making it impossible to further explore which type of COPD patients could gain more benefits. In the future research, patients should be further classified according to the indicators, such as the severity of emphysema, so as to explore more COPD subtypes that can benefit from BT treatment and to improve the effect of BT on treating COPD. Third, this study did not collect the airway biopsy samples of patients, as a result, the airway pathological changes before and after BT could not be explored, and the mechanism of action of BT in COPD could not be analyzed. Finally, this was a single-center randomized controlled trial with a small sample size. Because of the limited sample size of participants diagnosed with COPD in this study, the current results should be further validated by subsequent studies.