Abstract: AIM: To contrastively observe the effects of combinative usage of ipratropium bromide, anti-cholinergic inhalant and the small dosage of controlled release theophylline tablets or salbutamol on the patients with COPD.METHODS: Forty patients with stable COPD were randomly divided into two groups (n=20 in each): theophylline group or salbutamol group.In theophylline group, each case inhaled 2 puffs of ipratropium bromide ter in die, meanwhile take 0.1 g ophylline capsule orally every 12 hours, measured the maximum and minimum concentration of ophylline.In salbutamol group, each case inhaled 2 puffs of ipratropium bromide and salbutamol ter in die.During 8-weeks trial, the base FEV1.0 before using medicine and the FEV1.0 when all the drug were stopped at the end of 1st, 4th, and 8th week was measured, separately.The FEV1.0 amelioration ratio (△′ FEV1.0) compared with base FEV1.0 was obtained, and another FEV1.0 amelioration ratio (△FEV1.0) was also detected after bronchodilatation test by salbutamol.Furthermore, PEFR aberration rate was evaluated by measuring peak expiratory flow rate in morning and evening daily.The maximum concentration of ophylline is 8.7±2.1 mg·L^-1, the minimum is 6.1±2.3 mg·L^-1.RESULTS: △FEV1.0 increased markedly at end of 8th week in theophylline group (P <0.01) and decreased gradually in salbutamol group (P < 0.001).It showed that △FEV1.0 in theophylline group increased more significantly than that in salbutamol group from 4th week (P < 0.01).△′FEV1.0 increased in both two groups but more apparently in theophylline group (P <0.001), and PEFR aberration rate descended in theophylline group(P < 0.01).There were few side effects in both two groups. CONCLUSION: Combinative usage of ipratropium bromide and small dosage of theophylline have anti-inflammatory and immunonondulatory effect to treat COPD.The long-time combinative usage of ipratropium bromide and salbutamol, used for stable COPD, will decrease the reactivity of patient to salbutamol.

Key words: ipratropium bromide, small dosage theophylline, salbutamol, chronic obstructive pulmonary disease