Abstract
Purpose: To investigate the effect of combined administration of theophylline sustained-release tablets and thymalfasin on pulmonary function, immunity, and inflammation in elderly patients with chronic obstructive pulmonary disease (COPD) and respiratory failure.
 Methods: A total of 122 elderly patients in Fujian Geriatric Hospital, Fuzhou, China who suffered from acute attack of COPD with respiratory failure from January 2019 - January 2020 were selected for this study. The patients were divided randomly and evenly into study and control groups. Theophylline sustained-release tablets were administered to subjects in the control group, while theophylline sustained-release tablets and thymalfasin were administered to subjects in the study group. Pulmonary function indicators, viz, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC), blood gas indicators (PaCO2, PaO2, and SaO2), inflammatory factors (sICAM-1, PGE2, and hs-CRP), immune cells (Th17, Treg, and Th17/Treg), as well as exercise ability (the 6 min walking distance test) were evaluated for each group. Adverse reactions were also assessed.
 Results: There were no significant differences in pulmonary function, blood gas, inflammation, immunity, and exercise ability between the two groups before treatment (p < 0.01). However, all parameters improved significantly for both groups after treatment, with better outcomes for all parameters in the study group. A proportion of (14.75 %) patients in the study group showed adverse events, while 13.11 % of the patients in the control group exhibited adverse effects, meaning that the study group had a slightly but not significantly higher rate of adverse events.
 Conclusion: The combined administration of theophylline sustained-release tablets and thymalfasin reduces inflammation and improves physical immunity, leading to enhancement of blood gas and pulmonary function in elderly patients with COPD and respiratory failure. However, further clinical trials are required prior to application of this combination therapy in clinical practice.
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