COMPARATIVE STUDY OF LAMA PLUS LABA WITH ATORVASTATIN AND PANAX GINSENG ALONE AND IN COMBINATION IN COPD PATIENTS TO IMPROVE PULMONARY FUNCTIONS

Abstract

Chronic obstructive pulmonary disease (COPD) is a debilitating disease characterized by progressive airflow obstruction. The cornerstones of treatment are bronchodilator drugs of two different classes including beta agonists and muscarinic antagonists. Currently the Global initiative for COPD suggests the use of long-acting beta agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) in combination. In COPD statins reduce neutrophil influx within lungs. Panax ginseng lowers oxidative stress and suppresses cytokine pro-inflammatory mediators potentially responsible for COPD. The objective of this study was to evaluate the efficacy and safety profile of statins and panax ginseng alone and in combination with LABA and LAMA, for COPD patients. The study was conducted at National Medical Centre in 162 patients. The patients were randomly divided into three groups, each containing 54 patients. The study period were 12 weeks with follow up of patients. Baseline investigations were carried out including ESR, blood CP, blood urea, serum creatinine, serum uric acid, LFTs (SGPT and bilirubin) blood glucose and pulmonary function tests including spirometry. At baseline, no significant differences were observed between groups for Forced Expiratory Volume in 1 second (FEV1), Forced Vital Capacity (FVC), or Peak Expiratory Flow Rate (PEFR). By week 4, significant improvements were observed for treatments B and C. FEV1 increased in treatment B (62.71 ± 4.12) and C (64.56 ± 3.13) compared to A (61.12 ± 3.91), with treatment C showing a greater improvement (p = 0.035). These trends continued through week 12, where treatment C (67.89 ± 3.49) consistently outperformed A (62.19 ± 3.45) and B (63.45 ± 5.12). FVC results followed a similar pattern, with treatment B (63.45 ± 5.12) and C (67.89 ± 3.49) outperforming A (62.19 ± 3.45) by week 12. PEFR improved most significantly for treatment C (377.69 ± 30.66) compared to B (366.48 ± 27.68) and A (348.15 ± 24.11). Inflammatory markers such as CRP and ESR decreased significantly, particularly for treatment C, where CRP dropped to 1.83 ± 2.89 and ESR to 11.11 ± 4.34 by week 12, indicating reduced inflammation. Treatment C showed the best overall outcomes across all parameters. viii In conclusion, the clinical efficacy of statins and panax ginseng in COPD patients, in combination with LABA and LAMA, is comparatively more escalated and with less adverse effects in comparison to statins and panax ginseng being used alone in COPD patients.