To analyze the clinical efficacy of combined therapy with inhaled corticosteroids (ICS), long-acting muscarinic antagonists (LAMA), and long-acting β₂ agonists (LABA) in treating chronic obstructive pulmonary disease(COPD) -asthma overlap syndrome (ACOS).

A total of 67 ACOS patients admitted to our hospital from December 2021 to June 2024 were selected as subjects and divided into a control group (32 cases) and an observation group (35 cases) based on treatment regimens. The control group received ICS and LABA, while the observation group received ICS, LAMA, and LABA. Changes of CT signs of lung, Clinical efficacy, lung function, endothelial function, immune function, oxidative stress response, and adverse reactions were compared between the two groups.

The chest CT signs of the observation group were lower than those of the control group (P<0.05). The treatment effectiveness rate in the observation group was 31 cases (88.57%), higher than 22 cases (68.85%) in the control group (P<0.05). After treatment, the observation group showed higher forced vital capacity (FVC) (2.45±0.37) L, forced expiratory volume in the first second (FEV₁) (1.43±0.24) L, FEV₁/FVC ratio(60.67±3.89) %, and peak expiratory flow rate (PEF)(4.15±0.74) L/s compared to the control group FVC (2.23±0.28)L, FEV₁(1.25±0.31)L, FEV₁/FVC (55.99±2.49)%, PEF(3.70±0.15)L/s (P<0.05). Post-treatment levels of endothelin-1 (ET-1)(2.75±0.21)ng/L and soluble intercellular adhesion molecule-1(sICAM-1) (570.23±34.46) mg/ml were lower in the observation group than in the control group ET-1(3.05±0.55)ng/L, sICAM-1(597.82±44.83) mg/ml(P<0.05). Post-treatment levels of T helper 1 cell (Th1) (29.71±3.66)% and Th1/Th2 ratio (8.54±1.63) were higher in the observation group than in the control group Th1 (20.16±0.94) %, Th1/Th2 (7.38±0.96) (P<0.05). Post-treatment malondialdehyde (MDA) levels (6.13±0.99)nmol/L were lower in the observation group than in the control group (6.91±0.54)nmol/L, while superoxide dismutase (SOD) levels (51.05±4.73)U/ml were higher than in the control group (43.35±4.68)U/ml (P<0.05). The incidence of adverse reactions was 2 cases (5.71%) in the observation group, lower than 6 cases (18.75%) in the control group.

Triple therapy with ICS, LAMA, and LABA in ACOS patients improves treatment efficacy, enhances lung function, immune function, endothelial function, reduces oxidative stress response, and demonstrates high safety.