This study aims to demonstrate the effects of triple therapy (ICS/LABA/LAMA) and dual bronchodilators (LAMA/LABA) on air trapping in the lungs' COPD patients and inflammatory mediators

Inclusion Criteria:

• Patients who have met the criteria for COPD GOLD B defined by an exacerbation not more than 1 time in the last year prior to the study enrollment. These patients will be recruited in sequential sequence.
• Patients with COPD GOLD B are previously treated with either LAMA or LAMA/LABA or short-acting bronchodilators
• Patients who are able to provide informed consent.

Exclusion Criteria:

• - Concomitant with active and old pulmonary TB, lung cancer, bronchiectasis, lung fibrosis, destroyed lung, other malignancy, active heart diseases.
• Receiving long-term treatment with immunosuppressive drugs and systemic corticosteroids
• Being treated with triple therapy (ICS/LABA/LAMA)
• Being in terminally ill conditions