Objective:To observe the effects of salmeterol and fluticasone combined with the conventional treatment on the airway remodeling and bone metabolism in the patients with severe chronic obstructive lung disease ( chronic obstructive pulmonary disease, COPD. Methods:Totally 90 patients with severe COPD were divided into the observation group and the control group according to the order of admission. The control group was received the conventional treatment, and the observation group was treated with salmeterol and fluticasone additionally. The course of treatment was 8 weeks. Before the treatment and in the 3rd and 12th month after the treat-ment, the changes in the levels of bone mineral density ( BMD) in femoral neck bone, serum osteocalcin ( BGP) , alkaline phosphatase (AKP), the total number of induced sputum cells, neutrophils percentage, forced expiratory volume in one second (FEV1), leukocyte mediated element 8 (IL-8), matrix metalloproteinase 9 (MMP-9) and other indicators were detected and compared. Results: BGP, AKP and BMD of the two groups in the 3rd month after the treatment were not significantly changed (P>0. 05), while in the 12th month after the treatment, BMD in the observation group was significantly lower than that in the control group and that before the treat-ment, and BGP and AKP in the observation group were significantly higher than those in the control group and that before the treatment (P<0. 05). The total number of induced sputum cells, the percentage of neutrophils, FEV1, MMP-P and IL-8 in the two groups were significantly improved in the 12th month after the treatment (P<0. 05), and the difference between the two groups was statistically sig-nificant except IL-8 (P<0. 05). Conclusion:Salmeterol and fluticasone propionate can effectively improve airway remodeling in the patients with COPD. Short time use of salmeterol and fluticasone propionate shows no adverse effect on the bone metabolism, while long-term use would lead to reduced bone mineral density.