| Objective: The thesis is to comparation clinical therapeutic effect of high-intensityfocused ultrasound(HIFU) and pharmacotherapy on persistent allergic rhinitis(PAR) patients and explore the influence of HIFU on nasal mucuscilia transmission function,which is t-o discuss the validity and superiority of HIFU on PAR.Methodology: The thesis were randomly selected from the patients who were treated in Ear-Nose-Throat Department, The Second Hospital, Hebei Medical U-niversity from March 2014 to March 2015, from which there were 152 cases who were diagnosed as PAR according to the Gui de for diagnosis and treatment of allergic rhinitis(2009,the Chinese Wuyi Mountain diagnostic criteria of allergic rhinitis). They were divided into two groups under their own will, from which there are 72 patients are HIFU group(also named as Observation group) and the remaining patients are divided as Pharmacotherapy group(aka the Control group). For the Observation group, they were treated as HIFU assisted by nasa l endoscope, with the bilateral inferior turbinate, the front of middle turb inate, agger nasi and the anterosuperior part of nasal septum scanned. As for the Control group, they were treated with conventional nasal spray hormone medicine and antihistamine medicine. There are 23 cases of observation group patients voluntarily accept saccharin test before and after the treatment,which is to measure the function of nasal mucus cilia transmission, in the meantime, 23 cases of the non-allergic rhinitis patients refer to the Normal group. The clinical therapeutic effect was evalua ted according to the Chinese Lanzhou diagnostic criteria of allergic rhinitisand all the experiment data were processed for statistical analysis withthe help of SPAA19.0. It came out that all the data were confirmed to normal distribution, using the symbol ±S representing measurement data, X2 tobe examined for enumeration data, t tobe examined for before and after treatment and with the condition that α is 0.05. Only when P is less than 0.05,the data is statistically significant.Results:1 The comparison of basic information between the Observation group and the Control groupAfter comparing the date from the two groups, it shows that it has no statistical significance in their sex(t=-0.068,P=0.946>0.05), age(t=-0.505,P=0.615>0.05) and the score of their before treatment(t=-1.115,P=0.267>0.05).2 The comparison between before treatment and post treatment after one week, one month, six month and one year in the Observation groupFrom the view of the total effective rate, the treatment after one week is 56.94%(41/72), after one month is 100%(72/72), after six month is 90.28%(65/72), while after one year is 77.78%(56/72).After t test of the pre-treatment score(which is 9.0278±1.4629), it shows that the score after one week is 6.3611±1.2022, t is 16.852 and P is less than 0.05, which shows statistical significance. The score after one month is 3.5972±1.1465, t is 28.808, and P is less than 0.05, which shows statistical significance. The score after six months is 3.4028±2.1141, t is 19.420, and P is less than 0.05, which shows statistical significance. The score after one year is 4.2917±2.8701, t is 13.082, and P is less than 0.05, which shows statistical significance.3 The comparison between before treatment and treatment after one week, one month, six month and one year in the Comparison groupFrom the view of the total effective rate, the treatment after one week is 92.5%(74/80), after one month is 95%(76/80), after six month is 95%(62/80),while after one year is 52.5%(42/80).After t test of the pre-treatment score(which is 9.2875±1.4070), it shows that the score after one week is 4.0250±1.3310, t is 32.922 and P is less than 0.05, which shows statistical significance. The score after one month is 1.7750±1.9223, t is 32.977 and P is less than 0.05, which shows statistical significance. The score after six months is 4.5500±2.0370, t is 18.796, and P is less than 0.05, which shows statistical significance. The score after one year is 6.1625±2.0028, t is 13.008, and P is less than 0.05, which shows statistical significance.4 The comparison between the Comparison group and Observation group in therapeutic effectAfter X2 test, the X2 of therapeutic effect after one week in the two groups is 26.012, and P is less than 0.05, which shows statistical significance. The x~2 after one month is 3.697, and P is 0.036 which is more than 0.05,which shows no statistical significance. The x~2 after six months is 4.502, and P is 0.034 which is more than 0.05,which shows no statistical significance. The x~2 after one year is 10.571, and P is less than 0.05,which shows statistical significance.5 The comparison of basic information between the Observation gr oup and the Normal groupAfter comparing the date from the two groups, it shows that it has no statistical significance in their sex(t=-0.584,P=0.562>0.05), age(t=-0.343,P=0.733>0.05).6 The comparison between the Normal group and the Observation group in nasal mucus cilia transmission functionThe time of pre-treatment on the Observation group is 1026.57±158.39 s and the time of pre-treatment on the Normal group is 687.48±117.23 s. After t test, t is-8.740 and P is less than 0.05, which shows statistical significance.The time after one month by HIFU is 706.78±150.18 s, after t test with the Normal group, t is-0.492 and P is 0.627 which is more than 0.05, which shows non-statistical significance. but after t test with the Observation group before treatment, t is 8.139 and P is less than 0.05, which shows statistical significance.The time after one year by HIFU is 873.35±130.88 s, after t test with the Normal group, t is 5.205 and P is less than 0.05, which shows statistical significance.and after t test with the Observation group before treatment, t is 4.318 and P is less than 0.05, which shows statistical significance.Conclusion:1 According to the test score comparison between the Observation and Comparison group on the symptom and sign of nasal cavity before and after treatment, P scores are all less than 0.05, which indicates that both HIFU and Pharmacotherapy have good effectiveness.2 Comparing the clinical symptom score between before and after treatment, it comes out that HIFU has a effective treatment. But the test scores of post treatment after one year and six months are increased(P<0.05), which illustrates that with the time going after treatment, the therapeutic effectiveness is reducing and has a tendency of relapses.3 In the treatment comparison between HIFU and Pharmacotherapy, it indicates that the efficacy of medicine after the first week spreads faster than HIFU. But the long-term therapeutic effectiveness of HIFU is obviously higher than Pharmacotherapy.4 According to the time measurement of Saccharin Test in the part of Observation group, it remind that HIFU not only does not affect the nasal mucosa secretion and nasal mucus cilia transmission function, but also can help to recover the nasal mucus cilia transfer function. |
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