Study On The Effect Of Highly Selective Nasal Nerve Blockade By Nasal Endoscopy And Its Influence On Serum Vasoactice Intestinal Peptide Level In Patients With Moderate Or Severe Allergic Rhinitis

Objective1.To investigate the short-term and long-term clinical effect of nasal endoscopic high selective nasal nerve occlusion(pterygoid nerve posterior plexus+pharyngeal branch+anterior ethmoid nerve branch)in the treatment of moderate and severe allergic rhinitis.2.To investigate the effect of highly selective nasal endoscopic nerve blockade on patients with moderate or severe allergic rhinitis(AR)and its effect and correlation between the expressions of vasoactice intestinal peptide(VIP)in serum.Methods1.The clinical data of 30 patients with moderate and severe allergic rhinitis who underwent highly selective nasal branch occlusion in The Air Force Hospital from Northern Theater of PLA from 2018 June to February 2020 were analyzed retrospectively.A visual analogue scale(VAS)of subjective symptoms and rhinoconjunctivitis quality of life questionnaire(RQLQ)were summarized for scoring and selected to evaluate the surgical efficacy before,3 months after operation and 1 year after operation respectively.2.Peripheral blood of patients was collected before and 1 year after surgery,and the concentration of VIP in serum was detected by ELISA to compare the changes of VIP expression,and the correlation between them was evaluated by statistical treatment and analysis.3.Investigated the correlation of the peripheral serum content in VIP and the patient VAS scores in patients with moderate and severe AR.Results1.All patients were successfully treated and followed up,The follow-up rate was 100%.There weren’t any complications.All improved after symptomatic treatment.These patients had obtained the very good curative effect on the whole.Among them,the recent marked efficiency was 66.7%(20/30),The effective rate is 33.3%(10/30),Overall efficiency was 100%(30/30).The marked long-term efficiency of 1 year(and above)was 53.3%(16/30),The effective rate was 43.3%(13/30),Overall efficiency was 96.7%(29/30).The overall long-term effective rate after 1 year was slightly lower than that after 3 months.However,there was no significant difference between the two(p>0.05).2.VAS scores of subjective symptoms(nasal congestion,itching,sneezing,runny nose,ocular and pulmonary symptoms)and RQLQ scores were significantly lower than those of 3 months and 1 year after operation(p<0.05).Compared with 3 months after operation,the VAS score and RQLQ score of 1 year after operation were slightly higher,but the difference was not statistically significant(p>0.05).3.Level of serum VIP was also significantly decreased(18.42±0.64/39.89±1.30,pg/ml)in 1 year after operation(p<0.05).4.The change of serum VIP level was positively correlated with the change of symptom score(r=0.77).Conclusions1.Nasal endoscopic high selective nasal nerve occlusion(pterygoid nerve posterior plexus+pharyngeal branch+anterior ethmoid nerve branch)is not effective in the treatment of perennial,moderate AR patients,the short-term and long-term clinical effects are worthy of recognition.2.Highly selective nasal endoscopic nerve blockade can effectively improve the clinical symptoms in patients with moderate or severe AR,and the mechanism may be involved in reducing the production of VIP.