Study On The Therapeutic Effect Of Nasal Exhaled Nitric Oxide In Guiding Clinical Medication Of Allergic Rhinitis

Objective:To determine the efficacy of Fn NO in treating patients with allergic rhinitis(AR)with nasal spray hormone combined with antihistamines,The purpose of this study was to clarify the clinical significance of Fn NO guiding ICS in AR patients by comparing the changes of Fn NO level,Total Score scale of nasal Symptoms(TNSS),visual analog scale(VAS),nasal Mucosal Inflammation Quality of Life Questionnaire(min-RQLQ),and nocturnal nasal conjunctivitis Quality of Life Questionnaire(NRQLQ)before and after treatment.Methods:In this study,cases were collected strictly in accordance with the above diagnostic criteria.The patients were patients with allergic rhinitis who visited the otolaryngology outpatient department of the affiliated hospital of our University from January to July 2022,and 132 patients were finally included as research objects according to the diagnostic criteria of AR,the exclusion criteria and the suspension and exclusion criteria.Patients with initial n NO>500ppb were included in the observation group(78 cases),and patients with initial n NO<500ppb were included in the control group(54 cases).Both groups were treated with mometasone furoate suspension combined with desloratadine tablets.At the time of enrollment and 2 weeks after treatment,Fn NO level of patients was evaluated by TNSS table,VAS scale,min-RQLQ questionnaire and NRQLQ questionnaire before and after treatment.Results:(1)The allergens of AR from high to low were 71 cases(53.79%)of ragweed,57 cases(43.18%)of Artemisia annua,52 cases(39.39%)of tree I/pollen,46 cases(34.85%)of chenopodium,of which 11 cases(8.33%)were single positive.There were 11 cases(8.33%)with two positive types and 109 cases(82.58%)with three or more positive types.The number of allergens in AR patients was statistically significant(x~2=5.245,P=0.022).(2)Before treatment,Fn NO value and VAS score of observation group were significantly higher than those of control group(P<0.05);after treatment,Fn NO value and VAS score of observation group were significantly higher than those of control group(P<0.05);after treatment,Fn NO value,TNSS score and VAS score of two groups were significantly lower than those before treatment(P<0.05).Fn NO and VAS scores in observation group were significantly lower than those in control group before and after treatment(P<0.05).(3)min-RQLQ scores in observation group were higher than those in control group before treatment(P<0.05),and min-RQLQ and NRQLQ scores in 2 groups after treatment were significantly lower than those before treatment(P<0.05);The reduction degree of min-RQLQ score in observation group before and after treatment was significantly higher than that in control group(P<0.05).Conclusion:(1)The allergens of AR patients in spring and autumn were mainly chenopodium,ambrosia,Artemisia annua,tree pollen;(2)After treatment with inhaled corticosteroids and antiallergic drugs,Fn NO value decreased,nasal symptoms,pain and sleep quality were significantly improved;(3)There were differences in nasal symptoms,signs and sleep quality in patients with allergic rhinitis with different Fn NO values;(4)Dynamic follow-up of Fn NO levels is helpful to guide the application of therapeutic drugs for allergic rhinitis,such as inhaled corticosteroids and antiallergic drugs.