| Objection:This research is to evaluate the curative effects and security of cutting agger nasi and the inferior turbinates in treating allergic rhinitis and provides a certain scientific basis for its clinical applications from both clinic and basic.Method:The operator cuts agger nasi (in the shape of#) on both sides of 30 suitable subjects who suffer from persistent allergic rhinitis. The inferior turbinates on both sides are cut three parallel lines (up, middle and down). These three parallel lines are all deepen into periost and part debonding and peeling. The patients are only treated once. Visual analogue scale, VAS and Rhinocoujunctivitis Quality of Life Questionaire (Self-test version of Chinese version) are taken as main curative effects indexes and nasal endoscopic examine as an affiliation one. The untoward effects of subjects and drug combination are recorded during the treatment. The subjects are visited randomly,before, both one to four weeks after the treatment, to evaluate the curative effects and security of the clinical treatment. One piece of nasal mucosa tissues of the inferior turbinates of eight subjects’(both before and 4 weeks after the treatment) is used to try hematoxylin-eosin staining, toluidine blue staining and substance P IHC. Observe the following:1) The organization form of nasal mucosa tissue and inflammatory disorders on account of the infiltration of eosinophilic granulocyte.2) Mast cells’infiltration and degranulation and calculating the activated fraction of theirs’.3) The measurement of SP immunity group IOD. The researcher probes into the possibility that cutting agger nasi and the inferior turbinates in treating allergic rhinitis has a certain mode:nerve-immunity-target site.Results:1.Curative effects and security of clinical treatment(1) The results of VAS scale:VAS total points and scale differs a lot from before, one week and four weeks after the treatment, P＜0.05; VAS total points, VAS grading of rhinocnesmus and runny nose have no significant differences between one week and four weeks after the treatment, P>0.05. While that differs much in VAS grading of rhinobyon and sneezing, P<0.05.(2) The results of RQLQ:RQLQ scale scores vary a lot between before treatment and one week after the treatment, before treatment and four weeks after the treatment,and one week and four weeks after the treatment, P<0.05.(3) The results of nasal endoscopic examine:The differences of the inferior turbinate swelling one week and four weeks after the treatment compared with before treatment both possess statistical significance(P<0.05); At the same time, the researcher find the differences between one week and four weeks after treatment also has statistical significance(P<0.05).(4) No serious adverse events happen to the subjects in treatment.(5) Drug combination:None2. Mechanism of the preliminary discussion(1)Results of HE staining:The eosinophils infiltration of inflammatory lesions certain improves after treatment.(2) Results of SP immunohistochemical integral optical density determination: The difference is statistically significant, compared before and after treatment (P＜0.05).(3) Mast cells:Compared before and after treatment, the differences in Infiltration quantity, Degranulation situation and Activate the score of Mast cells are statistically significant(P<0.05).(4) Compared before and after treatment, there is a linear regression relationship between the variations of SP integral optical density and Mast cells activation score(F=34.334, P＜0.05).Conclusion:(1)Cutting Agger nasi and Inferior nasal concha is good for improving the symptom of Patients with allergic rhinitis, the quality of their life and swelling of Inferior nasal concha. The curative effect of this treatment is steady and the swelling of Inferior nasal concha improves progressively. No serious adverse events occurred.(2) Nasal cutting may reduce the Immune inflammation by the control of neurogenic inflammation to improve the Allergic rhinitis symptoms. |
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