Cytological Study On Nasal Secretion Before And After Treatment Of Non-allergic Rhinitis

Objective:By comparing the symptom scores and cytological results of nasal secretion before and after treatment with intranasal steroid or intranasal steroid combined with leukotriene receptor antagonists in patients with non-allergic Rhinitis(NAR)to understand the pathologic changes of nasal mucosa inflammation and subjective symptom improvement of patients with NAR after different treatment methods.It is expected that different types of NAR could be identified and precise individualized treatment is provided so as to offer ideas for clinical diagnosis and treatmentMethod:In this study,61 patients with NAR treated in the otolaryngology department were randomly divided into the budesonide treatment group(INS group)and the budesonide+Montelukast Sodium treatment group(INS+LTRA group)with 29 patients in INS group and 32 patients in INS+LTRA group respectively.Detailed medical history information was investigated by questionnaire survey,and baseline data of patients were compared between the two groups.Other data include total nucleated cell,neutrophile granulocyte,eosinophilic granulocyte,lymphocytes,differential count of monocytes and nasal symptom scores of the nasal secretions before and after treatment.Results:1.The exfoliated cells in patients with NAR in nasal secretion were mainly epithelial cells,neutrophils,eosinophils,lymphocytes,monocytes,and occasionally basophils.2.After treatment for 4 weeks in the INS group,the median of total nucleated cells,eosinophils,neutrophils,and the median of percentage of monocytes were all lower than that before treatment.However,the differences between the two groups were not statistically significant(P>0.05).In addition,the percentage of epithelial cells after treatment was higher than that before treatment.But the differences between the two groups were not statistically significant(P>0.05).After treatment for 4 weeks in the INS+LTRA group,the median of total nucleated cells were lower than that before treatment.However,the differences between the two groups were not statistically significant(P>0.05).The percentage of eosinophils after treatment was 1.00[0.00;2.00]%being obviously lower than 7.00[0.00;23.00]%before treatment(Z=-3.077,P=0.002).The percentage of epithelial cells were higher than that before treatment.However,the differences between the two groups were not statistically significant(P>0.05).3.The symptom scores of nasal congestion,runny nose,sneezing and nasal itch in patients in both INS group and INS+LTRA group were all lower than those before treatment(P<0.05).The symptoms of nasal congestion in patients in INS+LTRA group after treatment were significantly improved compared with the INS group(P<0.05).Differences in symptoms of runny nose,sneezing and nasal itching between the two groups before and after treatment were not statistically significant(P>0.05).Conclusion:1.Leukotriene receptor antagonists can inhibit the infiltration of eosinophils in the nasal mucosa and reduce the number of eosinophils in the nasal mucosa.2.Treated with steroid hormone alone or steroid hormone combined with leukotriene receptor antagonists for 4 weeks,the subjective symptoms of patients with NAR were improved.Symptom score of nasal congestion in INS+LTRA group was lower than that of INS group,which suggested that LTRA has an advantage in relieving nasal congestion.3.With cytological examination of nasal secretions,the nasal mucosa inflammation could be objectively evaluated,which could help to guide clinical medication and provide a basis for individualized and precise treatment of patients with NAR.