| ObjectiveBy observing the intervention effect of intranasal acupuncture and Yingxiang acupoint acupuncture in AR patients,the effect of two clinical effect acupoints in AR treatment was evaluated effectively;The concentrations of eotaxin,CCR3 and CCR3 in serum and nasal secretions of AR patients were measured before and after treatment by ELISA.FMRI was used to explore the characteristics of brain function activities of AR patients different from that of healthy people,and the changes of important brain function activities before,during and after intranasal acupuncture.Method1.In the second part,a total of 47 patients with allergic rhinitis were included,including 25 patients in the nasal acupuncture group and 22 patients in the external Ying Xiang acupuncture group.Before and after treatment,VAS,RQLQ,eotaxin and CCR3 were used as laboratory indexes.The patients were followed up 30 days after the treatment,and the vas and RQLQ were evaluated.2.In the second part,21 patients with allergic rhinitis were selected as the subjects of the third part,and 13 healthy subjects were recruited.With bilateral olfactory cortex as seed point,the subjects received a brain function network scan before,during and after the first acupuncture.Using fMRI technology,the following analysis was completed:(1)to explore the characteristics of brain function activities of patients with allergic rhinitis different from that of healthy people;(2)to screen the key brain areas and brain function networks targeted by intranasal acupuncture,and to find the target brain areas that play a key role in the integration of central network in the treatment of allergic rhinitis by intranasal acupuncture;(3)to compare the whole brain before,during and after acupunctureFunctional network connection,from the perspective of network regulation,to explore the central response characteristics of intranasal acupuncture in the treatment of allergic rhinitis.Result1.Clinical efficacy evaluation(1)Before and after treatment,the total score of vas and the scores of the two groups were significantly different(P<0.05).Among the groups,the score of runny nose was p<0.05,the score of external Ying Xiang acupuncture was better than that of internal nose acupuncture,and there was no statistical difference in the other items.During the follow-up.the score of vas in internal nose acupuncture group was statistically different from that before the treatment;the score of external Ying Xiang acupuncture group was only statistically different in the overall symptom,itch and olfactory function of nose compared with that before the treatment.Compared between the two groups,the intranasal acupuncture was superior to the external Ying Xiang acupuncture in the total score of vas,the overall symptoms of nose,itching,sneezing,runny nose and nasal obstruction(2)Before and after treatment,the total RQLQ scores of the patients in the intranasal acupuncture group and the external Ying Xiang acupuncture group and the scores of the patients in the intranasal acupuncture group were significantly lower than those in the control group(P<0.05).The results showed that the scores of non naso conjunctival symptoms in each group were p<0.05,the scores of intranasal acupuncture were better than those of external Yingxiang acupuncture,and there was no statistical difference in the other items.During the follow-up.the total scores and scores of RQLQ in the intranasal acupuncture group were statistically different from those before the treatment,while those in the external Yingxiang acupuncture group were only in the total scores of RQLQ,daily life,non naso conjunctival symptoms,related behaviors and ophthalmiaThere are statistical differences in the shape.Compared with the two groups,the intranasal acupuncture group was superior to the control group in daily life.sleep,non nasal conjunctival symptoms,nasal symptoms and emotions.(3)The serum CCR3 detection before and after treatment in the two groups was P<0.05.the difference was statistically significant.There was no statistical difference between the two groups.Serum Eotaxin detection before and after treatment in intranasal acupuncture group was P<0.05,which was statistically different.Serum Eotaxin content in Waiyingxiang acupuncture group also decreased compared with before treatment,but did not reach the statistically significant range.The intranasal acupuncture group and Waiyingxiang acupuncture group had no significant difference in the CCR3 content of nasal secretions compared with before treatment.2.Preliminary study on the central regulatory mechanism of intranasal acupuncture in the treatment of allergic rhinitis(1)Before treatment,the connections of bilateral olfactory cortex(including bilateral amygdala,hippocampal sulcus and parahippocampal gyrus)with left middle frontal gyrus and right cuneiform gyrus were enhanced,and no areas with weakened connections with bilateral olfactory cortex were found(2)Compared with that before acupuncture,the functional connection strength between the brain area and bilateral olfactory cortex of patients with allergic rhinitis showed two-way changes,including both the brain area with enhanced functional connection strength and the brain area with weakened functional connection strength.The left superior frontal gyrus,the right cingulate gyrus,the right cerebellum,the left superior parietal lobule,the left thalamus and the right superior frontal gyrus were stronger than that before acupunctureThe anterior central gyrus,bilateral posterior central gyrus,left middle occipital gyrus,left medial frontal gyrus,bilateral cuneiform gyrus and bilateral cerebellum were weaker than those before acupuncture.(3)Compared with before acupuncture,the areas of increased functional connection in the brain were left middle frontal gyrus,left superior frontal gyrus,left superior temporal gyrus,left cingulate gyrus and left thalamus.The areas of weakened connection were right posterior central gyrus.Compared with the acupuncture,the right medial frontal gyrus,right cuneiform gyrus,left medial frontal gyrus,left anterior central gyrus,right anterior central gyrus and left anterior central gyrusThe connection of parahippocampal gyrus was stronger than that of acupuncture,and the connection of right middle frontal gyrus was weaker than that of acupuncture.(4)Two weeks after acupuncture,four patients participated in the reexamination.The connections of right thalamus,right cingulate gyrus,left caudate nucleus,right thalamus and bilateral olfactory cortex increased,and the connections of bilateral cerebellum,right anterior central gyrus,right superior temporal gyrus,right cuneiform gyrus and bilateral olfactory cortex weakened.Conclusion1.The effects of intranasal acupuncture and external Yingxiang acupuncture on improving the symptoms and signs of patients with allergic rhinitis,and improving the quality of life of patients were similar.The follow-up showed that the effect of intranasal acupuncture was better than that of external Ying Xiang acupuncture in the short term.Intranasal acupuncture may reduce the recruitment and infiltration of eosinophils by inhibiting the expression of eotaxin and CCR3,so as to reduce the inflammatory response of allergic rhinitis.2.The method of functional connection based on bilateral olfactory cortex as seed point in resting state can reflect the internal connection of brain function to a certain extent,which provides a possible imaging approach for the diagnosis of allergic rhinitis.3.In the central level,the treatment of allergic rhinitis by intranasal acupuncture is multi-level and multi-channel,which has immediate effect and lasting effect after acupuncture.The mechanism of pivot regulation may be based on the thalamus,cingulate gyrus and amygdala,through the regulation of visceral pain system,emotional regulation system and cognitive control network,to restore the normal default network. |
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