Acupuncture Combined With Fluticasone Propionate Nasai Spray Treament Effect Of Persistent Allergic Rhinitis On Serum IL-4 And AQP5

Objective To observe the clinical efficacy of acupuncture combined with fluticasone propionate nasal spray in the treatment of persistent allergic rhinitis.MethodIn this study,40 patients with persistent allergic rhinitis who met the inclusion criteria were divided into the acupuncture group(20 cases)and the western medicine group(20cases)according to the central randomization method.The western medicine group was treated with fluticasone propionate nasal spray for 6 weeks,once a day in the morning,with 2 sprays in each nostril.Acupuncture and medicine group was also treated with nasal spray on the basis of acupuncture treatment.Acupuncture points were selected as Shangxing,Sibai(bilateral),Hegu(bilateral),Yintang,Shangyingxiang(bilateral),Chize(bilateral),Dazhui,and yingxiang(bilateral).After the qi was obtained by acupuncture at various points,the Dazhui point was treated with warm acupuncture,3 times a week for the first 4 weeks and 2 times a week for the last 2 weeks.The differences of total score of nasal symptoms(TNSS),total score of rhinitis concomitational symptoms(TNNSS),nasoconjunctival Quality of Life Scale(RQLQ)and laboratory indicators(IL-4,AQP5)were compared between the two groups before and after treatment,6 weeks after treatment(end of course),and follow-up(10 and 30 weeks after treatment).ResultsA total of 40 patients were included in this study,and no shedding was observed from the beginning to the end of follow-up.There were no statistically significant differences in gender,age,course of disease,TNSS score,TNNSS score,RQLQ score,IL-4 and AQP5 contents between the two groups before treatment(P>0.05).3.1 Comparison of TNSS and TNNSS scoresAt the 6th week after treatment(the end of the course of treatment)and during the two follow-up periods,the scores in both groups were decreased compared with before treatment,and the difference was statistically significant(P<0.05).At the 6th week after treatment,there was no statistically significant difference in scores between the two groups(P>0.05).At the 10 th week and 30 th week after treatment,the scores of the acupuncture group decreased significantly,and the differences between the two groups were statistically significant(P<0.05).3.2 Comparison of RQLQ ScoresAt the 6th week after treatment(the end of the course of treatment)and during the two the score of the western medicine group was decreased compared with that before treatment,the difference was statistically significant(P<0.05),and the score of the acupuncture medicine group was also decreased,but the difference was not statistically significant compared with that before treatment(P>0.05).During the follow-up at the10 th and 30 th week after treatment,the scores in the two groups were decreased compared with those before treatment,the difference was statistically significant(P<0.05),and the score in the acupuncture group was significantly decreased compared with that in the western medicine group,the difference was statistically significant(P<0.05).3.3 Comparison of IL-4 and AQP5 contentAt the 6th week after treatment(the end of treatment course),the contents of IL-4 and AQP5 in both groups were decreased compared with that before treatment.The contents of IL-4 and AQP5 in the acupuncture and drug group had statistical significance compared with that before treatment(P<0.05),while only the content of AQP5 in the western medicine group had statistical significance compared with that before treatment(P<0.05).After treatment,the contents of IL-4 and AQP5 in acupuncture group were significantly decreased compared with that in western medicine group,and the difference between the two groups was statistically significant(P<0.05).ConclusionThe combined use of acupuncture and moxibustion and fluticasone propionate nasal spray can significantly reduce the nasal typical symptoms and some concomitant symptoms such as headache,eye itching,pharyngeal itching,etc.,improve the quality of life of patients with persistent allergic rhinitis,and have a good long-term effect.Its mechanism may be related to the down-regulation of serum IL-4 and AQP5 levels,which is worthy of further research and clinical application.