OBSERVATION OF REMOTE AND RECENT THERAPEUTIC EFFECTS OF ACUPOINT-THREAD EMBEDDING, WESTERN MEDICINE OR ALLIED THERAPY ON PERENNIAL ALLERGIC RHINITIS

Objective: The comparison of the remote and recent therapeutic effects on perennial allergic rhinitis was carried on among single application of acupoint-thread embedding, western medicine (certirizine+flixonase) and allied therapy. Method: Ninety cases were randomized into thread-embedding group, western medicine group and embedding+western medicine group (allied-therapy group), 30 cases in each one. In thread embedding group, Yingxiang (迎香 LI 20) and Feishu (肺俞 BL 13) were selected for thread embedding, once a week, totally 4 treatments were required. In western medicine group, certirizine tablet 10 mg in combination with flixonase sprayer was applied once per day, continuously for 30 days in treatment. In allied-therapy group, both of the above methods were adopted continuously for 30 days in treatment. The therapeutic effects were in statistics at the end of treatment and 1 year later. Results: At the end of treatment, in thread-embedding group, 21 cases were remarkably effective, 3 cases effective and 6 cases no effect. In western medicine group, 20 cases were remarkably effective, 3 cases effective and 7 cases no effect. In allied-therapy group, 23 cases were remarkably effective, 2 cases effective and 5 cases no effect. It was shown in statistics that there was no significant difference in therapeutic effects among three groups ( P>0.05 ). But one year after the end of treatment, it was indicated that in thread-embedding group, 3 cases were remarkably effective, 10 cases effective and 17 cases no effect; in western medicine group, 2 cases were remarkably effective, 9 cases effective and 19 cases no effect; in allied-therapy group, 7 cases were remarkably effective, 11 cases effective and 12 cases no effect. The significant difference in the therapeutic effects had not been presented in the comparison between thread-embedding group and western medicine group (P>0.05), but that had been presented between allied-therapy group with either of the groups with single therapy applied (P<0.05). Conclusion: Quite good recent therapeutic effect of either acupoint-thread embedding or western medicine (certirizine+flixonase) was achieved on perennial allergic rhinitis. The remote therapeutic effect of allied therapy was more advantageous than that of single application of either thread embedding or western medicine.

Observation of Ultrastructure in Nasal Mucosa on Allergic Perennial Rhinitis Cases before and after the Operations

Objective: The partial inferior turbinectomy and septoplasty was applied to treat the allergic perennial rhinitis (APR), and to observe the ultrastructure changes of the nasal mucosa before and after the operations. Methods: For 36 cases of research objects diagnosed with APR, the partial inferior turbinectomy and septoplasty was administered. For 6 APR cases among them, the pre- and postoperative observation of anterior nasal mucosa of the inferior turbinate on the same side under the electron microscope was conducted for one year respectively. In addition, their pathological alterations of tissues were also conducted. Results: In the pre-operative observation under the electron microscope, it was found that the nasal mucosae epithelium cells were nude without cilia. The lamina propria had edema, and mesenchyme presented the infiltration of substantial eosinophilic granulocytes, basophilic granulocytes, plasmacytes and mast cells. Additionally, abundant degranulation and vacuolation of cytoplasts were observed. The plentiful glands, duct ectasia, edema and structural changes were also found. Some gland cells had degenerated. After the operation, it was found that the epithelium nudity still existed and the deficiency of cilia was not improved. Only a very small amount of microvilli existed. The edema of lamina propria was improved and eosinophilic granulocytes were rarely observed in mesenchyme. However, the infiltration of basophilic granulocytes, plasmocytes and mast cells was still observed. The particle structure was generally stable and the central crystal was clear without degranulation. Meanwhile, the amount of glands was reduced and the tissue structure tended to be recovered. Overall, the nasal mucosa showed changes as chronic inflammation. Conclusions: For the treatment of APR with the methods presented by our research institution, in one year before and after the operation, ultrastructural changes of inferior turbinate mucosa tissues were observed from the preoperatively pathological changes of typical APR to the chronic inflammation with the primary infiltration of neutrophilic granulocyte and mast cells.

Study on Cytokines IL-2,IL-6,IL-10 in Patients of Chronic Allergic Rhinitis Treated with Acupuncture

OBJECTIVES: To observe the plasmatic concentration of IL-6, IL-10 and IL-2 in the patient of chronic allergic rhinitis before and after acupuncture therapy. METHODS: Cytokine levels were determined before and after treatment in 30 healthy volunteers (Group A) and 90 patients of chronic allergic rhinitis (Group B) with an increased plasma IL-10 level. Group B was then divided into 3 subgroups: 30 patients treated with real acupuncture (Group B1); 30 patients treated with sham acupuncture (Group B2); 30 non-treated patients (Group B3). RESULTS: The allergic subjects of group B1, compared with controls, showed a significant reduction of IL-10 after a specific treatment with acupuncture (P

Clinical Research into Ke Min Yin for Treatment of Persistent Allergic Rhinitis in Patients with Qi Deficiency and Blood Stasis

Persistent allergic rhinitis (PAR) is one of the common diseases at ear-nose-throat department. From August 1998 to May 2001, we randomly selected 60 cases of PAR with qi deficiency and blood stasis for a clinical observation. 30 patients in the treatment group were treated with Ke Min Yin (克敏饮), a herbal medicine, to supplement qi, expel wind, nourish blood and promote blood circulation; and the other 30 cases in the control group were treated with cetrine. Through systematic observation and statistical processing, the clinical research is summarized and reported in the following.

A CLINICAL OBSERVATION ON THERAPEUTIC EFFECTS OF ACUPUNCTURE FOR ALLERGIC RHINITIS

The author applied acupuncture to treat52 cases of allergic rhinitis with certaintherapeutic effectiveness confirmed by afollowing-up for one year and more.The resultis reported as follows.

Treatment of 48 Cases of Perennial Allergic Rhinitis with Thunder-fire Moxibustion

Perennial allergic rhinitis is an allergic reaction of the nasal mucosa. It is characterized by paroxysmal and repeated runny nose, sneeze, stuffy nose, rhinocnesmus and nasal mucosa edema. The author used ＂Doctor ZHAO＇s thunder-fire moxibustion＂ in treating 48 cases of this disease. Now it is reported as follows.

Effects of Acupuncture-moxibustion on Monocyte Th1/Th2 Cytokine in Peripheral Blood of Patients with Perennial Allergic Rhinitis

Objective： To observe the effects of acupuncture-moxibustion on symptoms, signs, and Th1/Th2 cytokine, and regulation on Th1/Th2 in patients with perennial allergic rhinitis（PAR） to provide experimental basis for acupuncture treating allergic rhinitis and investigate the mechanism. Methods： Thirty patients with allergic rhinitis were treated with acupuncture-moxibustion, and 30 healthy cases were the control. Clinical symptoms, signs, and nasal mucosa were observed, and contents of IL-4, IFN-γ, and granulocyte-macrophage colony stimulating factor （GM-CSF） in the supernatant of peripheral blood monocyte cultured with PHA by ELISA, before treatment, after one course of treatment, and after two courses of treatment. Results： Before the treatment, the contents of IL-4, and GM-CSF were higher （P〈0.01） and IFN-γ was lower （P〈0.01） in the PAR cases than in the control cases. In the PAR cases, the content of GM-CSF was positive correlation with that of IL-4 （P〈0.01）, and negative correlation with IFN-7 （P〈0.01）. After the treatment, contents of IL-4 and GM-CSF were lowed （P〈0.01）, content of IFN-γ was increased （P〈0.05）, and all IL-4, GM-CSF and IFN-γ had no difference compared with those in the control cases. Conclusion： Acupuncture- moxibustion could improve the symptoms and signs in PAR patients, enhance the immune function. It may be achieved by regulating the expression of Th1 and Th2, correcting the imbalance of Th1/Th2.

Vesiculation Therapy of Cantharides Extract forPerennial Allergic Rhinitisand Its Effect on Serum Tolal IgE

The therapy of 10% Cantharides extract in treating 50 cases of perennial allergic rhinitis(PAR) was studied. The extract was plastered and blistered on Dazhui and Neiguan points. It was observedby nasal mucosa provocative test, cells in nasal secretion test and serum total IgE test. The results showedthat ite effective rate was 88% . After treatment the allergic nasal mucosa provocative test of the treatedgroup was alleviated obviously ( P < 0 . 01 ) and the number ot eosinopnil affd basophil in nasal secretion de-creased significantly ( P < 0 . 01 , P < 0 . 05 ) . The serum total lgE also reduced significantly I P < 0 . 01 ) .

《变应性鼻炎及其对哮喘的影响》指南2010年修订版解读

《变应性鼻炎及其对哮喘的影响》(Allergic rhinitis and its impact on asthma,ARIA)指南最新修订版(简称ARIA2010版)最近由《Journal of Allergy and Clinical Immunology》杂志全文发表。与旧版ARIA指南使用循证医学的方法不同,ARIA2010版采用推荐、评估、发展和评价分级(Grading of Recommendations,Assessment,Development and Evaluation,GRADE)工作组提出的透明的、系统化的方法修订了临床建议,以提高其实用价值。

腺样体切除术后圆枕增生与变应性鼻炎的关系

人们已经注意到,变应性鼻炎（allergic rhinitis,AR）患儿腺样体肥大发病率较非AR患儿高,近几年AR患儿发病率逐渐增高,我们考虑,腺样体切除术后圆枕增生可能和AR有密切关系,本文用回顾性分析的方法对此问题进行了探讨。

南昌地区变应性鼻炎患者变应原皮肤点刺试验结果分析

由于生活习惯、地理环境和气候的不同,各地变应性鼻炎（AR）变应原分布特点有很大区别,了解和分析南昌地区常见变应原分布情况,对预防和治疗该地区AR具有重要的指导意义。我科对南昌地区959例AR患者进行变应原皮肤点刺试验（skin prick test,SPT）,现报道如下。

变应性鼻炎患者常见变应原生物共振检测分析

变应性鼻炎（AR）是耳鼻咽喉科常见疾病,可严重影响患者的生活质量。由于各地地理环境和气候不同,变应原具有明显的区域性。为探讨德州市AR常见变应原分布情况,本文回顾性分析2007年1月～2009年12月耳鼻咽喉科门诊及皮肤科变态反应室利用生物共振检测171例拟诊AR患者变应原结果,以了解本地AR常见变应原分布情况,为AR诊断、预防及特异性免疫治疗（specificimmunotherapy,SIT）提供依据。现将检测分析报道如下。

正确认识气传变应原及避免措施

避免变应原是预防变应性疾病的根本措施,但现实生活中完全避免变应原是非常难的。本文就室内气传变应原的生物学特征、分子生物学、致敏、环境暴露的评估以及避免措施进行综述。

鼻腔细胞学研究现状

鼻腔细胞学是一种安全、便捷、高效的检测方法,是指导鼻腔疾病诊断和治疗的极好指标,在鼻科学病理研究中占有重要地位。鼻腔细胞的收集方法包括擤鼻法、鼻黏膜刷片法、鼻黏膜拭子法、鼻黏膜刮片法、鼻腔盥洗液法、膨胀海绵法和鼻黏膜活检法。鼻分泌物中炎性细胞的检出是鼻腔、鼻窦炎性疾病诊断和鉴别的重要依据。炎性细胞和鼻黏膜上皮结构细胞的改变还可作为评价鼻腔炎症疗效的客观指标。鼻腔细胞学研究还用于鼻腔、鼻窦炎性疾病的疗效预测和鼻腔微生物学研究。然而诊断标准不统一、技术手段相对简单的现状局限了鼻腔细胞学的发展,这一领域技术的进步将促进人们对鼻部疾病认识的深入。

重视鼻炎研究

鼻炎（rhinitis）和（鼻）鼻窦炎（sinusitis或rhinosinusitis）是耳鼻咽喉头颈外科的主要常见病,美国（人口3亿）每年诊治过敏性鼻炎患者约3～6千万例（人口10%～20%）,鼻窦炎患者约为3.1千万例（人口10%）。鼻炎是由鼻腔黏膜炎症反应而导致的急性或慢性症状性疾病,慢性鼻炎更为常见。

Hippo通路相关分子在变应性鼻炎中的研究进展

辅助性T细胞1/辅助性T细胞2(T helper 1 cells/T helper 2 cells,Th1/Th2)免疫失衡、调节性T细胞/辅助性T细胞17(regulatory T lymphocytes/T helper 17 cells,Treg/Th17)比例下调以及树突细胞(Dendritic cell,DC)的活化等参与了变应性鼻炎(AR)的发生发展过程。Hippo通路是一种非常保守的信号传导通路,具有调节细胞增殖、凋亡的功能。新近的研究发现,Hippo信号通路中哺乳动物不育系20样激酶1/2、Yes相关蛋白和转录共激活因子PDZ结合基序等主要成员也表达于上述免疫细胞中,并在AR、哮喘等呼吸道变应性炎症的发病中发挥着重要作用。进一步研究Hippo通路有助于深入了解AR的发病机制,本文就Hippo通路的主要成员对Th1/Th2、Treg/Th17和DC的作用进行综述,以期为AR及其他呼吸道变应性疾病的临床治疗提供新的干预靶点和思路。

合肥地区变应性鼻炎患者变应原皮肤点刺试验

变应性鼻炎（AR）是耳鼻咽喉头颈外科常见病、多发病,是一个全球关注的健康问题。AR严重影响患者生活质量和工作效率,尤其对儿童学习能力、注意力、性情等均可造成不利影响,如合并哮喘则病情更加难以控制。在临床实践中,变应原皮肤点刺试验（skin prick test,SPT）对于特异性变应性疾病的诊断能提供有用的诊断信息。

中西医结合治疗变应性鼻炎的疗效观察

变应性鼻炎（AR）分为常年性AR和季节性AR,是耳鼻咽喉科临床常见病和多发病。AR属非感染性疾病,经常反复发,难以治愈。根据2008年版《变应性鼻炎及其对哮喘的影响》（allergic rhinitis and its impact on asthma,

变应性鼻炎治疗前后生活质量评估

变应性鼻炎（AR）是特应性个体接触变应原后由IgE介导的介质释放、并有多种免疫活性细胞和细胞因子等参与的鼻黏膜慢性炎症反应性疾病。近年来,随着国家工业化程度的提高,患病率呈上升趋势[1,2],其病情反复发作可引起支气管哮喘、变应性鼻窦炎等一系列严重并发症。

基于倾向评分回归调整探讨艾灸治疗常年变应性鼻炎灸感与灸效的前瞻性队列研究

目的:采用倾向评分回归调整(PSRA)均衡基线资料,比较艾灸同一穴位(上印堂)不同灸感(热敏灸态vs静息态)治疗常年变应性鼻炎(PAR)灸效差异。方法:采用前瞻性队列研究设计,纳入106例合格受试者,用艾条悬灸上印堂激发灸感,根据热敏灸感的有无,自然分组为热敏灸组(n=69)和传统灸组(n=37)。两组均在上印堂施灸,每次时间为30min,每天1次,连续四周,共计24次。结局指标为变异性鼻炎症状量表(TNSS)、伴随症状量表(TNNSS)以及生存质量调查问卷(RQLQ)。结果:使用PSM进行1:1配对,匹配容差0.02,成功匹配25对,共50例患者。两组患者基线资料均无统计学差异(P>0.05)。匹配后,治疗后热敏态组TNSS评分为4.01±1.52,低于静态组的5.42±1.10,有统计学意义(P<0.01);热敏态组TNNSS评分为1.26±0.43,低于静态组的1.52±0.50,有统计学意义(P<0.01);热敏态组RQLQ评分为37.62±6.01,低于静态组的47.22±7.76,有统计学意义(P<0.01);说明热敏灸组在改善PAR患者症状、体征和生活质量方面均有疗效优势。将倾向性评分匹配前单因素分析具有差异的结果纳入进行多因素logistic回归分析,结果显示,是否用药、病程为艾灸疗效的独立危险因素(P<0.05)。结论:艾灸热敏态穴位治疗PAR的临床疗效优于静息态组。