The Effect Of Nasal Irrigation In The Treatment Of Allergic Rhinitis

Background and objectiveFor a long time, Allergic rhinitis as a global public health problem, WHO claim that need long-term drug to control disease, has brought huge burden to patients and society, it has been a hot topic of clinical treatment strategies. At present, the glucocorticoids are the most effective first-line therapy for the treatment of allergic rhinitis, this view has obtained the widespread global identity, but most patients will have a psychological fear and resistance to corticosteroids for its side effects. It is hard to standardize the AR treatment, also hard to control it. In recent years, the nasal irrigation is widely used to the treatment of nasal and sinus disease, it is a kind of good treatment for its operation simply, safety and tolerability, can be accepted by patient. How is the effective of nasal wash in the treatment of allergic rhinitis? In this paper, We compared the nasal symptoms in patients with allergic rhinitis and the influence of related parameters of airway inflammation, explore the significance of nasal irrigation in the treatment of allergic rhinitis.MethodsFrom Sep 2012 to May 2013,61 cases diagnosed as AR (allergic rhinitis) after SPT (skin prick test) were Selected and randomly divided into three groups:17 patients in group A used nasal steroid; 20 cases in group B used nasal irrigation; 24 patients in group C combined irrigation with nasal steroid. Before and after 3 months treatment, nasal VAS (visual analogue scale) score, RQLQ (Rhinoconjunctivtis Quality of life Questionnaire) score, nasal lavage EOS, The nasal proocation, FENO (fractional exhaled nitric oxide) values, induced sputum EOS were observed and compared in each group.Results1. Three groups of sex ratio, age, height, body weight had no significant difference (P> 0.05), and prove that comparable between the 3 groups.2. After treatment, VAS score were significantly reduced in all of three groups (P< 0.01). there was no significant differences between three groups before treatment, there was no significant differences between three groups too after 3 months of treatment.3. After treatment, RQLQ score were significantly reduced in all of three groups(P< 0.01). there was no significant differences between three groups before treatment, there was no significant differences between three groups too after 3 months of treatment.4. After treatment, nasal lavage EOS were significantly reduced in all of three groups (P< 0.01). there was no significant differences between three groups before treatment, after 3 months of treatment, Group A and C was lower than that in group B (p< 0.05), but, there was no significant difference between A and C (p> 0.05).5. After treatment, The positive rate of nasal provocation were significantly reduced (P< 0.01)only ingroup C.6. After treatment, FeNO were significantly reduced in all of three groups(P< 0.01). there was no significant differences between three groups before treatment, after 3 months of treatment, FENO has no significant difference between group A and group C (p> 0.05), were less than in group B(p<0.05).7. After treatment, induced sputum EOS were significantly reduced only in group C(P< 0.01). there was no significant differences between three groups before treatment, after 3 months of treatment, induced sputum EOS has no significant difference between group A and group C (p> 0.05), were less than in group B(p<0.05).Conclusions1. Three months nasal irrigation can alleviate nasal symptoms, and improve quality of life of patients with AR, can effectively reduce the related inflammation, achieve a similar effect to the nasal steroid.2. The nasal irrigation combined with nasal steroid can reduce inflammation of the nasal mucosa and the EOS inflammation in lower airway. More obvious effect can be achieved than simple to use nasal irrigation or nasal corticosteroids alone.