Metabolomic Study Of The Mechanism For Intranasal Acupuncture In The Treatment Of Allergic Rhinitis

Objective:1.To confirm the efficacy of intranasal acupuncture in AR;2.To explore the mechanism of action of intranasal acupuncture in the treatment of AR from metabolomics perspective.Methods: The 40 AR recruited patients were divided into two groups and treated with intranasal acupuncture and oral loratadine for 14 days.Signs and symptoms before and after treatment were recorded with the Visual Analogue Scale(VAS)and the Total Medication Score(TNSS),and meanwhile nasal secretions were collected with polyurethane sponges for metabolomic UPLC-MS analysis of changes in metabolites.Results:1.After the treatment and observation,the statistical calculation of the effective rate of the acupuncture group and the control group were 85% and70% respectively,and the evaluation of the efficacy of the patients between the two groups was compared by the rank sum test,p<0.05,which was statistically significant,and the efficacy of the acupuncture group was significantly better than that of the control group.2.The TNSS and VAS scale scores were compared between the two groups of patients before and after treatment using the independent samples t-test,with a statistically significant difference of p<0.05.And comparing the post-treatment scale scores of the two groups of patients,p<0.05,the difference is significant.3.The changes and differences in metabolites before and after treatment were compared between the two groups,and the differential metabolites were counted.There were 13 different metabolites in the acupuncture group,20 in the control group and 9 between the two groups after treatment.There were 4identical differential metabolites among the metabolites that changed after treatment in each of the two groups with the same trend,with citicoline up-regulated and 5-Fluorouridine monophosphate,N-Oleoylethanolamine and4-ethylamino-6-isopropylamino-1,3,5-triazin-2-ol down-regulated.4.Using metabolic pathway enrichment analysis,5 metabolic pathways were obtained from the result of differential metabolites.Both the acupuncture group and the control group were associated with choline metabolism in cancer.Also the acupuncture group was associated with terpenoid backbone biosynthesis,while the control group was associated with the renin-angiotensin system.In contrast,differential metabolites between the two groups after treatment were associated with ferroptosis,phenylalanine,tyrosine and tryptophan biosynthesis.Conclusions: Both intranasal acupuncture and oral loratadine are capable of treating AR.However,intranasal acupuncture is more effective and efficient in treating AR than oral loratadine.The effects of intranasal acupuncture and oral loratadine on AR patients differ at the metabolomic level,probably due to differences in their pathways of action.Nevertheless,in the two metabolic pathways,ferroptosis and phenylalanine,tyrosine and tryptophan biosynthesis,intranasal acupuncture treatment had a more positive effect.