Evaluation Of The Efficacy And Mechanism Of Acupuncture On Papillary Ganglion In The Treatment Of Perennial Allergic Rhinitis

This study will be tested whether the acupuncture can regulate some function on perennial allergic rhinitis patients by puncturing sphenoPerennial allergic rhinitis (PAR) is such a common disease in modern society,However,nasal spray hormone which was commonly used could lead to nasal mucosal harm. Nasal decongestants could cause medicamentous rhinitis after a long time abuse and made symptoms heavier. Puncturing sphenopalatine ganglion(SPG) played an active function on perennial allergic rhinitis patients.The result of puncturing SPG was better than common body points acupuncture after a review on past research.This research firstly puncture on healthy people SPG and observe their nasal ventilation and nasal Nitric Oxide,neuropeptides and cytokine n nasal secretion to find basic mechanism.Then with random controlled blinded test,39 cases of results concluding observed group(puncturing SPG) and controlled group (short placebo needling) were also observed in order to discuss the mechanism of results.Random controlled blinded test was firstly used in PAR treatment by puncturing SPG.Nasal airway resistance(NAR),acoustic rhinometry(AR),nasal Nitric Oxide,neuropeptides and cytokine in nasal secretion were firstly tested to evaluate the change of nasal ventilation objectivelyTest 1:The research on mechanism by puncturing on healthy people SPG to observe their nasal ventilation and nasal Nitric Oxide,neuropeptides and cytokine in nasal secretionIn this study, nasal ventilation and nasal Nitric Oxide,neuropeptides and cytokine in nasal secretion of 10 healthy volunteers were observed.Disposable needles of 60mm in length and 0.35 mm in diameter (Dongbang Medical Apparatus Co.Ltd., Suzhou, China) were used. For the active acupuncture group, the acupuncture point in sphenopalatine ganglion (right side) was selected. The acupuncture practitioner should penetrate the needle from point to sphenopalatine ganglion. The point is located at the lower border of the zygomatic arch, slightly posterior to the suture protuberance between the zygomatic process and temporal process, and about 1.5cm anterior to the Xiaguan (St 7) point, which is felt as an arch depression. The needle is inserted at the middle of the arch depression and avoiding the bone tissue, the needle tip goes obliquely anteriorly until the whole needle body is beneath the skin. Each needle was rotated until the participants felt " de-qi" sensations when the patient has a feeling of severe electric shock at the ipsilateral buccal region or a feeling of water splashing in the nose. The needle was twirled and lifted and thrust 3-5 times to give repeated stimulation. Clean dry cotton was pressed after acupuncture on point for 2 minutes.Subjective evaluation items are nasal symptom grade:including total and each symptom(nasal block,nasal itching,sneezing and running nose);Subjective evaluation items (3 times):before acupuncture,20minutes and 2 hours after acupuncture.(1)Nasal airway resistance(NAR),acoustic rhinometry(AR),nasal Nitric Oxide,neuropeptides and cytokine in nasal secretion were firstly tested;(2) nasal neuropeptides and cytokine of such as NGF、NPY、SP and VIP.Conclusion:1.This study showed significant improvement in nasal ventilation and increased sympathetic nerve excitability after acupuncture on SPG compared to sham acupuncture in health volunteers.2.Puncturing SPG affect nasal neuropeptides sending out.3. Nasal neuropeptides were not changed obviosly.4 Nasal ventilation can be observed and reduce disturbanceThe results suggest that acupuncturing SPG might be an effective and safe treatment for controlling the symptoms of allergic rhinitis. 39perennial allergic rhinitis patients were randomly separated into 2 groups:Observation group and control group.Observation group received puncturing on sphenopalatine ganglion with proper long needle.Control acupuncture group received only short needle stimulation on skin same as SP group without stimulation to sphenopalatine ganglion.A VAS(visual analog scale)questionnaire,NAR(nasal airway resistance),acoustic rhinometry(AR),nasal Nitric Oxide in nasal secretion were tested before acupuncture and after 3 times acupuncture. The data indicate that acupuncture stimulation leads to a excitation of sympathetic nerve activity than parasympathetic nerve activity. After that people nerve system can receive an active regulation to prevent rhinitis and reduce the risk of rhinitis. And observation group and a control group will use to reduce pain disturbance.To observe the effect of treatment for perennial allergic rhinitis by puncturing sphenopalatine ganglion compared with controlled acupuncture group.1.Following randomization,Thirty nine cases were randomly divided into an observation group and a control group.2.The observation group(n=20)were treated by puncturing sphenopalatine ganglion.The needle,60mm in length and 0.35 mm in diameter,is inserted at the middle of the arch depression and avoiding the bone tissue, the needle tip goes obliquely anteriorly until the whole needle body is beneath the skin.The therapeutic effect is the best when the patient has a feeling of severe electric shock at the ipsilateral buccal region or a feeling of water splashing in the nose.The control group (n=19) were treated by using 25mm length needle and 0.25mm in diameter to penetrate the from "Zhibi 3" point also.3.Both groups have treatments once per week,3 times is a course,to compare the results after 1 course.4.To observe the data.There are 4 items evaluated before and after treatment: ① Changes of the main symptoms,② nasal airway resistance(NAR),③ acoustic rhinometry(AR),④ nasal Nitric Oxide in nasalComparing the patients’ main symptoms before and after treatment:After treatment,sensation of Nasal itching,sneezing,running nose,nasal block and nasal total symptoms had a obvious improvement after treatment.(P value are 0.0464,0.0125, 0.0039,0.0303, 0.0010). For nasal block symptom and total nasal sense in observation group were significantly improved than control group (P<0.05).In the two groups,and the observation group in the improvement of the NAR (nasal airway resistance) were significantly improved than the control group(P<0.05).There were no significantly improved between the two groups after acupuncture on Nasal AR(acoustic rhinometry)and NO (Nitric Oxide) (P>0.05).It is shown that puncturing sphenopalatine ganglion can bring with a distinct effects on perennial allergic rhinitis and improve patients nasal ventilation and subject symptoms such as Nasal itching,sneezing,running nose,nasal block and nasal total symptoms,which were significantly improved than the control group.Pucturing points can be changed by puncture SPG. Tools were easier.It was safe with clear results and not rich,.Generally,puncturing SPG is tiny treatment.Because time was limited,the clinical mechanism can not be explain soon.Such as comparing oral drugs and puncturing SPG on PAS;the treatment frequency;long time result;How to strengths stimulation in order to regulate nasal neuropeptides and cytokine obviously.Above all,there are still a long way to run.