Efficacy And Safety Of Latent Myofascial Trigger Point Injection In The Treatment Of Moderate And Severe Allergic Rhinitis

ObjectiveThis study aims to explore the efficacy and safety of head-neck latent myofascial trigger point injection in the treatment of moderate and severe allergic rhinitis,and to provide new ideas and methods for the treatment of allergic rhinitis.Methods65 patients with moderate and severe allergic rhinitis who met the inclusion criteria were selected.The location and injection of the trigger point were performed by experienced medical personnel and the injection solution include 2%lidocaine hydrochloride injection,compound betamethasone injection,vitamin B12 injection(500ug)and 0.9%normal saline diluted to 20ml.After the injection,the patient should be observed for half an hour before leaving.Record the patient's symptom score and drug use before treatment,15 minutes after treatment,1 week after treatment,2 weeks after treatment.4 weeks after treatment,8 weeks after treatment,12 weeks after treatment,and 24 weeks after treatment,and record occurrence of related adverse events.The primary outcome event was total nasal symptom score(TNSS),and the secondary outcome event was medication use and eye symptom score during follow-up periods.TNSS mainly includes four common nasal symptoms of AR:itchy nose,nasal congestion,rhinorrhea and sneezing.The severity of each symptom was measured on a scale of 0 to 3 points,and the sum of the four symptoms was TNSS.0 point without any symptoms,1 point with obvious symptoms but rarely noticed discomfort,2 points with obvious discomfort symptoms but tolerable,3 points with severe symptoms that are intolerable and affect daily life and sleep.TNSS ranges from 0 to 12 points.Secondary outcome events were drug use and eye symptom scores.In order to avoid unbearable symptoms of AR after treatment,the patient can be treated with medication recommended by current guidelines and expert consensus.Each use of antihistamine was counted as 1 point,2 points for each INCS and oral glucocorticoid was required at 3 points.Eye symptoms include itchy eyes and watery eyes and severity is indicated on a scale of 0 to 3 points.The SPSS21.0 software was used for statistical analysis of the data.The statistical description of the measurement data was expressed as mean±standard deviation,and the comparison of different time points was analyzed by repeated measurement analysis of variance.The difference was statistically significant at P<0.05.Results1.40 subjects were included in this study,including 22 males(55.0%)and 18 females(45.0%).The youngest age was 13 years old,the oldest was 62 years old,the mean age was 38.28111.50 years old,the medical history was the shortest for 1 year,the longest for 20 years,and the mean was 6.3614.24 years.2.After treatment,the total nasal symptoms scores showed a gradually decreasing trend.The total nasal symptoms scores including itching.nasal congestion,rhinorrhea and sneezing were lower than before treatment.Eye symptom scores decreased significantly,indicating that itchy eyes and watery eyes had been significantly relieved.3.TNSS decreased significantly and showed immediate effect after treatment,and the effect was sustained and stable within 24 weeks of follow-up periods.4 patients relapsed,three after a cold and one after smoking.However,even in 4 patients who relapsed,symptoms were less severe than before treatment.2 patients reported no response to treatment,with no significant changes in all the scoring indicators,accounting for 5%of the patients who comnleted the follow-un and the overall effective rate was 95%4.The TNSS increased between 12 weeks after treatment and 24 weeks after treatment,but the score was still significantly lower than before treatment.5.There were no adverse events associated with injection therapy.In our study,2 patients experienced palpitations,dizziness after injection treatment,and the symptoms disappeared after short rest.We considered it as the reaction of syncope,which may be related to nerve reflex.ConclusionThe latent myofascial trigger point injection has an obvious effect on relieving symptoms in patients with moderate and severe allergic rhinitis,and no serious adverse reactions have been observed.Therefore,it can be popularized and applied in clinical work.Large randomized controlled trials are also needed,and the underlying.mechanism of action also needs to be further studied.