| Purpose:Allergic rhinitis(allergic rhinitis,AR,)referred to as allergic rhinitis,refers to atopic individuals after contact with allergens by immunoglobulin Ig E mediated medium release,and a variety of immunoreactive cells and cytokines involved in the occurrence of chronic inflammatory reactive diseases in the nasal mucosa.The main clinical manifestations are sneezing,runny nose,nasal congestion,itching nose and other typical symptoms.Based on previous clinical observations and related literature studies,it was found that warm acupuncture can significantly improve the clinical symptoms of allergic rhinitis patients,but there are few studies on its mechanism of action.The central God of this study To explore the central action mechanism of warm acupuncture for perennial allergic rhinitis by ALFF and Re Ho analysis with Rs-fMRI as the technical means.At the same time,the clinical effect of warm acupuncture for perennial AR was simply verified by TNSS?TNNSS scale.and provide theoretical support for the clinical warming acupuncture treatment of perennial AR.Methods:The study was carried out in the affiliated hospital of Sichuan traditional Chinese Medicine Hospital/Chengdu University of traditional Chinese Medicine from December 2019 to January 2020,A total of 30 patients with perennial allergic rhinitis were included,including 1 case(not treated according to the treatment plan),5 cases falling off(due to insufficient course of treatment,unable to complete the trial),24 cases of allergic rhinitis in the trial group completed the trial,and 30 cases of healthy the sex and age of the trial group.1.Clinical StudiesThirty patients with perennial allergic rhinitis were treated with warm acupuncture for 4 weeks,before treatment,2 weeks after treatment after treatment,4weeks after treatment(end of treatment),2 weeks after treatment(follow-up 1),5 time nodes after 4 weeks after treatment(follow-up 2),with nasal symptom score(TNSS)and nasal adjoint symptom score(TNNSS)2.Rs-fMRI research(1)The difference of brain functional area imaging between patients and healthy people Rs-fMRI perennial AR.the 30 perennial AR patients(trial group)and 30 healthy subjects(health group)to be included were Rs-fMRI scanned in resting state using fMRI imaging techniques.the differences in brain function imaging between the two groups were compared by ALFF and Re Ho analysis.(2)The difference of imaging Rs-fMRI brain function area AR patients before and after warm acupuncture treatment.the perennial AR patients who completed the trial,within 48 hours after the end of treatment,were Rs-fMRI scanned again in the resting state.after ALFF and Re Ho analysis,the brain function imaging changes of perennial allergic rhinitis patients in the resting state before and after warm acupuncture treatment were compared.Results:1.clinical study part :1)The total score and each score of the TNSS?TNNSS before and after treatment in the trial group passed the rank sum test,and the difference was statistically significant(P<0.05).indicating that warm acupuncture and moxibustion can effectively control the symptoms of allergic rhinitis.2)This trial,the effective rate of warm acupuncture treatment for perennial allergic rhinitis was 66.7%for 2 weeks,87.5% for 4 weeks,83.3% for 2 weeks after treatment and 75% for 4weeks after treatment.2.fMRI part :1)The ALFF values of bilateral inferior frontal gyrus,medial frontal gyrus,anterior central gyrus and upper right frontal gyrus were significantly higher than those of normal subjects,left cingulate gyrus and bilateral cingulate isthmus ALFF were significantly lower than those of normal subjects;right medial frontal gyrus,caudate nuclear head,left inferior frontal gyrus and corpus callosum frontal forceps Re Ho were significantly higher than those of normal subjects.The left middle frontal gyrus,the center of semicircular circle and the A of caudate nuclear head were treated with.2)The LFF value was significantly higher than that of normal subjects,while the ALFF values of right semicircular center and dorsal thalamus were significantly lower than those of normal subjects.The REHO values of bilateralsemicircular center,left internal capsule hind limb,hippocampus and temporal lobe were significantly higher than those of normal subjects,while those of bilateral superior frontal gyrus and left corpus callosum were significantly lower than those of normal subjects.3)Compared with the two,the results showed that there was no overlap between the brain region and the brain region associated with AR,but both involved the limbic system.Conclusion : 1.Warm acupuncture treatment can significantly improve the main and concomitant symptoms of allergic rhinitis patients.2.According to the fMRI results,it can be concluded that :1)the medial frontal gyrus,the inferior frontal gyrus,and the cingulate gyrus may be the related brain regions in patients with allergic rhinitis.changes of brain function before and after.2)warm acupuncture treatment,including: middle frontal gyrus,caudate nuclear head,posterior limb of internal capsule,hippocampus,temporal lobe,dorsal thalamus,semicircular center,mainly involving the marginal system.3)the above two points do not overlap,it is suggested that the mechanism of warming acupuncture for allergic rhinitis may not directly involve the center,but it still needs more and more rigorous trials to confirm. |
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