The Clinical Efficacy Of Intranasal Acupuncture In The Treatment Of Allergic Rhinitis And Research Based On The Inflammatory Mechanism Of "TRPV1/SP"

ObjectiveIn recent years,the prevalence of allergic rhinitis(AR)has increased year by year,and acupuncture treatment has become an important treatment.Nei Ying Xiang and Nasal Hill are the new intranasal acupoints,the purpose of this study is to explore their clinical efficacy and the regulatory role of TRPV1/SP on the neuroendocrine-immune network system of nasal mucosa in allergic rhinitis.From both clinical and basic aspects,we provides a scientific basis for the clinical application of intranasal acupuncture.Methods1.In this study,there are 30 allergic rhinitis patients(intranasal acupuncture group)and 15 healthy controls(normal control).The acupuncture group will be received 7 acupuncture treatments,once every other day for 2 weeks;The normal control group did not have any special intervention.We used scale score(VAS?TNSS?RQLQ)as the efficacy evaluation index.The laboratory test indicators of endoscopic examination,blood eosinophils(EOS)count,TRPVland SP are used as the second evaluation index.Before and after treatment,in the intranasal acupuncture group test the clinical symptom scale score and the blood routine EOS and serum TRPV1/SP.The normal control group only performed the blood routine EOS and the serum TRPV1/SP.2.In the animal experiments,30 New Zealand rabbits randomly divided into group A(normal group),group B(model group),group C(false acupuncture group),group D(Wai Yingxiang group),group E(intranasal acupuncture group).Except for the normal group,allergic rhinitis model of New Zealand rabbits was made by ovalbumin sensitization.There was no special intervention in the normal group and the model group.The sham acupuncture group was treated with a non-acupoint shallow thorn method.The acupuncture Wai Ying Xiang group acupuncture the Wai Yingxiang point,and the intranasal acupuncture needle the Nei Yingxing.C?D?E group have the needle for 30min,once every other day,a total of 7 times.On the second day after the intervention treatment,the abdominal aorta blood of new zealand rabbits was taken to measure blood EOS count and serum IgE.And then the nasal mucosa was decapitated to perform HE staining and immunohistochemical staining of TRPV1/SP.Observe the following:During modeling and treatment of the new zealand rabbits,we observe the changes of behavioral scores and in blood routine EOS counts,and we can detect serum IgE levels by Elisa,in addition to this,we can detect the expression of TRPV1 and SP by immunohistochemistry.Results1.The clinical efficacy of intranasal acupuncture and its influence on EOS and serum TRPV1/SP levels in AR patients(1)Scale scores:The scores of VAS,TNSS and RQLQ decreased significantly after intervention,and the difference before and after acupuncture was statistically significant(P<0.05).Among the 30 subjects,5 were ineffective,21 were effective,4 were markedly effective,the ineffective rate was 16.6%,the effective rate was 70.1%,the marked efficiency was 13.3%,and the total effective rate was 83.4%.(2)Endoscopic examination results:Before and after acupuncture,we observe the changes of nasal mucosa.It was found that the pare color of the nasal mucosa of some patients was gradually congested and the swelling of the lower turbinate was slightly relieved.(3)Laboratory test indicators:In the comparison of the differences between the groups before and after treatment,the routine blood EOS count and serum TRPV1/SP content in the peripheral blood were statistically significant(P<0.05).2.The effect of Intranasal Acupuncture on behavior and laboratory indicators of animal Allergic Rhinitis model(1)Behavioral scores:Before and after treatment,there was no significant change in the behavioral scores of the model group.The behavioral scores of the sham acupuncture group did not decrease significantly.The behavior score of acupuncture Wai Ying Xiang group and intranasal acupuncture group decreased significantly,indicating that intranasal acupuncture has a significant effect on nasal symptoms in animal models of allergic rhinitis.(2)Comparison of eosinophil counts in blood samples of animal models:There was no significant difference in EOS counts among groups.There were no significant differences(P>0.05)between the normal group and the model group,the intranasal acupuncture group and the model group,the normal group and the intranasal acupuncture group.(3)Results of the serum IgE determination by Elisa method:In this experiment,the IgE content of the model group was significantly increased compared with the normal group(P<0.05);The sham acupuncture group was compared with the model group,there was no significant change in serum IgE content(P>0.05).Serum IgE levels were significantly lower in the acupuncture group and the intranasal acupuncture group compared with the model group(P<0.05).The serum IgE content in the intranasal acupuncture group was significantly lower than that in the Wai Ying Xing group,there was no statistical difference between the two groups(P>0.05).(4)HE staining results of nasal mucosa:The cilia of the nasal mucosa in the normal group were neatly arranged,no obvious shedding and eosinophil infiltration was not obvious;The nasal mucosa of the model group and the sham acupuncture group were disorderly arranged,and the glandular hyperplasia was serious.and eosinophil infiltration was Obvious;In the intranasal acupuncture group and the Wai Ying Xiang group,the nasal mucosa glands were slightly hyperplasia,and the cilia were slightly arranged.Compared with the model group and the sham acupuncture group,the eosinophil infiltration was obvious.(5)Immunohistochemical results:The results of the scanning:The model group compared with the sham acupuncture group,there was no significant difference of the TRPV1 and SP immunohistochemical staining of the nasal mucosa between the two groups.There are brown-yellow positive particles everywhere.The immunohistochemical staining of TRPV1 and SP in the nasal acupuncture group and the Wai Ying Xiang group showed that the brown-yellow positive particles were significantly weakened,and the intranasal acupuncture group showed a significant weakening trend compared with the Wai Ying Xiang group.Conclusion(1)Intranasal acupuncture can effectively alleviate nasal symptoms(VAS,TNSS)and improve the quality of life(RQLQ).It may play a role by reducing EOS count and serum TRPV1 and SP levels through nasal mucosal neuroendocrine-immune network system.(2)Intranasal acupuncture can not only significantly improve the nasal symptoms of rabbit models of allergic rhinitis,but also reduce serum IgE levels.In terms of EOS,there was no significant change in blood counts,and eosinophil infiltration in the nasal mucosa showed significant changes.In addition,according to the immunohistochemical results of TRPV1 and SP in the nasal mucosa,it is speculated that intranasal acupuncture may affect the neuroendocrine-immune network regulation of AR by activating TRPV1 and depleting the neuropeptide SP secreted by sensory nerve fibers.