四种内迎香穴鼻内针刺取穴方法治疗变应性鼻炎患者的即刻疗效及安全性评价OA

Objective To evaluate the immediate effectiveness and safety of four intranasal acupuncture methods based on different intranasal localizations of Neiyingxiang(EX-HN 9)for improving nasal ventilation in patients with allergic rhinitis(AR).Methods A total of 120 patients with AR were randomly divided into four groups with 30 cases in each group,the agger nasi group,the inferior turbinate-alar junction group,the inferior turbinate top group,and the nasal septum group.All patients received one 20-minute session of intranasal acupuncture.The agger nasi group received acupuncture at the agger nasi site,the inferior turbinate-alar junction group at the junction of the infe-rior turbinate and alar cartilage,the inferior turbinate top group at the top of the inferior turbinate directly facing the nostril,and the nasal septum group at Little's area of the nasal septum.Before acupuncture and within 5 min after treat-ment,the assessments and measurements were performed including nasal obstruction symptom evaluation(NOSE)scale used to evaluate the severity of nasal obstruction before and after acupuncture,a nasal resistance/nasal flow analyzer applied to detect nasal airway resistance(NAR)and nasal respiration volume(NS),the visual analogue scale(VAS)adopted to assess pain intensity.The incidence of nasal bleeding and other adverse events were recorded,and patients' willingness to receive repeat treatment was statistically analyzed.Results Compared with baseline within group,all four groups showed decreased NOSE scores and NAR as well as elevated NS after treatment(all P＜0.05).Compared with the agger nasi group and the inferior turbinate-alar junction group,the inferior turbinate top group had higher NOSE scores and lower NS;the nasal septum group presented higher NOSE scores and NAR along-side lower NS(P＜0.05).The nasal septum group yielded significantly higher VAS scores than the other three groups(P＜0.05),with 11 cases(36.67％)of massive nasal bleeding observed,while no severe nasal hemorrhage occurred in the remaining groups.The proportions of patients willing to receive repeated intranasal acupuncture treat-ment were 70.00％(21/30)in the agger nasi group,76.67％(23/30)in the inferior turbinate-alar junction group,43.33％(13/30)in the inferior turbinate top group,and 3.33％(1/30)in the nasal septum group,respectively,with statistical significant difference among groups(x2=39.91,P＜0.001).Conclusion All four intranasal acupunc-ture methods can immediately improve nasal ventilation in patients with AR.The agger nasi group and inferior turbinate-alar cartilage junction group achieved superior therapeutic improvement compared with the inferior turbinate top group and nasal septum group,accompanied by better safety and higher patient acceptability.