ABSTRACT
Objective:To compare the clinical value of visual analogue scale （VAS）, Lebel scale and total nasal symptom scores （TNSS） in evaluating nasal allergen provocation test （NAPT）. Methods:A total of 151 patients suspected of allergic rhinitis admitted to the Department of Otolaryngology-Head and Neck Surgery of our hospital from April 2020 to September 2020 were included, of which 76 were positive for house dust mites and 75 were negative for allergens. Nasal airway resistance（NAR） was measured by active anterior nasal manometry. Nasal symptoms were evaluated by VAS, Lebel and TNSS. House dust mite allergen was used for NAPT by spray method. An increase≥40% in NAR was used as the gold standard for objective evaluation of NAPT. ROC curves of VAS, Lebel and TNSS were drawn to compare the evaluation effectiveness of different subjective evaluation methods, and the optimal critical point of each ROC curve was obtained. Results:With NAR increased by ≥40% as the gold standard, the area under ROC curve of VAS was 0.884, and the sensitivity and specificity were 97.75% and 80.65%, respectively. The area under ROC curve of Lebel was 0.773, and the sensitivity and specificity were 68.54% and 75.81%, respectively. The area under ROC curve of TNSS was 0.792, and the sensitivity and specificity were 68.54% and 79.03%, respectively. There was no significant difference between Lebel and TNSS（P>0.05）. The VAS differed significantly from Lebel and TNSS（P<0.05）. The Kappa values of VAS, Lebel, TNSS and NAR were 0.803, 0.432 and 0.459, respectively. Conclusion:The VAS, Lebel, TNSS subjective scale and NAR are consistent in evaluating the efficacy of NAPT, with the VAS assessment showing highest consistency with NAR. As objective assessment instruments are not widely used in China, subjective assessment method could be adopted to evaluate the efficacy of NAPT in clinical practice, and VAS scale is recommended as a priority.
Subject(s)
Animals , Humans , Allergens , Nasal Provocation Tests/methods , Rhinitis, Allergic/diagnosis , Nose , PyroglyphidaeABSTRACT
Background: Allergic rhinitis (AR) impacts 10-30% of the world affecting the quality of life of many. Hence, the requirement of a treatment targeted at delivering maximum symptom control and has minimum to no side effects. Objectives: Comparison of efficacy of Bilastine and Fexofenadine in patients suffering from intermittent allergic rhinitis with the help of Total Nasal Symptom Scoring(TNSS) and assessment of side effects- sedation and cardiac toxicity. Methodology: 60 subjects diagnosed with intermittent allergic rhinitis (IAR) were recruited and divided into groups of 30 each. One group was started on Bilastine 20mg OD and the other on Fexofenadine 120mg OD. TNSS was calculated based on symptom severity at presentation, on 10th day and 30th of antihistamine therapy. AEC values and ECG changes were compared for both groups at day 0, day 30. Measurement of sedation was done at day 10, day 30. Intergroup comparison and intragroup assessment of TNSS and its variables, sedative effects and ECG changes at day 0 and day 30 were done using Un-paired and Paired T-test. Results: Patients showed reduction in symptoms of AR with both drugs. TNSS and Rhinorrhoea showed significant improvement in Fexofenadine group as compared to Bilastine. AEC values showed significant reduction in both groups. Statistically significant ECG changes were seen after 30 days of Fexofenadine therapy but were clinically insignificant. No sedative effects were noted with both drugs. Conclusion: Both Bilastine and Fexofenadine were found to be effective in reducing symptoms in patients with IAR. Fexofenadine was more effective than Bilastine in overall symptom control and specifically in controlling rhinorrhoea after one month of therapy. Both the drugs had no sedative effects or cardiac toxicity.