RESUMEN
Chronic nonallergic rhinitis syndromes encompass various conditions, of which vasomotor rhinitis is the most common form, representing approximately 80% of patients, also referred to as nonallergic rhinopathy (NAR), nasal hyperreactivity, neurogenic rhinitis, or idiopathic rhinitis. Expert panels have recommended replacing vasomotor rhinitis terminology because it is more descriptive of this condition that is characterized by symptoms triggered by chemical irritants and weather changes through chemosensors, mechanosensors, thermosensors, and/or osmosensors activated through different transient receptor potential calcium ion channels. Elucidating the specific role of transient receptor potential vanilloid 1, triggered by capsaicin, has been an important advancement in better understanding the pathophysiology of NAR because it has now been shown that downregulation of transient receptor potential vanilloid 1 receptors by several therapeutic compounds provides symptomatic relief for this condition. The classification of NAR is further complicated by its association with allergic rhinitis referred to as mixed rhinitis, which involves both immunoglobulin E-mediated and neurogenic mechanistic pathways. Comorbidities associated with NAR, including rhinosinusitis, headaches, asthma, chronic cough, and sleep disturbances, underscore the need for comprehensive management. Treatment options for NAR include environmental interventions, pharmacotherapy, and in refractory cases, surgical options, emphasizing the need for a tailored approach for each patient. Thus, it is extremely important to accurately diagnose NAR because inappropriate therapies lead to poor clinical outcomes and unnecessary health care and economic burdens for these patients. This review provides a comprehensive overview of NAR subtypes, focusing on classification, diagnosis, and treatment approaches for NAR.
Asunto(s)
Rinitis , Humanos , Rinitis/diagnóstico , Rinitis/terapia , Rinitis/clasificación , Rinitis Vasomotora/diagnóstico , Rinitis Vasomotora/terapia , Canales Catiónicos TRPV/metabolismo , Enfermedad CrónicaRESUMEN
Objective: To evaluate the mental state and quality of life in patients with vasomotor rhinitis (VMR) before and after treatment, and to provide guidance for improving the overall health of VMR patients. Methods: Two hundred and twenty VMR patients (VMR group, 118 males, 102 females; aged from 18 to 72 years old), three hundred and twenty allergic rhinitis (AR) patients (AR group, 178 males, 142 females; aged from 18 to 79 years old) from January 2016 to September 2019 were selected in the otolaryngology clinic of Affiliated Hospital of Guizhou Medical University, four hundred and twenty-three healthy people (control group, 243 males, 180 females; aged from 19 to 70 years old) were selected in physical examination center at the same time by continuous enrollment method, symptom check list (SCL-90), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the mental state of VMR patients before and after treatment, and 12-item short form health survey version 2.0 (SF-12v2) was used to evaluate their quality of life, statistical data were collected and analyzed by ANOVA and t-test. Results: The scores of eight factors (physical function, role physical function, general health, vitality, role-emotional, mental health) of SF-12v2 in VMR patients before treatment were lower than that of posttreatment, that of AR patients and the control group, the differences were significant (all P<0.05), the scores of somatization, obsession, depression, anxiety and psychosis in SCL-90 in VMR patients before treatment were significantly higher than that of posttreatment, that of AR patients and the control group (all P<0.05), the SAS and SDS in VMR patients before treatment (51.28±16.32; 53.28±18.55) were significantly higher than that of posttreatment (38.53±13.21; 39.35±13.34), that of AR patients (42.23±14.32; 43.32±13.78) and the control group (29.78±10.07;33.46±10.55; t(SAS) were 9.007, 6.813 and 20.59; t(SDS) were 9.043, 7.154 and 17.260, all P<0.05). Conclusion: VMR patients generally suffer from psychological damage, which seriously affects the quality of life of the patients. On the basis of routine treatment, we should attach more importance to the negative psychology of VMR patients and intervene when necessary.
Asunto(s)
Rinitis Alérgica , Rinitis Vasomotora , Adolescente , Adulto , Anciano , Ansiedad/psicología , Depresión/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Rinitis Alérgica/psicología , Rinitis Vasomotora/psicología , Rinitis Vasomotora/terapia , Adulto JovenRESUMEN
Viewed 60 men and women (mean age 26.2±2.4 years) with rhinitis, including: 30 people (18 women and 12 men) 20-45 years with verified diagnoses of persistent allergic rhinitis and 30 patients (16 males and 14 females) 18-35 years (mean age 22.5±1.7 years) - neurovegetative form of chronic vasomotor rhinitis in the phase of exacerbation, receiving basic therapy with antihistamines of the II generation, stabilizers of membranes of mast cells and decongestants, divided by random sampling into 4 groups: 1A (20 patients with allergic rhinitis) and 2A (20 patients with vasomotor rhinitis) were received within 30 days in addition to the basic therapy of the nasal cavity washing procedure with the device Dolphin; in the groups 1B (10 patients with allergic rhinitis) and 2B (10 patients with vasomotor rhinitis) only basic treatment was carried out. By the end of the treatment course, the severity of the symptom 'difficulty in nasal breathing' in patients in groups 1A and 2A, decreased 2.6 times and met the criterion of 'minor violation', while in groups 1B-decreased only 1.3 times, and in 2B-changes were not significant and corresponded to 'moderate violation'. Manifestations of rhinorrhea after therapy decreased in the group of 1A 2.0 times, and in the group of 2A 1.7 times, which was regarded as' a slight manifestation of the symptom', whereas in the groups of 1B and 2B only a tendency to improve was revealed. At the end of the follow - up period, the severity of the symptom 'sneezing' decreased in patients in group 1A by 4.0 times, in group 2A-3.3 times and corresponded to 'no disturbance', while in groups 1B and 2B changes were less than 3.0 and 2.7 times respectively. At the end of the treatment course in patients in groups 1A sense of smell was restored in the group 2A -the degree of severity of olfaction decreased 3.0 times, while in the group of 1B-only 1.2 times, and in the group of 2B-has not changed. According to the visual analog scale (VAS), on the background of treatment optimized by nasal lavage with the device Dolphin complex, the greatest decrease in the degree of violations of household activity was revealed in patients with allergic rhinitis - 2.9 times. After treatment, the effect of rhinitis symptoms on sleep disturbance decreased in groups 1A and 2A 1.9 times, while in groups 1B and 2B - only 1.3 times. The use of nasal lavage with device Dolphin complex in the treatment of allergic and vasomotor rhinitis contributed to a decrease in the frequency of use of intranasal vasoconstrictive drugs by the 10th day of observation by 1.8 and 1.6 times, respectively, and by the 15th day-by 2.3 and 2.4 times, respectively. In the groups of standard treatment (1B and 2B) revealed a significant reduction in the frequency of decongestants was observed only after 15 days of treatment. Thus, the inclusion of a full volumetric nasal lavage with the device Dolphin complex in the treatment of patients with persistent allergic and neurovegetative form of chronic vasomotor rhinitis contributes to the reduction of clinical simtomatics, reduces the severity of violations of everyday life and the frequency of decongestants, improves night sleep of patients.
Asunto(s)
Rinitis Alérgica , Rinitis Vasomotora , Irrigación Terapéutica , Adulto , Femenino , Antagonistas de los Receptores Histamínicos , Humanos , Masculino , Cavidad Nasal , Rinitis Vasomotora/terapia , Adulto JovenRESUMEN
The objective of the present study was to evaluate the dynamics of the nasal breathing function and the quality of life in the patients following septoplastic surgery with the use of the classical method in comparison with the application of the latex tissue glue. The study included 58 patients presenting with diagnosis of deflected septum of the nose and vasomotor rhinitis. The following methods were employed for the purpose: anterior active rhinomanometry, evaluation of the transport function of the nasal cavity, and the questionnaire study for the determination of the patients' quality of life. The patients were allocated to two groups. Group 1 was comprised of the patients who underwent the classical surgical intervention (septal surgery with the mechanical disintegration of the inferior turbinated bones. The patients of the second group were treated with the use of the modified surgical procedure with the use of the latex tisue glue. The study has demonstrated that the patients treated with the use of the modified approach (including the application of the latex glue) recovered faster and reported a higher quality of life during the postoperative period than the patients of the first group treated by the conventional method.
Asunto(s)
Adhesivos , Hemostáticos , Obstrucción Nasal , Rinitis Vasomotora , Adhesivos/uso terapéutico , Humanos , Obstrucción Nasal/terapia , Tabique Nasal , Calidad de Vida , Rinitis Vasomotora/terapia , Rinomanometría , Resultado del Tratamiento , Cornetes NasalesRESUMEN
Objective: To observe the therapeutic effect of simple 3.0% saline nasal irrigation and combined treatment of 3.0% saline nasal irrigation and budesonide nasal spray for vasomotor rhinitis (VMR), and explore the long-term effect for VMR. Through examination of levels of substance P (SP) and mucin (MUC)5B in nasal lavage fluid, the mechanisms of nasal irrigation treatment for VMR was discussed. Methods: One hundred and one patients from Department of Otorhinolaryngology Head and Neck Surgery, Huashan Hospital of Fudan University with VMR were randomly divided into 4 groups. The number of patients was 24 in control group, 25 in budesonide nasal spray treatment group (budesonide group), 25 in nasal irrigation treatment group (nasal irrigation group) and 27 in budesonide nasal spray + nasal irrigation group (combined treatment group). Control patients were left untreated. Budesonide group was under budesonide nasal spray treatment, nasal irrigation group was treated using 3.0% saline with a temperature of 40â and combined treatment group was given both treatments. The duration of the intervention period was 3 months (90 days). Visual Analog Scale (VAS) was used to evaluate nasal symptoms, and the health-related quality of life was assessed using the 12-item Short Form Health Survey version 2.0 (SF-12v2). Enzyme-linked immunosorbent assay (ELISA) was used to assess the contents of SP and MUC5B in nasal lavage fluid before and after 3-month treatments in budesonide and nasal irrigation group in the study. MUC5B in nasal lavage fluid after the SP challenge and anticholinergic drug intervention in control group were also evaluated with ELISA. Results: Nighty out of 101 patients completed the study. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 vs 3.82±0.15, 6.18±0.17 vs 3.92±0.15, t value was 8.193, 10.060, respectively, all P<0.05) and SF-12v2 score increased (146.00±1.23 vs 152.30±0.97, 146.00±1.08 vs 155.40±0.90, t value was 3.982, 6.697, respectively, all P<0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 vs 5.72±0.15, 146.10±1.17 vs 147.00±0.94, t value was 1.038, 0.607, respectively, all P>0.05) after the first month. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 vs 5.05±0.15, 6.18±0.17 vs 5.10±0.12, t value was 3.374, 5.351, respectively, all P<0.05) and SF-12v2 score increased (146.00±1.23 vs 150.90±0.76, 146.00±1.08 vs 153.60±0.94, t value was 3.373, 5.343, respectively, all P<0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 vs 5.78±0.17, 146.10±1.17 vs 148.10±0.80, t value was 0.716, 1.438, respectively, all P>0.05) after the second month. By the end of the third month, in nasal irrigation and combined treatment group, the VAS score was diminished (5.96±0.17 vs 4.80±0.12, 6.18±0.17 vs 4.44±0.13, t value was 5.485, 8.264, respectively, all P<0.05) and SF-12v2 score was elevated (146.10±1.17 vs 150.80±0.96, 146.00±1.08 vs 152.90±0.85, t value was 3.163, 5.008, respectively, all P<0.05), but there were no significant differences in budesonide group (5.91±0.21 vs 5.68±0.18, 146.00±1.23 vs 148.40±0.85, t value was 0.819, 1.587, respectively, all P>0.05). Additionally, SP in nasal lavage fluid decreased and MUC5B showed no statistical changes in budesonide group after three months, however, SP showed no any changes and MUC5B reduced significantly in nasal lavage fluid in nasal irrigation group. Furthermore, the anticholinergic drug could not decrease the concentration of MUC5B after the SP challenge in nasal cavity in control group. Conclusions: The therapeutic effect of simple nasal irrigation with 3.0% saline or combined treatment of 3.0% saline nasal irrigation and nasal corticosteroids is superior to simple nasal corticosteroids. Nasal corticosteroids plays a role in the inhibition of sensory nerve endings in nasal mucosa, but neurotransmitter plays a limited role in the pathogenesis of VMR.
Asunto(s)
Antiinflamatorios/uso terapéutico , Budesonida/uso terapéutico , Lavado Nasal (Proceso)/métodos , Rinitis Vasomotora/terapia , Administración Intranasal , Adulto , Terapia Combinada/métodos , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Masculino , Mucina 5B/análisis , Proyectos Piloto , Calidad de Vida , Cloruro de Sodio/uso terapéutico , Sustancia P/análisis , Factores de Tiempo , Escala Visual AnalógicaRESUMEN
CONCLUSIONS: The potential effects of KOS are still uncertain regarding the most effective air pressure to be used as well as the physiological effects on the nasal mucosa. The results of the study do not support a convincing treatment effect by KOS on IR. OBJECTIVES: Idiopathic rhinitis (IR) is a common disorder, affecting â¼10-20% of the population. A new method for treating IR, Kinetic Oscillation Stimulation (KOS), has been reported to have beneficial effects on total vasomotor symptom scores (TVRSS). The primary objective with this study was to evaluate if a mean pressure of 65 mbar, pressure amplitude of 100 mbar, and 68 Hz treatment with KOS had a positive effect on total vasomotor symptom scores (TVRSS), as compared with a mean pressure of 65 mbar, pressure amplitude of 4 mbar, and 68 Hz treatment in patients with idiopathic rhinitis. METHODS: Two hundred and seven patients were randomized (Full Analysis Set, FAS) in the study, including five visits and lasting for â¼25 weeks. All patients had two treatment episodes, and all patients had at least one treatment, meant as active, with high amplitude pressure for 10 min in each nostril. Group 1 had two such treatments, and Group 2 had one treatment with low amplitude pressure, initially meant as placebo, on one occasion. Because of numerical improvements in these two groups, a new control group, Group 3, was introduced. They had one new control treatment where the balloon was inserted into the nose, without any air inflation and without oscillations. RESULTS: KOS treatment with high amplitude pressure did not have significant beneficial effects as compared to low amplitude pressure on TVRSS. Numerical improvements in TVRSS and SNOT 22 were found when comparing high and low amplitude pressure treatments with uninflated balloon treatment. However, this part of the study was initially single-blinded, and these results were secondary objectives.
Asunto(s)
Rinitis Vasomotora/terapia , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Presión , Rinitis/terapia , Adulto JovenRESUMEN
The objective of the present work was the comparative analysis of the results of the application of different methods for the treatment of the children presenting with vasomotor rhinitis. It was shown that the proposed combined approach including remedial therapy for the normalization of the function of the vegetative nervous system and the local application of fluctuating current to the nasal cavity mucosa has an advantage over the traditional modalities. Specifically, this newly developed simple and efficacious method for the combined conservative treatment of vasomotor rhinitis in the children has practically no contraindications for use, yields the most stable positive functional outcomes, and can by recommended for the application in both inpatient and outpatient settings to manage the patients with vasomotor rhinitis.
Asunto(s)
Terapia por Estimulación Eléctrica/métodos , Rinitis Vasomotora/terapia , Adolescente , Niño , Femenino , Humanos , Masculino , Resultado del TratamientoAsunto(s)
Rinitis Vasomotora , Corticoesteroides/uso terapéutico , Antagonistas Colinérgicos/uso terapéutico , Antagonistas de los Receptores Histamínicos/uso terapéutico , Humanos , Descongestionantes Nasales/uso terapéutico , Rociadores Nasales , Rinitis Vasomotora/diagnóstico , Rinitis Vasomotora/tratamiento farmacológico , Rinitis Vasomotora/etiología , Rinitis Vasomotora/terapia , Cloruro de Sodio/administración & dosificaciónRESUMEN
The objective of the present study was to improve the effectiveness of the treatment of the patients presenting with deflection of the nasal septum and vasomotor rhinitis by developing a method for endonasal electrophoresis in the postoperative period. The study involved 102 patients allocated to three groups. All of them underwent septoplasty including splinting of the nasal septum and submucous laser vaporization of the inferior turbinate bones. The patients of group 3 were treated with the use of an original septal stent with the integrated electrode that allowed to reduce the injurious effect of the procedure of nasal electrophoresis and thereby to decrease the duration of the rehabilitation period following the intranasal surgical intervention; moreover, this approach enhanced the effectiveness of surgery.
Asunto(s)
Electrodos , Electroforesis/instrumentación , Tabique Nasal/cirugía , Deformidades Adquiridas Nasales/terapia , Rinitis Vasomotora/terapia , Rinoplastia/métodos , Cornetes Nasales/cirugía , Adolescente , Adulto , Diseño de Equipo , Femenino , Humanos , Terapia por Láser , Masculino , Persona de Mediana Edad , Deformidades Adquiridas Nasales/complicaciones , Rinitis Vasomotora/complicaciones , Férulas (Fijadores) , Resultado del Tratamiento , Adulto JovenRESUMEN
PURPOSE OF REVIEW: The purpose of this review is to briefly discuss methods for classifying Nonallergic rhinitis (NAR), the current understanding of its immunopathogenesis, scientific evidence-based treatment options along with anecdotal clinical experience for selecting different treatment regimens for these challenging patients. RECENT FINDINGS: NAR also known as idiopathic rhinitis, irritant-induced rhinitis and vasomotor rhinitis is a heterogeneous condition that has been classified many different ways, but currently there is no consensus on definition for this condition due to its poorly elucidated mechanism(s) of action. A typical patient presents with nasal congestion, postnasal drainage with or without a cough associated with, to a lesser extent, some degree of sneezing, itching, and rhinorrhea. Recent studies have proposed more specific approaches for characterizing rhinitis subtypes. It is speculated that this condition is due to an autonomic imbalance resulting in an overactive parasympathetic and perhaps an underactive sympathetic nervous system. Our poor understanding of NAR mechanism(s) of action has significantly hindered progress in developing novel therapies for this condition. SUMMARY: Further investigation is required to understand the neurogenic signaling pathways that lead to this aberrant response. Until we have selective therapies for NAR, treatment requires selecting the medication or combination of medications best suited to the symptomatic needs of the patient.
Asunto(s)
Sistema Nervioso Parasimpático , Rinitis Vasomotora , Transducción de Señal/inmunología , Sistema Nervioso Simpático , Epistaxis/inmunología , Epistaxis/patología , Epistaxis/fisiopatología , Epistaxis/terapia , Humanos , Sistema Nervioso Parasimpático/inmunología , Sistema Nervioso Parasimpático/patología , Sistema Nervioso Parasimpático/fisiopatología , Rinitis Vasomotora/inmunología , Rinitis Vasomotora/patología , Rinitis Vasomotora/fisiopatología , Rinitis Vasomotora/terapia , Sistema Nervioso Simpático/inmunología , Sistema Nervioso Simpático/patología , Sistema Nervioso Simpático/fisiopatologíaRESUMEN
Rhinitis and related problems such as facial pressure and nasal congestion are a very common reason people seek medical care. There are four, often overlapping, syndromes or conditions that account for most of what patients perceive as "nose" problems or rhinitis. These conditions are irritant rhinitis, the anterior nasal valve effect, migraine with vasomotor symptoms, and allergic rhinitis. Virtually all patients with allergic rhinitis have some concomitant irritant or nonallergic rhinitis. Many migraine sufferers with vasomotor nasal symptoms will have their nasal congestion, headaches, and runny noses exacerbated by irritant rhinitis, allergic rhinitis, and/or a preexisting nasal valve effect. Failure to consider all of the causes for the symptoms will result in poor clinical outcomes. The work-up and management of these common conditions is discussed in this article.
Asunto(s)
Rinitis , Adulto , Femenino , Humanos , Trastornos Migrañosos/diagnóstico , Trastornos Migrañosos/terapia , Cavidad Nasal/fisiología , Rinitis/clasificación , Rinitis/complicaciones , Rinitis/diagnóstico , Rinitis Alérgica Perenne/diagnóstico , Rinitis Alérgica Perenne/terapia , Rinitis Alérgica Estacional/diagnóstico , Rinitis Alérgica Estacional/terapia , Rinitis Vasomotora/diagnóstico , Rinitis Vasomotora/terapiaRESUMEN
The objective of this work was to study the feasibility and effectiveness of the cavitational low-frequency ultrasound treatment of vasomotor rhinitis in combination with the application of topical corticosteroids. The study included 220 patients with the confirmed neurovegetative form of vasomotor rhinitis treated with the use of a Kavitar apparatus for the ultrasonic cavitational jet lavage. The data obtained indicate that the low-frequency cavitational treatment of intranasal mucosa in combination with the application of topical corticosteroids may be recommended as an efficatious method for the treatment of vasomotor rhinitis.
Asunto(s)
Corticoesteroides/administración & dosificación , Mucosa Nasal/efectos de los fármacos , Rinitis Vasomotora/terapia , Terapia por Ultrasonido/métodos , Administración Intranasal/métodos , Administración Tópica , Adulto , Terapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Lavado Nasal (Proceso)/métodos , Mucosa Nasal/fisiopatología , Rinitis Vasomotora/fisiopatología , Resultado del TratamientoRESUMEN
Nonallergic rhinitis represents a non-IgE-mediated group of disorders that share the symptoms of nasal congestion, rhinorrhea, sneezing, and/or postnasal discharge but not pruritus that characterizes allergic rhinitis. Nonallergic rhinitis may be divided into two broad categories, inflammatory and noninflammatory etiologies. The inflammatory causes include postinfectious (viral and bacterial), rhinitis associated with nasal polyps, and nonallergic rhinitis with eosinophilia, where eosinophils are present in nasal smears but skin testing for aeroallergens is negative. The noninflammatory causes include idiopathic nonallergic rhinitis (formerly referred to as vasomotor rhinitis or colloquially as an "overreactive nose"); rhinitis medicamentosa, which is medication-induced rhinitis; hormone related (pregnancy); systemic disease related (severe hypothyroidism); and structural defect related (deviated septum, head trauma causing cerebrospinal fluid rhinorrhea). The classic symptoms of idiopathic nonallergic rhinitis are nasal congestion, postnasal drip, and sneezing triggered by irritant odors, perfumes, wine, and weather changes. The diagnosis of rhinitis begins with a directed history and physical exam. Examination of the nasal cavity with attention to appearance of the septum and inferior turbinates is recommended. Skin testing for seasonal and perennial aeroallergens is helpful in establishing the presence or absence of IgE antibodies and to help differentiate nonallergic from allergic rhinitis. Topical H(1)-receptor antagonist (antihistamine) nasal sprays, intranasal steroids, intranasal anticholinergics, and oral decongestants are options for pharmacotherapy. It is important to inquire about hypertension, arrhythmias, insomnia, prostate hypertrophy, or glaucoma to prevent undesirable side effects associated with the oral decongestant pseudoephedrine.
Asunto(s)
Rinitis/etiología , Humanos , Rinitis/clasificación , Rinitis/diagnóstico , Rinitis/terapia , Rinitis Vasomotora/diagnóstico , Rinitis Vasomotora/etiología , Rinitis Vasomotora/terapiaAsunto(s)
Técnicas Cosméticas/efectos adversos , Ácido Hialurónico/administración & dosificación , Inyecciones Intradérmicas/efectos adversos , Rinitis Vasomotora/etiología , Adulto , Femenino , Humanos , Ácido Hialurónico/efectos adversos , Rinitis Vasomotora/inducido químicamente , Rinitis Vasomotora/diagnóstico , Rinitis Vasomotora/terapiaRESUMEN
BACKGROUND: Non-allergic rhinopathy (NAR), formerly known as vasomotor rhinitis, is a non-allergic and non-infectious chronic disease that is accompanied by nasal hyperemia, rhinorrhea, and no increase in the number of eosinophils. Although the medications for NAR, including intranasal corticosteroids and intranasal antihistamine, have been used in clinical practice, given the relative paucity of effective therapy with available medications, alternative non-pharmacologic treatments could play an important role in treating NAR. Acupuncture treatment is representative potential alternative therapy for the treatment of various diseases, including rhinitis. Therefore, the objective of this study was to evaluate the efficacy of pricking blood at Neiyingxiang (ExHN 9) relative to acupuncture treatment at Waiyingxiang (LI 20) in patients with NAR. METHODS/DESIGN: A randomized, parallel-group, controlled, assessor single-blinded, trial will be conducted. Fifty participants with NAR will be randomized into one of two groups: either the control group with acpuncture treatment at LI 20 or the experimental group with pricking blood at ExHN 9. After randomization, a total of three sessions of treatment will be performed once a week in both groups. The total nasal symptom score (TNSS) and the Mini-Rhinoconjunctivitis Quality-of-Life Questionnaire (MiniRQLQ) at baseline and the end of the trial will be used to evaluate the efficacy of each treatment. DISCUSSION: This study will be the first randomized trial to evaluate the efficacy of pricking blood for the treatment of NAR. The results of this study will help establish an alternative approach for treating patients with NAR that do not respond to Western medication.
Asunto(s)
Terapia por Acupuntura , Rinitis Vasomotora/terapia , Terapia por Acupuntura/efectos adversos , Protocolos Clínicos , Estudios Cruzados , Humanos , Evaluación de Resultado en la Atención de Salud , Método Simple CiegoRESUMEN
This article reviews a uniform way to describe nonallergic rhinitis in its various forms. The insights into its pathophysiology are briefly reviewed. A classification scheme for the different forms is provided. This is followed by descriptions of the diagnosis, evaluation, and management of nonallergic rhinitis.
Asunto(s)
Rinitis , Antiinflamatorios/uso terapéutico , Antagonistas Colinérgicos/uso terapéutico , Humanos , Educación del Paciente como Asunto , Rinitis/diagnóstico , Rinitis/etiología , Rinitis/fisiopatología , Rinitis/terapia , Rinitis Vasomotora/diagnóstico , Rinitis Vasomotora/etiología , Rinitis Vasomotora/fisiopatología , Rinitis Vasomotora/terapia , RinoplastiaRESUMEN
This review focuses on the poorly understood condition of nonallergic rhinopathy (NAR) at a clinical level, with an eye on current optimal treatment. NAR is the new designation for the conditions formerly referred to as vasomotor rhinitis or nonallergic idiopathic rhinitis. The clinical characteristics and differential diagnosis are provided in detail in this review, and the disease should now be characterized sufficiently for clinical studies.
Asunto(s)
Rinitis Vasomotora/diagnóstico , Rinitis Vasomotora/terapia , Humanos , Prevalencia , Rinitis Vasomotora/epidemiologíaRESUMEN
OBJECTIVES: Chronic rhinitis without an allergic or infectious etiology (vasomotor rhinitis) is a common disease for which there are only few and not very effective therapeutic treatment options. The current placebo-controlled, partially double-blinded pilot study evaluated the effects of acupuncture on the symptoms of vasomotor rhinitis. DESIGN: A total of 24 patients with confirmed diagnosis of vasomotor rhinitis were randomly allocated to either acupuncture or sham laser acupuncture treatment. The sham laser was a deactivated laser pen beaming normal red light. The main outcome measure was the alteration of the nasal sickness score (NSS; score(max) 27 points). Secondary outcome measures were the evaluation of a subjective symptoms score by patients' diaries and of their quality of life (SF-12 health survey). A credibility assessment regarding the respective treatment was performed. The study is registered as an International Standard Randomised Controlled Trial, number NCT00682162. RESULTS: NSS of patients treated by acupuncture was significantly reduced from 9.3 +/- 3.89 to 4.1 +/- 3.20 points (p < 0.001), whereas NSS declined from 5.6 +/- 2.74 to 3.7 +/- 2.61 points after sham treatment (p < 0.05). Comparison between the groups revealed a significant change of NSS (Mann-Whitney, p < 0.01), an analysis that also considers the significant difference between the baseline values of both groups (p < 0.05). Secondary outcome measures did not show significant differences between both groups. The credibility assessment was comparable for both treatments. CONCLUSIONS: This pilot study showed significant effects of acupuncture compared to a sham treatment in the NSS on symptoms of vasomotor rhinitis. These results may justify the performance of a large randomized trial to strengthen our understanding of the therapeutic value of acupuncture in the treatment of vasomotor rhinitis.