Journal of Traditional Chinese Medicine ›› 2023, Vol. 43 ›› Issue (4): 787-794.DOI: 10.19852/j.cnki.jtcm.20230524.001
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Early intervention improves clinical responses to seasonal allergic rhinitis by stimulation in sphenopalatine ganglion (Xinwu acupoint)
GUO Yuhao1,2, HUANG Liangran3, ZHANG Lei4, YANG Wei5, HUANG Lixia1, LIU Wei3, FAN Yuyan1(
)
- 1 Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
2 Beijing Neurosurgical Institute, Beijing 100050, China
3 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
4 Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China
5 Department of Traditional Chinese Medicine, Beijing Tongren Hospital, Beijing 100005, China
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Received:2022-06-03Accepted:2022-10-14Online:2023-08-15Published:2023-05-24 -
Contact:Prof. FAN Yuyan, Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. fanyy2002@hotmail.com. Telephone: +86-10-67096611 -
Supported by:National Natural Science Foundation of China: Study on the “Metabolic Memory” Effect of eNOS in Glomerular Endothelial Cells and the Role and Mechanism of Astragaloside IV in the Early Stages of Diabetic Nephropathy(81774214);Fundamental Research Funds of Chinese Medicine in Capital Medical University: Exploration of the Efficacy and Mechanism of Early Acupuncture Intervention in Seasonal Recurrent Rhinitis: a Randomized Clinical Study(16ZY03)
Cite this article
GUO Yuhao, HUANG Liangran, ZHANG Lei, YANG Wei, HUANG Lixia, LIU Wei, FAN Yuyan. Early intervention improves clinical responses to seasonal allergic rhinitis by stimulation in sphenopalatine ganglion (Xinwu acupoint)[J]. Journal of Traditional Chinese Medicine, 2023, 43(4): 787-794.
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Table 1 Supplementary acupuncture points and techniques for early intervention for seasonal allergic rhinitis
| Acupoint | Direction | Depth (mm) |
|---|---|---|
| Pishu (BL20) | Obliquely toward the spine | 13 to 20 |
| Weishu (BL21) | Obliquely toward the spine | 13 to 20 |
| Zhongwan (CV12) | Perpendicular to the skin | 8 to 13 |
| Qihai (CV6) | Perpendicular to the skin | 8 to 13 |
| Zusanli (ST16) | Perpendicular to the skin between 20 to 30 the tibia and the fibula | 13 to 25 |
| Sanyinjiao (SP36) | Perpendicular to the skin | 13 to 25 |
| Baihui (GV20) | Transversely and downward toward the nose | 10 to 15 |
| Yintang (GV29) | Perpendicular to the skin | 5 to 8 |
Table 1 Supplementary acupuncture points and techniques for early intervention for seasonal allergic rhinitis
| Acupoint | Direction | Depth (mm) |
|---|---|---|
| Pishu (BL20) | Obliquely toward the spine | 13 to 20 |
| Weishu (BL21) | Obliquely toward the spine | 13 to 20 |
| Zhongwan (CV12) | Perpendicular to the skin | 8 to 13 |
| Qihai (CV6) | Perpendicular to the skin | 8 to 13 |
| Zusanli (ST16) | Perpendicular to the skin between 20 to 30 the tibia and the fibula | 13 to 25 |
| Sanyinjiao (SP36) | Perpendicular to the skin | 13 to 25 |
| Baihui (GV20) | Transversely and downward toward the nose | 10 to 15 |
| Yintang (GV29) | Perpendicular to the skin | 5 to 8 |
Figure 1 The location of the acupuncture needle in sphenopalatine ganglion (Xinwu acupoint) A: acupuncture needle points. The sphenopalatine ganglion (Xinwu acupoint), stimulated with a needle of 0.35 mm diameter and 60 mm length, is located under the zygomatic arch between the coronoid process and the mandibular condyle, B: high-resolution CT scan of the pterygopalatine fossa in the coronal plane after acupuncture showing needle penetration into the pterygopalatine fossa. Arrow: the acupuncture is inserted into the sphenopalatine ganglion (Xinwu acupoint).
Figure 1 The location of the acupuncture needle in sphenopalatine ganglion (Xinwu acupoint) A: acupuncture needle points. The sphenopalatine ganglion (Xinwu acupoint), stimulated with a needle of 0.35 mm diameter and 60 mm length, is located under the zygomatic arch between the coronoid process and the mandibular condyle, B: high-resolution CT scan of the pterygopalatine fossa in the coronal plane after acupuncture showing needle penetration into the pterygopalatine fossa. Arrow: the acupuncture is inserted into the sphenopalatine ganglion (Xinwu acupoint).
Table 2 Baseline characteristics of the SA and SPG groups
| Item | SPG group (n = 19) | SA group (n = 18) | P value |
|---|---|---|---|
| Age (years) | 33.4±10.9 | 42.6±8.2 | 0.006 |
| Sex [male, n (%)] | 7 (41.2) | 10 (58.8) | 0.402 |
| Duration (years) | 10.4±3.6 | 11.32±5.0 | 0.523 |
| TNSS | 31.5±5.3 | 34.2±2.7 | 0.069 |
| Nasal obstruction | 7.4±2.1 | 8.3±1.2 | 0.097 |
| Nasal itching | 7.6±1.9 | 8.2±1.1 | 0.228 |
| Sneezing | 8.3±1.2 | 8.7±1.0 | 0.266 |
| Rhinorrhea | 8.2±1.6 | 8.9±1.0 | 0.155 |
| RQLQ | 89.5 (73.8, 104.3) | 89.0 (66.0, 94.0) | 0.543 |
| Sleeping | 10.0 (8.5, 14.5) | 12.0 (6.0, 15.0) | 0.939 |
| Nonnasal/nonocular symptoms | 23.5 (17.3, 28.8) | 21.0 (13.0, 28.0) | 0.360 |
| Behavior | 11.5 (9.0, 14.5) | 13.0 (10.0, 17.0) | 0.328 |
| Nasal symptoms | 15. (11.0, 20.3) | 16.0 (11.0, 21.0) | 0.725 |
| Ocular symptoms | 15.0 (10.0, 17.3) | 11.0 (6.0,20.0) | 0.404 |
| Emotional function | 14.5 (9.8, 19.3) | 15.0 (7.0, 19.0) | 0.522 |
Table 2 Baseline characteristics of the SA and SPG groups
| Item | SPG group (n = 19) | SA group (n = 18) | P value |
|---|---|---|---|
| Age (years) | 33.4±10.9 | 42.6±8.2 | 0.006 |
| Sex [male, n (%)] | 7 (41.2) | 10 (58.8) | 0.402 |
| Duration (years) | 10.4±3.6 | 11.32±5.0 | 0.523 |
| TNSS | 31.5±5.3 | 34.2±2.7 | 0.069 |
| Nasal obstruction | 7.4±2.1 | 8.3±1.2 | 0.097 |
| Nasal itching | 7.6±1.9 | 8.2±1.1 | 0.228 |
| Sneezing | 8.3±1.2 | 8.7±1.0 | 0.266 |
| Rhinorrhea | 8.2±1.6 | 8.9±1.0 | 0.155 |
| RQLQ | 89.5 (73.8, 104.3) | 89.0 (66.0, 94.0) | 0.543 |
| Sleeping | 10.0 (8.5, 14.5) | 12.0 (6.0, 15.0) | 0.939 |
| Nonnasal/nonocular symptoms | 23.5 (17.3, 28.8) | 21.0 (13.0, 28.0) | 0.360 |
| Behavior | 11.5 (9.0, 14.5) | 13.0 (10.0, 17.0) | 0.328 |
| Nasal symptoms | 15. (11.0, 20.3) | 16.0 (11.0, 21.0) | 0.725 |
| Ocular symptoms | 15.0 (10.0, 17.3) | 11.0 (6.0,20.0) | 0.404 |
| Emotional function | 14.5 (9.8, 19.3) | 15.0 (7.0, 19.0) | 0.522 |
Figure 2 Flow diagram of the trial SAR: seasonal allergic rhinitis; SPG: sphenopalatine ganglion; SA: sham acupuncture; TCM: Traditional Chinese Medicine; TNSS: total nasal symptom score; RQLQ: rhinoconjunctivitis auality of life questionnaire.
Figure 2 Flow diagram of the trial SAR: seasonal allergic rhinitis; SPG: sphenopalatine ganglion; SA: sham acupuncture; TCM: Traditional Chinese Medicine; TNSS: total nasal symptom score; RQLQ: rhinoconjunctivitis auality of life questionnaire.
Table 3 Difference in nasal symptom scores and RQLQ scores between past nasal symptoms and symptoms after 4 weeks of intervention with health education, supplementary acupuncture in the SA group
| Item | Past nasal symptoms | Symptoms after intervention | P value | |
|---|---|---|---|---|
| TNSS | 34.2±2.7 | 26.2±4.2 | < 0.001 | |
| Nasal obstruction | 8.3±1.2 | 6.7±1.5 | < 0.001 | |
| Nasal itching | 8.2±1.1 | 6.4±1.2 | < 0.001 | |
| Sneezing | 8.7±1.0 | 6.7±1.2 | < 0.001 | |
| Rhinorrhea | 8.9±1.0 | 6.3±1.5 | < 0.001 | |
| RQLQ | 89.0 (66.0, 94.0) | 64.0 (58.0, 74.0) | < 0.001 | |
| Sleeping | 12.0 (6.0, 15.0) | 8.0 (6.0, 12.0) | 0.054 | |
| Nonnasal/nonocular symptoms | 21.0 (13.0, 28.0) | 16.0 (12.0, 22.0) | 0.159 | |
| Behavior | 13.0 (10.0, 17.0) | 11.0 (9.0, 12.0) | 0.030 | |
| Nasal symptoms | 16.0 (11.0, 21.0) | 12.0 (9.0, 14.0) | 0.001 | |
| Ocular symptoms | 11.0 (6.0, 20.0) | 9.0 (8.0, 12.0) | 0.025 | |
| Emotional function | 15.0 (7.0, 19.0) | 10.0 (8.0, 12.0) | 0.106 |
Table 3 Difference in nasal symptom scores and RQLQ scores between past nasal symptoms and symptoms after 4 weeks of intervention with health education, supplementary acupuncture in the SA group
| Item | Past nasal symptoms | Symptoms after intervention | P value | |
|---|---|---|---|---|
| TNSS | 34.2±2.7 | 26.2±4.2 | < 0.001 | |
| Nasal obstruction | 8.3±1.2 | 6.7±1.5 | < 0.001 | |
| Nasal itching | 8.2±1.1 | 6.4±1.2 | < 0.001 | |
| Sneezing | 8.7±1.0 | 6.7±1.2 | < 0.001 | |
| Rhinorrhea | 8.9±1.0 | 6.3±1.5 | < 0.001 | |
| RQLQ | 89.0 (66.0, 94.0) | 64.0 (58.0, 74.0) | < 0.001 | |
| Sleeping | 12.0 (6.0, 15.0) | 8.0 (6.0, 12.0) | 0.054 | |
| Nonnasal/nonocular symptoms | 21.0 (13.0, 28.0) | 16.0 (12.0, 22.0) | 0.159 | |
| Behavior | 13.0 (10.0, 17.0) | 11.0 (9.0, 12.0) | 0.030 | |
| Nasal symptoms | 16.0 (11.0, 21.0) | 12.0 (9.0, 14.0) | 0.001 | |
| Ocular symptoms | 11.0 (6.0, 20.0) | 9.0 (8.0, 12.0) | 0.025 | |
| Emotional function | 15.0 (7.0, 19.0) | 10.0 (8.0, 12.0) | 0.106 |
Table 4 Difference in nasal symptom scores and RQLQ scores between past nasal symptoms and symptoms after 4 weeks of intervention with health education, supplementary acupuncture in the SPG group
| Item | Past nasal symptoms | Symptoms after intervention | P value |
|---|---|---|---|
| TNSS | 31.5±5.3 | 15.3±4.4 | <0.001 |
| Nasal obstruction | 7.4±2.1 | 3.4±1.8 | <0.001 |
| Nasal itching | 7.6±1.9 | 3.6±1.7 | <0.001 |
| Sneezing | 8.3±1.2 | 4.0±1.5 | <0.001 |
| Rhinorrhea | 8.2±1.6 | 4.4±1.6 | <0.001 |
| RQLQ | 89.5 (73.8, 104.3) | 41.0 (27.8, 53.8) | <0.001 |
| Sleeping | 10.0 (8.5, 14.5) | 3.0 (2.8, 6.0) | 0.001 |
| Nonnasal/nonocular symptoms | 23.5 (17.3, 28.8) | 11.5 (7.0, 14.0) | <0.001 |
| Behavior | 11.5 (9.0, 14.5) | 6.0 (5.3, 11.3) | 0.001 |
| Nasal symptoms | 15.5 (11.0, 20.3) | 8.0 (5.8, 10.0) | <0.001 |
| Ocular symptoms | 15.0 (10.0, 17.3) | 5.5 (2.8, 7.3) | <0.001 |
| Emotional function | 14.5 (9.8, 19.3) | 8.0 (3.0, 11.3) | 0.002 |
Table 4 Difference in nasal symptom scores and RQLQ scores between past nasal symptoms and symptoms after 4 weeks of intervention with health education, supplementary acupuncture in the SPG group
| Item | Past nasal symptoms | Symptoms after intervention | P value |
|---|---|---|---|
| TNSS | 31.5±5.3 | 15.3±4.4 | <0.001 |
| Nasal obstruction | 7.4±2.1 | 3.4±1.8 | <0.001 |
| Nasal itching | 7.6±1.9 | 3.6±1.7 | <0.001 |
| Sneezing | 8.3±1.2 | 4.0±1.5 | <0.001 |
| Rhinorrhea | 8.2±1.6 | 4.4±1.6 | <0.001 |
| RQLQ | 89.5 (73.8, 104.3) | 41.0 (27.8, 53.8) | <0.001 |
| Sleeping | 10.0 (8.5, 14.5) | 3.0 (2.8, 6.0) | 0.001 |
| Nonnasal/nonocular symptoms | 23.5 (17.3, 28.8) | 11.5 (7.0, 14.0) | <0.001 |
| Behavior | 11.5 (9.0, 14.5) | 6.0 (5.3, 11.3) | 0.001 |
| Nasal symptoms | 15.5 (11.0, 20.3) | 8.0 (5.8, 10.0) | <0.001 |
| Ocular symptoms | 15.0 (10.0, 17.3) | 5.5 (2.8, 7.3) | <0.001 |
| Emotional function | 14.5 (9.8, 19.3) | 8.0 (3.0, 11.3) | 0.002 |
Table 5 Difference in the symptoms after 4 weeks of intervention with health education, supplementary acupuncture in terms of nasal symptom scores and RQLQ scores between the SA and SPG groups
| Item | SPG group (n = 19) | SA group (n =18) | P value |
|---|---|---|---|
| TNSS | 15.3±4.4 | 26.2±4.2 | <0.001 |
| Nasal obstruction | 3.4±1.8 | 6.7±1.5 | <0.001 |
| Nasal itching | 3.6±1.7 | 6.4±1.2 | <0.001 |
| Sneezing | 4.0±1.5 | 6.7±1.2 | <0.001 |
| Rhinorrhea | 4.4±1.6 | 6.3±1.5 | 0.001 |
| RQLQ | 41.0 (27.8, 53.8) | 64.0 (58.0, 74.0) | <0.001 |
| Sleeping | 3.0 (2.8, 6.0) | 8.0 (6.0, 12.0) | 0.001 |
| Nonnasal/nonocular symptoms | 11.5 (7.0, 14.0) | 16.0 (12.0, 22.0) | 0.007 |
| behavior | 6.0 (5.3, 11.3) | 11.0 (9.0, 12.0) | 0.006 |
| Nasal symptoms | 8.0 (5.8, 10.0) | 12.0 (9.0, 14.0) | 0.002 |
| Ocular symptoms | 5.5 (2.8, 7.3) | 9.0 (8.0, 12.0) | 0.001 |
| Emotional function | 8.0 (3.0, 11.3) | 10.0 (8.0, 12.0) | 0.089 |
Table 5 Difference in the symptoms after 4 weeks of intervention with health education, supplementary acupuncture in terms of nasal symptom scores and RQLQ scores between the SA and SPG groups
| Item | SPG group (n = 19) | SA group (n =18) | P value |
|---|---|---|---|
| TNSS | 15.3±4.4 | 26.2±4.2 | <0.001 |
| Nasal obstruction | 3.4±1.8 | 6.7±1.5 | <0.001 |
| Nasal itching | 3.6±1.7 | 6.4±1.2 | <0.001 |
| Sneezing | 4.0±1.5 | 6.7±1.2 | <0.001 |
| Rhinorrhea | 4.4±1.6 | 6.3±1.5 | 0.001 |
| RQLQ | 41.0 (27.8, 53.8) | 64.0 (58.0, 74.0) | <0.001 |
| Sleeping | 3.0 (2.8, 6.0) | 8.0 (6.0, 12.0) | 0.001 |
| Nonnasal/nonocular symptoms | 11.5 (7.0, 14.0) | 16.0 (12.0, 22.0) | 0.007 |
| behavior | 6.0 (5.3, 11.3) | 11.0 (9.0, 12.0) | 0.006 |
| Nasal symptoms | 8.0 (5.8, 10.0) | 12.0 (9.0, 14.0) | 0.002 |
| Ocular symptoms | 5.5 (2.8, 7.3) | 9.0 (8.0, 12.0) | 0.001 |
| Emotional function | 8.0 (3.0, 11.3) | 10.0 (8.0, 12.0) | 0.089 |
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