Volume 29, Issue 12 (3-2023)
RJMS 2023, 29(12): 487-496 |
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Vatankhah A, Dabirifar S, Khaleghi F. Investigating the Effect of Cellulose Powder and Cromolyn Sodium in Controlling Allergic Rhinitis Symptoms and Quality of Life and Its Relationship with CT Scan Findings. RJMS 2023; 29 (12) :487-496
URL: http://rjms.iums.ac.ir/article-1-8120-en.html
URL: http://rjms.iums.ac.ir/article-1-8120-en.html
Assistant Professor, Department of Radiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran , fateme.khaleghi2016@gmail.com
Abstract: (697 Views)
Background & Aims: Allergic rhinitis is an inflammatory disease of the nasal mucosa, the prevalence of which is estimated at 40% in children and 10-30% in adults. The symptoms of the disease include frequent sneezing, runny nose, itching of the nose, throat and eyes, which can significantly affect the patient's daily life and activities. Over time, these symptoms may lead to depression, anxiety and loss of performance by affecting a person's psyche. In the United States, this disease accounts for 2.5% of medical visits. Unfortunately, only in a small number of patients, the symptoms may be suppressed for a long time and may not return. Currently, the prevalence of disease is increasing in industrialized countries, especially in urban areas, and it imposes a lot of costs on societies. On the other hand, due to the fact that the cause of the disease is unknown, no definitive treatment has been proposed yet. But the existing symptomatic treatments have been able to relieve the annoying symptoms of the disease to some extent. The most effective treatment in patients with severe and permanent symptoms is the use of topical intranasal corticosteroids. Cellulose powder is used as a thickener in many nasal sprays. Due to the fact that cellulose powder acts as a protective layer, it plays a role in preventing the inhalation of pollen, dust and allergens and prevents these substances from reaching the nasal mucosa. As a result of allergies, the nasal mucosa has a low surface tension, and allergens can easily pass through the nasal mucosa and be absorbed by the nasal mucosa, and cellulose powder reduces the symptoms of patients by compensating this system. Also, intranasal cromolyn is widely available today and is used in the treatment of allergic rhinitis with the mechanism of inhibiting the granulation of mast cells. Although this drug is safe for general medicinal use, it is not used as a line of treatment because compared to antihistamines and intranasal corticosteroids, it is less effective in reducing symptoms, the results of a study showed. that consumption of cellulose powder significantly improved all symptoms of allergic rhinitis and especially runny nose in these people and no clinical side effects were reported in these people. Also, Nasaliz was able to control hay fever well and significantly improved the patients' symptoms. In general, CT scan is usually not recommended for simple rhinitis. However, when rhinosinusitis or nasal polyp is suspected, especially if it does not respond to medical treatment, CT scan is useful. Due to the chronic nature of this disease on one hand and patients' self-treatment and lack of attention to medical recommendations on the other hand, definitive and effective treatment of allergic rhinitis has become a challenge for patients and treatment staff. The present study was designed and carried out with the aim of investigating the effects of nasal cellulose powder and sodium cromolyn in controlling the symptoms of allergic rhinitis and quality of life, as well as its relationship with CT scan findings in patients referred to Baqiyatullah Clinic.
Methods: The present study is a clinical trial that was conducted on patients with allergic rhinitis who were referred to the ENT clinic of Baghiy A. (Aj). The study was conducted as a random and single-phase study in two groups (50 people for each group) using Cromolyn spray with a dose of 3 puffs per day and nasal spray with a dose of 3 puffs per day for 6 weeks in patients. RQLQ quality of life questionnaire, nasal endoscopy score based on Lund criteria, Kennedy score, and visual analog scale (VAS) was completed. Also, in this study, patients with a clinical diagnosis of allergic rhinitis were selected for a CT scan of the Paranasal sinuses without medical treatment. They were referred to the CT scan departments of Baqiyatullah University of Medical Sciences and underwent a Paranasal CT scan and indicators such as polyps, mild mucosal thickening without obstruction, increased bone density of the sinus wall, septal deviation, inferior corneal hypertrophy, and Conca Bellaza were investigated. Then, the findings of the CT scan were reported blindly by only one radiologist. The data collected from both study groups were compared by the respective statistical tests. The significance level for data difference was considered 0.05.
Results: The severity of nasal congestion after 6 weeks of treatment was 2.27 ± 0.97 in the sodium Cromolyn group and 4.61 ± 1.1 in the cellulose powder group. There was a significant difference in the mean severity of nasal congestion after treatment between the two groups. (P=0.03). Statistical analysis showed that the intensity of sneezing and also the intensity of runny noses in both groups improved significantly after the completion of the treatment. (P=0.00). The mean RQLQ score after treatment was 22.525 ± 5.71 in the sodium Cromolyn group and 25.85 ± 2.91 in the cellulose powder group. There was no significant difference between the two groups in the average RQLQ score after treatment. (P=0.073). In this study, the relationship between CT scan findings in both groups of patients before and after the use of both drug categories was investigated. In this study, both groups of patients underwent CT scans before starting the treatment, and the most common findings in both groups in the CT scan were polyps, mild mucosal thickening without obstruction, increased bone density of the sinus wall, and septal deviation. hypertrophy of the inferior cornea and Conca Blesa, also according to the obtained results, no statistically significant difference was found between the findings of the CT scan in both groups (P-value<0.05).
Conclusion: Based on the results of this study, it can be concluded that nasal decongestant can be used as an effective drug without complications in the treatment of allergic rhinitis patients due to the improvement of symptoms and quality of life. But in terms of effectiveness, it is not more effective than Cromolyn. On the other hand, there is no correlation between CT scan findings among patients with allergic rhinitis, and it can be said that the use of radiology and especially CT scans is not recommended for allergic rhinitis.
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