Wang Jinling, Chen Fuquan, Meng Meijuan, Zhang Xu, Chen Yang, Huang Weiguo, Wang Yinchun
Department of Otolaryngology, Xijing Hospital, Fourth Military Medical University, Xi'an 710032.
Lin Chuang Er Bi Yan Hou Ke Za Zhi. 2003 Nov;17(11):643-5.
To investigate the effect and mechanisms of botulinum toxin type A(BTA) on vasomotor rhinitis.
A retrospective study of 32 patients with vasomotor rhinitis who received BTA injection at 4 points in bilateral nasal cavities with 2.5 units at each point had been done. The state of rhinorrhea, nasal obstruction, sneeze and nasal mucosa edema of each patient were recorded and scored before and after the application of BTA respectively with follow-ups of 6-30 months. Twelve guinea pigs were randomly divided into 2 groups: BTA group and control group. Merocel sponge soaked with 10 units (0.2 ml) BTA was put into left nasal cavity under general anesthesia for one hour in BTA group. Saline replaced BTA in control group. The inferior turbinate mucosa of guinea pig ware harvested under general anesthesia at 7, 14, 28 days after BTA treatment and was observed with HE staining and electron microscope.
Rhinorrhea improved significantly in all 32 patients while sneeze, nasal obstruction and mucosa edema reduced partly. The reducing of rhinorrhea lasted averagely 6 weeks. Twelve patients had an episode of nasal dryness or increased rhinorrhea at the day of injection. No other complications were found. Seven, fourteen days after local BTA application, the degenerations of glandular epithelium and canal epithelium were observed in nasal mucosa of guinea pigs. Most of the glandular cells showed normal at 28 days after BTA treatment.
BTA can induce the degeneration of glandular cells in nasal mucosa and thus obviously relieve over rhinorrhea of patients with vasomotor rhinitis.
探讨A型肉毒毒素（BTA）对血管运动性鼻炎的作用及机制。
回顾性研究32例接受BTA鼻腔四点注射（每点2.5单位）的血管运动性鼻炎患者。分别记录并评分每位患者在应用BTA前后的流涕、鼻塞、喷嚏及鼻黏膜水肿情况，随访6 - 30个月。将12只豚鼠随机分为2组：BTA组和对照组。BTA组在全身麻醉下将浸有10单位（0.2 ml）BTA的Merocel海绵置于左侧鼻腔1小时，对照组用生理盐水替代BTA。在BTA处理后7、14、28天，全身麻醉下取豚鼠下鼻甲黏膜，进行HE染色及电镜观察。
32例患者流涕均明显改善，喷嚏、鼻塞及黏膜水肿部分减轻。流涕减轻平均持续6周。12例患者在注射当日出现鼻干或流涕增多。未发现其他并发症。局部应用BTA后7、14天，豚鼠鼻黏膜腺上皮和管上皮出现变性。BTA处理后28天，多数腺细胞显示正常。
BTA可诱导鼻黏膜腺细胞变性，从而明显减轻血管运动性鼻炎患者的流涕症状。
