声学鼻疗法后鼻气流与患者报告结局的纵向变化：一项初步研究。

文献信息

中文摘要

背景与目的： 声学鼻疗法已成为变应性鼻炎（AR）和慢性鼻窦炎（CRS）潜在的非药物辅助治疗手段，但其对鼻气流及患者报告结局影响的纵向证据仍然有限。这项早期阶段研究评估了为期4周的声学鼻疗法干预及治疗停止后随访期内客观鼻气流和症状负担的变化。
方法： 在30名经临床医生诊断或症状符合AR和/或CRS的成人中开展了一项前瞻性单臂准实验纵向初步研究。参与者使用双侧鼻内声学装置，每次10分钟，每日两次，持续4周。在基线、治疗后以及停止治疗后的随访时评估结局。主要纵向结局为峰值鼻吸气流量（PNIF）和鼻-鼻窦结局测试-22（SNOT-22）评分。还探索了亚组、依从性、相关性、应答者和多变量分析等次要变量。
结果： PNIF在干预后即刻未见显著变化（-2.0 L/min，p = 0.67），但在治疗后与随访之间增加（+12.2 L/min，p = 0.036）；从基线到随访的变化不显著（+10.1 L/min，Holm校正后p = 0.069）。症状负担在治疗期间显著改善（-15.43分，p < 0.0001），但在停止治疗后部分回升（+11.97分，p = 0.0003），基线与随访之间无显著差异（-3.47分，p = 0.242）。治疗后，66.7%达到最小临床重要差异，随访时降至33.3%。客观气流变化与症状改善并不一致。
结论： 本研究提供了声学鼻疗法用于被归类为患有AR和/或CRS成人的早期纵向证据。患者报告的症状在积极治疗期间改善，并在停止治疗后减弱，而客观鼻气流的变化则较不一致。这些产生假设的发现支持开展对照研究，以明确疗效、最佳剂量和应答持久性。

英文摘要

BACKGROUND AND AIMS: Acoustic nasal therapy has emerged as a potential non-pharmacological adjunct for allergic rhinitis (AR) and chronic rhinosinusitis (CRS), but longitudinal evidence on its effects on nasal airflow and patient-reported outcomes remains limited. This early-phase study evaluated changes in objective nasal airflow and symptom burden following a 4-week acoustic nasal therapy intervention and a follow-up period after treatment withdrawal.
METHODS: A prospective single-arm quasi-experimental longitudinal pilot study was conducted in 30 adults with clinician-diagnosed or symptom-consistent AR and/or CRS. Participants used a bilateral intranasal acoustic device for 10 min twice daily for 4 weeks. Outcomes were assessed at baseline, post-treatment, and follow-up after discontinuation. The primary longitudinal outcomes were peak nasal inspiratory flow (PNIF) and Sino-Nasal Outcome Test-22 (SNOT-22) scores. Secondary variables of subgroup, adherence, correlation, responder, and multivariable analyzes were also explored.
RESULTS: PNIF showed no significant change immediately post-intervention (-2.0 L/min, p = 0.67) but increased between post-treatment and follow-up (+12.2 L/min, p = 0.036); change from baseline to follow-up was not significant (+ 10.1 L/min, p = 0.069 after Holm adjustment). Symptom burden improved significantly during treatment (-15.43 points, p < 0.0001) but partially attenuated after discontinuation (+11.97 points, p = 0.0003), with no significant difference between baseline and follow-up (-3.47 points, p = 0.242). At post-treatment, 66.7% achieved the minimum clinically important difference, decreasing to 33.3% at follow-up. Objective airflow changes did not consistently align with symptom improvement.
CONCLUSION: This study provides early longitudinal evidence on acoustic nasal therapy in adults classified as having AR and/or CRS. Patient-reported symptoms improved during active treatment and attenuated after withdrawal, while changes in objective nasal airflow were less consistent. These hypothesis-generating findings support controlled studies to clarify efficacy, optimal dosing, and durability of response.