[Experimental study on nasal mucosa injury and repair induced by nasal decongestants in guinea pigs]

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2018 Jun 7;53(6):432-439. doi: 10.3760/cma.j.issn.1673-0860.2018.06.008.
[Article in Chinese]

Abstract

Objective: To observe the process of nasal mucosa injury and repair induced by nasal decongestants in guinea pigs Methods: Sixty-five male guinea pigs were randomly divided into 4groups by digital random method.The guinea pigs in Group A (20 guinea pigs)were treated with 2 sprays of 0.1% Naphazoline 6 times a day for 2 weeks; Group B (20 guinea pigs)with 2 drops of 1% Ephedrine 6 times a day for 2 weeks; Group C(20 guinea pigs) with 2 sprays of Naphazolin hydrochloride and Chlorphenamine Maleate Nasal Spray 8 times a day for 2 weeks.Group D (5guinea pigs)did not do any intervention as a control group.At the end of first and second weekend, 6 guinea pigs randomly selected from each group were observed the morphological changes of the nasal cavity with nasal endoscope and pathological microscope.Two weeks after stopping use of decongestant, 24 animals were grouped.Three guinea pigs were selected randomly from each group to form Group E (n=9) and Group F (n=9)respectively. The 6 remaining guinea pigs falled into Group G. Group E received 2 sprays of Mometasone Furoate Nasal Spray once a day for 2 weeks; Group F received 1 ml 2.3% saline to wash the nasal cavities once a day for 2 weeks.Group F was used to show the natural progess without any treatment.At the end of the third and fourth weekend, nasal endoscopic and pathological microscopes were used to observe the nasal cavity structure and the pathological changes of nasal mucosa. Results: Nasal mocusa congestion and edema were observed with nasal endoscopy after 2 weeks of using nasal decongestant. Cell edema, blood vessel expansion, acute and chronic inflammatory cell infiltration, cilium lodging or loss were observed under the pathological microscope in GroupA, B, C. After using MometasoneFuroate Nasal Spray and 2.3% saline for 2 weeks, the above changes were all recovered in Group E and F. No recovery was found in Group G. Conclusions: Short-term and over dose of nasal decongestant can result in the injury of nasal mucosa in guinea pigs, and the injury is much severe as using decongestant last longer.MometasoneFuroate nasal spray and 2.3% saline can repair the injury.

目的: 观察减充血剂对豚鼠鼻黏膜的损伤作用,并探讨糖皮质激素及盐水冲洗对鼻黏膜损伤的修复作用。 方法: 采用数字随机法(以下同)将65只雄性豚鼠随机分为4组;A组(20只)用0.1%盐酸萘甲唑啉喷鼻液双侧鼻孔喷鼻,每次2喷,每日6次,喷鼻2周;B组(20只)用1%呋麻滴鼻液双侧鼻孔滴鼻,每次2滴,每日6次,滴鼻2周;C组(20只)用色甘萘甲那敏鼻喷雾剂双侧喷鼻,每次2喷,每日8次,喷鼻2周。D组(5只):未做任何干预处理,作为空白对照组。在使用鼻减充血剂第1周末和第2周末,从A、B、C组分别随机抽取6只豚鼠,从D组抽取1只豚鼠,用鼻内镜观察鼻腔形态学改变;随后处死并取鼻黏膜,HE染色并在显微镜下观察组织细胞学改变。2周后停用鼻减充血剂,从A、B、C三组剩余的豚鼠中每组随机抽取3只,组成甲组( 9只),再次从三组豚鼠中每组随机抽取3只,组成乙组( 9只),最后剩余的6只豚鼠组成丙组。甲组用糠酸莫米松双侧喷鼻治疗,每次2喷,每日1次;乙组用2.3%盐水冲洗双侧鼻腔治疗,每次1 ml,每日1次;丙组无任何治疗措施。治疗后第1、2周末,比较甲乙丙各组内镜下所见的鼻黏膜颜色、鼻甲形态差异以及显微镜下鼻黏膜组织水肿、充血、纤毛损伤的差异(采用等级计分方式进行半定量评估)。采用SPSS 19.0软件进行统计学分析,Fisher确切概率法进行检验。 结果: 使用减充血剂2周后与使用前及使用1周后相比,A、B、C三组豚鼠鼻内镜下鼻黏膜充血、水肿,显微镜下组织水肿、充血、纤毛损伤差异均有统计学意义(P值均<0.05)。糖皮质激素及2.3%盐水治疗2周后,甲乙组豚鼠鼻内镜下鼻黏膜颜色、鼻甲形态以及显微镜下鼻黏膜组织水肿、充血、纤毛损伤较治疗前均有恢复,差异均有统计学意义(P值均<0.05)。 结论: 短期、大剂量鼻用减充血剂可致豚鼠鼻黏膜损伤,用药时间越长损伤越重,鼻喷糖皮质激素和2.3%盐水有助于损伤的修复。.

Keywords: Glucocorticoids; Naphazoline; Rhinitis; Saline soultion, hypertonic.

MeSH terms

  • Animals
  • Chlorpheniramine / adverse effects
  • Ephedrine / adverse effects
  • Guinea Pigs
  • Male
  • Mometasone Furoate / therapeutic use
  • Naphazoline / adverse effects
  • Nasal Decongestants / adverse effects*
  • Nasal Mucosa / drug effects*
  • Nasal Mucosa / injuries
  • Random Allocation
  • Swine

Substances

  • Nasal Decongestants
  • Mometasone Furoate
  • Chlorpheniramine
  • Ephedrine
  • Naphazoline