Vibroacoustic Therapy With Oscillating Positive Expiratory Pressure in the Treatment of Nasal Congestion

Evaluation of the Efficacy and Safety of Vibroacoustic Therapy With Oscillating Positive Expiratory Pressure in the Treatment of Nasal Congestion: A Randomized, Double-Blind, Placebo-Controlled Parallel-Group Clinical Trial

This is a prospective study. It enrolls subjects with allergic rhinitis, with or without asthma, who have nasal congestion as the main symptom and meet the inclusion criteria, aiming to evaluate the efficacy and safety of acoustic vibration combined with an oscillating positive expiratory pressure device in the treatment of patients with nasal congestion. On the premise that subjects agree to use basic medications (antihistamines, mometasone furoate nasal spray, ICS-LABA), they are instructed to use the acoustic vibration therapy device and the oscillating positive expiratory pressure therapy device respectively, 3 times a day for 3 minutes each time. Indicators related to nasal congestion will be measured immediately after a single use, as well as at 2 weeks, 4 weeks, and 8 weeks of use, so as to monitor the improvement of nasal ventilation and accompanying symptoms in the subjects.

Objective: To evaluate the efficacy and safety of acoustic vibration combined with an oscillating positive expiratory pressure device in the treatment of patients with nasal congestion.

Methods: A total of 200 subjects with nasal congestion as the main symptom who met the inclusion criteria were enrolled in this study. Among them, 100 subjects were treated with an acoustic vibration therapy device (treatment group), including 50 subjects with allergic rhinitis and 50 subjects with allergic rhinitis complicated with asthma; the other 100 subjects were treated with an oscillating positive expiratory pressure therapy device (without acoustic function, only with oscillating positive expiratory pressure function) as the control group, which also included 50 subjects with allergic rhinitis and 50 subjects with allergic rhinitis complicated with asthma. On the premise that subjects agreed to use basic medications (antihistamines, mometasone furoate nasal spray, ICS-LABA), they were instructed to use the acoustic vibration therapy device or the oscillating positive expiratory pressure therapy device, respectively, 3 times a day for 3 minutes each time. Nasal congestion-related indicators were measured immediately after a single use, as well as at 2 weeks, 4 weeks, and 8 weeks of use. The improvement of nasal ventilation and accompanying symptoms was monitored to clarify the efficacy and safety of the two devices.

Key Inclusion Criteria:

Subjects aged 12-50 years at the time of signing the informed consent form, regardless of gender;Meeting the guideline diagnostic criteria for allergic rhinitis with or without asthma;Presenting with significant nasal congestion for at least 1 week, with or without asthma, and symptoms poorly controlled despite the use of intranasal glucocorticoids and/or other therapeutic drugs;Patients with moderate to severe seasonal allergic rhinitis (SAR) with a mean Total Nasal Symptom Score (TNSS) ≥ 9 points, including nasal congestion ≥ 3 points;Willing and able to complete follow-up visits and scoring assessments at 2 weeks, 4 weeks, and 8 weeks during the study period as required by the protocol;Regular use of standard medications;Willing to receive treatment with acoustic vibration or oscillating positive expiratory pressure device 3 times a day for 3 minutes each time, and perform corresponding check-in and reporting;Voluntarily signing the informed consent form before the start of any study-related procedures, able to communicate smoothly with researchers, understand and be willing to strictly comply with the requirements of this clinical study protocol to complete the study.

Expected Outcomes:

Statistically significant improvements in relevant parameters in the oscillating positive expiratory pressure therapy device group after treatment, including: Peak Nasal Inspiratory Flow (PNIF), Peak Expiratory Flow (PEF), Fractional Exhaled Nitric Oxide(FeNO), Visual Analogue Scale (VAS), Total Nasal Symptom Score + Total Non-Nasal Symptom Score (TNSS + TNNSS), Rhinitis-Related Quality of Life Questionnaire (RQLQ), Asthma Control Test (ACT), Asthma Quality of Life Questionnaire (AQLQ), anterior rhinoscope (ENT), Pulmonary Function Tests, etc. The safety of acoustic vibration therapy device and oscillating positive expiratory pressure therapy device in the treatment of nasal congestion will be clarified, specifically including the incidence of adverse events such as no epistaxis, dyspnea, etc.

Hypothesis:

In the treatment of subjects with nasal congestion as the main symptom, whether they have simple allergic rhinitis or allergic rhinitis complicated with asthma, nasal congestion and related symptoms are significantly improved after daily treatment with acoustic vibration or oscillating positive expiratory pressure devices 3 times a day.

Inclusion Criteria:

• Subjects aged 12-50 years at the time of signing the informed consent form, regardless of gender; Meeting the guideline diagnostic criteria for allergic rhinitis with or without asthma; Presenting with significant nasal congestion for at least 1 week, with or without asthma, and symptoms poorly controlled despite the use of intranasal glucocorticoids and/or other therapeutic drugs; Patients with moderate to severe seasonal allergic rhinitis (SAR) with a mean Total Nasal Symptom Score (TNSS) ≥ 9 points, including nasal congestion ≥ 3 points; Willing and able to complete follow-up visits and scoring assessments at 2 weeks, 4 weeks, and 8 weeks during the study period as required by the protocol; Regular use of standard medications; Willing to receive treatment with acoustic vibration or oscillating positive expiratory pressure device 3 times a day for 3 minutes each time, and perform corresponding check-in and reporting; Voluntarily signing the informed consent form before the start of any study-related procedures, able to communicate smoothly with researchers, understand and be willing to strictly comply with the requirements of this clinical study protocol to complete the study.

Exclusion Criteria:

• Exclusion criteria identified by pre-examination with nasal endoscopy include: definite structural/mechanical obstruction (moderate-to-severe nasal septum deviation, moderate-to-severe nasal valve collapse, grade 3-4 nasal polyps, and inferior turbinate hypertrophy that may reduce decongestion reversibility); A history of severe epistaxis within 3 months, or use of anticoagulants; Complicated with unstable asthma; Patients currently receiving special treatment regimens, including biologic therapy and dust mite desensitization therapy; Complicated with major diseases of the respiratory or cardiovascular system: such as moderate-to-severe COPD, coronary heart disease, bronchiectasis, pulmonary infection, or respiratory tract infection; Suffering from malignant tumors or having a history of malignant tumors (except for cutaneous squamous cell carcinoma, basal cell carcinoma, or cervical carcinoma in situ that have been completely resected with no evidence of recurrence); Having undergone major surgery within 3 months before randomization, or planning to undergo major surgery during the study period; Suffering from severe concomitant diseases or other conditions that, in the investigator's judgment, make the patient unsuitable for participation in this trial.