What is allergic rhinitis?
Allergic rhinitis, also known as: allergic rhinitis, is an immune disease of the nasal mucosa that occurs in patients with allergies after exposure to an allergen. If exposure to allergens is not avoided, allergic rhinitis persists, and even though there are certain periods when there are no symptoms, the chronic inflammatory state of the nasal mucosa persists in the presence of allergens.
Allergic rhinitis is a common nasal disease and allergic disorder. The population prevalence of allergic rhinitis in China is: 6.32%. The prevalence is higher in western industrialized countries, about 10-40%.
Who are the most affected people?
People with a family history of allergic diseases; children under 13-15 years of age whose immune system is not fully developed; people with allergic diseases (eczema, asthma, drug allergy, etc.).
What are the causes of the disease?
Exposure to allergens (decoration materials, pollutants, chemicals, dust, latex, smoking environment, animal dander, pollen, dust mites, insect excrement, mold, certain foods, occupation, etc.) With the accelerated industrialization of society and the improvement of people’s living standards, some new allergens continue to appear, such as aromatic hydrocarbon compounds from diesel combustion, latex in medical gloves, etc. have strong allergenicity. In addition, some indoor pollution sources such as cigarettes and formaldehyde released from wooden furniture are also important allergens. All these factors are one of the main reasons for the increasing incidence of allergic rhinitis worldwide year by year.
What are the signs and symptoms of allergic rhinitis?
There are four typical symptoms of allergic rhinitis, namely: itchy nose, sneezing, runny nose and nasal congestion.
Nasal itching: In mild cases, there is an ant-like sensation in the nose, but in severe cases, it is unbearable and the nose is often rubbed from time to time.
Sneezing: continuous sneezing, often up to several or a dozen in a row.
Runny nose: a large amount of clear water-like nasal discharge, and in severe cases, the nasal discharge continues throughout the day.
Nasal congestion: intermittent or persistent, unilateral or bilateral, or alternating blockage on both sides.
Children need to be carefully questioned and observed by parents or physicians because they do not give detailed descriptions of their symptoms.
Allergic rhinitis needs to be differentiated from the common cold!
Allergic rhinitis is often misdiagnosed as a recurrent cold, and the disease can be differentiated according to the following points
1. The onset of a cold is acute and usually lasts only 7-10 days.
2, the cold can start as a watery clear snot, and later as yellow sticky purulent snot.
3, the cold is often accompanied by systemic symptoms, such as: headache, fever, muscle and joint pain, etc.
Treatment of allergic rhinitis.
The basic principle: allergic rhinitis is a disease triggered by contact with allergens, the current treatment means are to reduce or control the symptoms of human allergy to allergens through drugs, rather than eradicating external allergens, only should try to find the cause of allergy, completely avoid before it is possible to completely no longer attack. Treating allergic rhinitis through one-time eradication, surgical eradication and other methods are fundamentally against the principle. Gene replacement therapy is not yet mature and is unlikely to be used clinically in the last 10 years. For patients who cannot avoid allergens (e.g., fungus) only continuous medication can be used, so it is important to use medication rationally, avoid long-term systemic medication, and local medication is preferred.
1. Avoid contact with allergens.
Try to avoid or reduce contact with allergens, such as: no indoor carpeting, no suede sofas, frequent removal of house dust and bed dust, do not eat suspected allergy food, try not to use insecticides, air fresheners, etc., avoid contact with cigarette smoke, etc. However, because some allergens are ubiquitous and hidden, it is very difficult to avoid them completely.
2.Desensitization treatment.
Also known as specific immunotherapy, it is the only allopathic treatment that can change the immune mechanism of allergic patients as recommended by the World Health Organization and the Global Society for Allergy, Asthma and Immunology. This method is to give standardized desensitization vaccine to allergic patients over a period of time, starting with a low dose, increasing the dose with a certain course of treatment, and reaching the optimal maintenance dose for the patient within about 3 months, and then maintaining the treatment with a frequency of 1-2 monthly injections (according to the progress of the course of treatment), after a certain period of time (generally 3-5 years), the patient can be treated with the vaccine. After a certain period of time (usually 3-5 years), the patient will not have allergic symptoms even if he/she is exposed to allergens in his/her life again.
3.Medication.
Antihistamine use.
They should be used only for the initial treatment and control of histamine-related symptoms (nasal itching, sneezing, runny nose, etc.). Dose adjustment for different types and severity of allergic rhinitis.
Nasal glucocorticoid usage.
Nasal hormones provide significant improvement in all four major symptoms, especially in nasal congestion compared to antihistamines, and can be used as a preventive measure against allergic rhinitis attacks. Nasal hormones have been recommended by the World Health Organization as the first choice for the treatment of allergic rhinitis in 2001 because of their ease of use, precise efficacy, low side effects, low price and long duration of use. The correct use of nasal glucocorticoids is described in the Appendix. Dose adjustment for different types and severity of allergic rhinitis.
Topical decongestants should be used very often! The main decongestants are ephedrine, hydroxymetazoline, naphthazoline, etc., which are used as nasal drops or nasal spray to improve nasal congestion but are not effective for other symptoms. These drugs, in general, should not be used continuously for more than seven days, especially hydroxyzoline long-term use may lead to irreversible drug rhinitis.
4. Surgical treatment.
Surgical procedures are only used for those who still have nasal blockage after regular medication, and a few still have serious impact on life and workers. The purpose of surgical treatment is to improve ventilation, not to treat allergies. Commonly used methods include radiofrequency treatment of the inferior turbinate and poor nasal framework structure to improve nasal ventilation.
Can allergic rhinitis be cured?
The development of allergic rhinitis depends on the patient’s allergic constitution and the allergens in the environment, one without the other. Allergic constitution is genetically related, and the current medical level cannot change the allergic constitution at the genetic level, nor is it possible to remove external allergens. However, by avoiding allergens and using nasal hormones (e.g., Reynocort, Cochlear, Endosulfan, etc.) properly, good symptom control can be achieved, even without the onset of the disease. Specific immunotherapy (also known as standardized desensitization) is the only allopathic treatment that can change the immune mechanism of allergic patients, and successful desensitization can lead to a radical cure.
Proper use of nasal glucocorticoids.
Spraying method.
1. spray the right nose with the left hand and the left nose with the right hand; 2. alternate administration.
Adjustment of the minimum maintenance dose.
Regular daily spraying decreases to every other day, every other day, every second day, every third day, and so on to maintain no symptoms as the minimum maintenance amount, but do not stop the drug. Resistance is usually rare with long-term treatment. The initial treatment regimen can be repeated in case of recurrence.
Health tips.
1, the diagnosis must be correct: please make sure to go to the regular hospital to make a correct diagnosis of your disease!
2.Try your best to find allergens: avoiding contact with allergens is the cure (decoration, animal fur, environmental pollution, pollen, mites and dust, damp fungi, smoking, etc.).
3. Treatment philosophy should be corrected.
(1) Do not hope to be cured by 1 medication, because allergens may always be with you!
(2) Do not hope to be cured by local surgery, because allergic rhinitis is an immune disease, drug treatment is the main means, only when drug treatment can not improve the “nasal blockage” to consider surgery to lift the “nasal blockage” problem, not allergies! The allergy is not a problem.
4, the treatment method should be correct: according to the WHO recommended program, intermittent moderate and persistent allergic rhinitis, nasal glucocorticoids are the first line of medication!
5. Treatment time should be scientifically controlled.
Intermittent allergic rhinitis: nasal glucocorticosteroids are used two weeks before the attack and continue to be used until two weeks after the attack stops; persistent allergic rhinitis: nasal glucocorticosteroids should be used for a long time and gradually reduced to the lowest maintenance amount (until the allergen can be avoided), and oral anti-blocking amines should not be used for a long time.