Acute rhinitis is an acute inflammatory disease of the nasal mucosa caused by a viral infection, also known as “cold” or “wind”. So colds are not just for internists, but also for otorhinolaryngologists. Acute rhinitis symptoms include nasal congestion, runny nose, fever, etc. The duration of the disease is usually 7 to 10 days. 200 or more viruses are associated with acute rhinitis. It can develop in all seasons and is more common in winter.
Acute rhinitis is the most common disease in humans and occurs in countries around the world. Adults usually have an average of 2 to 5 infections per year and children can have 6 to 10 episodes per year (up to an average of 12 per year in school-age children). And due to the degeneration of the immune system, the number of symptomatic infections per year increases in the elderly.
The causative organisms of acute rhinitis are viruses. Various respiratory viruses can cause the disease, rhinovirus (30-80%) being the most common, influenza (5%-15%) and parainfluenza viruses, coronavirus (10-15%) and adenovirus are also common, as well as enterovirus and respiratory syncytial virus. Among them, enteroviruses cause the shortest incubation period, while rhinoviruses, respiratory syncytial viruses and parainfluenza viruses have a longer incubation period. Infections caused by respiratory syncytial virus, parainfluenza virus, and coronavirus tend to lack immunity, resulting in repeated infections throughout life, while rhinovirus, enterovirus, and adenovirus can produce a longer period of immunity. When the resistance of the body is reduced due to various causes and the defense function of the nasal mucosa is damaged, the virus invades the body mainly through the respiratory tract, and the bacteria that have been latent in the upper respiratory tract grow and multiply and increase their virulence, so that the disease is combined with bacterial secondary infections such as streptococcus, staphylococcus, pneumococcus, H. influenzae and C. catarrhalis on top of the primary viral infection. Viruses are usually transmitted by droplets (aerosols) or by direct contact with nasal secretions and objects infected by the infected person. It has been shown that rhinoviruses are most contagious during the first three days of illness, after which they become much less contagious.
Acute rhinitis in the case of viral infection, some systemic triggering factors lead to its onset, such as cold, overwork, malnutrition, excessive smoking and alcohol, vitamin deficiency, endocrine disorders and systemic chronic diseases of the heart, liver and kidneys, etc., which can affect the normal metabolism and decrease immune function. In addition, crowded living, poor indoor ventilation, dry air and other environmental factors are also one of the causes. Local factors are chronic diseases of the nasal cavity and adjacent focal diseases, which can impede the ventilation and drainage of the nasal cavity, affecting its physiological function and facilitating the local growth and reproduction of pathogens, such as nasal septal deviation, chronic rhinitis, nasal polyps, chronic sinusitis, chronic tonsillitis, etc.
The clinical manifestations of acute rhinitis are: incubation period of about a few hours or 1 to 2 days, a dry, burning or foreign body sensation in the nose, itching, a few patients also have a foreign body sensation in the conjunctiva of the eyes, the patient is cold, general discomfort. The nasal mucosa is congested and dry. About 2-7 days later, nasal congestion appears, which gradually worsens, with frequent sneezing, clear water-like nasal discharge with reduced sense of smell, occlusive nasal sound when speaking, and possible nasal bleeding; at the same time, systemic symptoms reach their peak, such as fever (mostly low fever), lethargy, loss of appetite, and headache, etc. If complicated by acute sinusitis, the headache is aggravated. The nasal mucosa is diffusely hemorrhagic, swollen, and the nasal passage or floor of the nasal cavity is filled with watery or mucus-like secretions. The nasal vestibule may become red, swollen and chapped due to the stimulation of large amount of secretions and inflammatory irritation reaction. Clear nasal discharge decreases and gradually becomes mucopurulent, and when combined with bacterial infection, the nasal discharge becomes purulent, and the systemic symptoms gradually decrease. If there is no complication, it will be cured after 7-10 days. And the cilia transport function of nasal mucosa usually can be fully recovered in about 8 weeks.
Due to the direct spread of infection and inappropriate treatment (such as forceful nasal blowing), the infection can spread to adjacent organs and produce various complications: 1.
1.The spread of infection through the sinus opening to the sinuses causes acute sinusitis, which is manifested by aggravation of symptoms in remission, local pain and headache, and pus.
2.Complication of acute otitis media via the eustachian tube, the probability of complicating middle ear infection in the cold population is as high as 30%; it can manifest as deep dull pain in the ear or fluctuating throbbing pain, tinnitus and hearing loss, ear leakage and other symptoms.
3.Infection spreads downward and complicates acute pharyngitis, acute laryngitis, tracheitis and bronchitis, and pneumonia can be complicated in children and elderly people with low resistance.
4, through the nasolacrimal ducts cause conjunctivitis, dacryocystitis, less common.
Acute rhinitis is a self-limiting disease with a duration of about 7 to 10 days. There are no drugs that can be directly cured, mainly supportive treatment and symptomatic treatment, and pay attention to the prevention of complications.
Systemic treatment with plenty of water, light diet, evacuation of stool, and attention to rest.
1, early with sweating therapy: can reduce the symptoms and shorten the course of the disease. Such as ginger, brown sugar and white onion decoction hot water.
2, antipyretic and analgesic drugs: aspirin, acetaminophen, etc.
3, Chinese patent medicine: dredge the wind and dispel the surface to drive away evil.
4.Anti-viral drugs can be used in the early stage of the disease.
5.When combined with bacterial infection or suspected complications, systemic application of antibacterial drugs for treatment.
Local treatment.
1, decongestant nasal spray, can reduce mucosal congestion, swelling and reduce nasal congestion, improve drainage, such as 1% ephedrine saline, or 0.05% hydroxymetazoline, pediatric drug concentration is appropriately reduced. The use of decongestants should be within 1 week.
2, acupuncture and acupressure methods can be used to reduce nasal congestion.
Symptomatic treatment for patients with fever give ice packs for physical cooling. Vomiting and diarrhea patients are treated with antiemetic and antidiarrheal drugs, and attention is paid to maintaining the water-salt and electrolyte balance. To promote the correct method of nasal blowing: tightly press one side of the nose and gently blow out the secretions from the opposite nasal cavity; or spit out the nasal snot after inhaling it into the pharynx.
Prevention of acute rhinitis.
1, the disease can occur in large or small localized epidemic, the virus can be transmitted in the air through aerosols, during the epidemic should avoid close contact with patients, do not go in and out or less access to public places, pay attention to the ventilation of the living room. You can wear a mask when you go out.
2, the virus that causes acute rhinitis can live in the environment for a long time, so it can be carried by hand contact and subsequently cause infection by touching the eyes or nose. So wash your hands regularly and correct the bad habits of rubbing your eyes and picking your nose can play a role in preventing colds.
3, vaccination: Vaccination is mainly used for the prevention of special influenza for the elderly, children and other susceptible groups. For the common cold, due to the wide variety of viruses causing the disease, more than 200 species have been identified, and their antigens rarely cross-react, vaccination has a limited role in the prevention.
4.Chinese herbal medicines such as Banlangen have certain preventive effects and can be taken in decoction or in punch.
5, often exercise, advocate cold water washing or cold water bath to enhance physical fitness.
6, pay attention to the combination of work and rest, diet and reconciliation.