When it comes to rhinitis, many people take it for granted that the nose is inflamed and that eating anti-inflammatory drugs will make it better, but in fact, in clinical work, we often hear patients say: I have eaten a lot of anti-inflammatory drugs for rhinitis but they don’t work. What is the reason?
The first thing you need to do is to start with the cause of the inflammation, most of the inflammation is caused by the infection bacteria, this part of the inflammation to choose the antibacterial anti-inflammatory drugs sensitive to the causative bacteria, the effect is certainly exact, here the emphasis is on the infection of the causative bacteria sensitive antibacterial drugs effective, different causative bacteria and different organism state sensitive antibacterial drugs are different.
A part of the inflammation is caused by viral infections, when antibacterial anti-inflammatory drugs are definitely ineffective and antiviral drugs are needed.
Finally, there is a part of inflammation caused by allergic reactions (also known as allergic reactions) caused by sterile inflammation, when antibacterial anti-inflammatory drugs are certainly also ineffective.
In short, the causative factors of inflammation are different, and the etiological treatment of inflammation cannot be generalized to antibacterial and anti-inflammatory treatment.
Rhinitis, as an inflammation of the mucous membrane of the nasal cavity, is divided into the following common types depending on its cause: acute rhinitis, chronic rhinitis, allergic rhinitis (allergic rhinitis), atrophic rhinitis, etc.
First of all, acute rhinitis is introduced. The first thing to explain acute rhinitis is to emphasize the concept of the name of the problem, we often say in the people’s mouth cold is referred to the acute rhinitis, a disease two kinds of call, not clinically heard the patient said I have a cold caused rhinitis. The second point emphasizes that acute rhinitis is a viral infection, so if only the nose is not ventilated, running water-like or white nasal mucus in the early stage of the cold, oral antibacterial anti-inflammatory drugs are ineffective, but if the nasal mucus becomes yellow thick nasal mucus, then often combined with bacterial infection, the complications of sinusitis, then it is necessary to apply antibacterial anti-inflammatory drugs, different bacterial infection nasal mucus color is different, need to take antibacterial drugs The color of the nasal discharge differs from one bacterial infection to another, and the antibacterial medication needed is also different. The third point is emphasized because there are thousands of viruses and they are prone to mutation, this time the cold is this virus, next time it will be replaced by another, so it is difficult to follow the cold acute rhinitis.
Chronic rhinitis, mostly due to recurrent episodes of acute rhinitis treatment is not timely or delayed or other adverse stimuli such as drugs, harmful gas stimulation caused by a sterile inflammation of the nasal mucosa, so antibacterial anti-inflammatory drugs are not effective. Clinically, the main symptom is poor ventilation of the nasal cavity with nasal congestion, and the main treatment is symptomatic treatment to restore the ventilation of the nasal cavity in addition to removing the cause. The first point that needs to be emphasized here is the choice of topical nasal sprays, the first choice is hormonal nasal sprays, many people mentioned hormones to produce resistance, worried about the damage to the body. In fact, the nasal local application of hormonal sprays, especially mometasone furoate nasal spray, also known as endosulfan, its bioavailability is very low, that is, this drug only works locally, basically not absorbed into the blood. So there is no need to worry about the side effects on the human body. The second point emphasized is: nasal topical sprays like nasal drops, furosemide nasal drops and other drugs that are sprayed into the nasal cavity and the patient immediately feels the ventilation, because there are strong astringent blood vessels and mucous membrane components, long-term application is likely to cause drug rhinitis, the clinic generally does not advocate the first choice of such drugs, even if the application should not exceed 1 week. The third point emphasized is: the correct method of nasal medication: now the clinical application of nasal spray is basically a suspension, so you need to fully shake the solution before application, in addition to the direction of the nasal spray to the nasal cavity should be directed toward the lateral wall of the nasal cavity, should not be directed toward the medial wall of the nasal cavity, that is, the septum.
Allergic rhinitis (allergic rhinitis), as the name suggests, is an allergic reaction to a substance, resulting in episodes of sneezing, watery mucus, nasal congestion and other symptoms. Therefore, antibacterial and anti-inflammatory drug treatment is ineffective.
The first point that needs to be emphasized here is that allergens that are clearly identified or clinically tested positive must be allergic rhinitis, but if there are no clear allergens or allergen tests are negative, it does not necessarily mean that it is not allergic rhinitis, because there are thousands of allergens, and only a few dozen are used for clinical testing.
The second point emphasized is that hormonal nasal sprays are the first choice of drugs for this disease. Since these drugs inhibit the release of active substances in the nasal cavity, they do not work immediately after application and need to wait until the active substances have been metabolized in the body before they can play a therapeutic role.
The third point to emphasize is that the root cause of allergic rhinitis is allergic problem, avoiding allergens is the best prevention method, but sometimes it is not possible to avoid allergens, it is necessary to insist on long-term application of anti-allergic drugs for symptomatic treatment. Desensitization can also be performed if there is a clear allergen. Desensitization is the injection of specific allergens by repeated and incremental doses of allergens to improve the patient’s tolerance to the allergenic allergens and to achieve no further onset of disease after re-exposure to the allergenic allergens or a significant reduction in their symptoms despite the onset of disease. The treatment is divided into two clinical phases: a dose accumulation phase and a dose maintenance phase, with a total duration of not less than 2 years. It can be administered subcutaneously or sublingually. People with such allergies need to avoid the following allergy-prone or allergy-inducing foods in their daily diet: seafood, pineapple, mango and other foods. They can improve their allergies by insisting on consuming foods such as jujube, barley and enoki mushrooms for a long time.
The fourth point emphasized is: the current clinical development of microwave, low-temperature plasma, ultrasonic knife and other nasal turbinate surgical treatment, its treatment principle is to surgically destroy the turbinate mucosa, reduce the overall nerve sensitivity of the nasal mucosa, to achieve control of the disease. The advantages are that a small clinical operation can maintain the efficacy for months or even years; for patients with turbinate hypertrophy affecting nasal ventilation, the problem of nasal ventilation can be solved at the same time; when the sensitivity of the nasal mucosa healing returns to the preoperative period, the operation can be performed again.
The fifth point to emphasize is: the widespread use of aspirin drugs in clinical practice has resulted in more and more aspirin intolerance: aspirin rhinitis, bronchial asthma and nasal polyps, and the clinical manifestations of aspirin rhinitis are similar to allergic rhinitis. This drug should be discontinued if necessary.
The sixth point to emphasize is that allergic rhinitis and bronchial asthma belong to one airway and one disease, so do not separate the two when treating them.
Atrophic rhinitis refers to the atrophy of the nasal mucosa, including the submucosal blood vessels, glands and bones, which clinically causes symptoms such as hyperventilation of the nasal cavity, dryness of the nasal cavity, inappropriate discharge of nasal crusts and even malodor, olfactory disturbance, nasal bleeding and headache. The etiology of this disease is partly of unknown cause considered to be related to malnutrition, genetics, endocrine dysfunction, autoimmune diseases, etc. The other part is mainly secondary to nasal infection, surgery, and long-term exposure to irritating gases, etc. Therefore, the effect of antibacterial and anti-inflammatory drug treatment is only effective in patients with secondary infections.
It should be emphasized here that atrophic rhinitis in some patients is currently caused by damage to the nasal mucosa due to long-term application of tap water or saline or other so-called prescription drugs for nasal cleansing and nasal drip.