Treatment
1.Avoid contact with allergens
(1) Reduce the number of dust mites indoors; maintain the relative humidity of the living space to below 60%, but too low (e.g. below 30%-40%) will cause discomfort; clean carpets; wash bedding and curtains, mite allergens are soluble in water, washing textiles can remove most of them; use air purifiers with filters, vacuum cleaners, etc.
(2) Avoid allergens in the corresponding pollen allergy season.
(3) Avoid allergens for patients allergic to animal fur.
2. Drug treatment
The following factors should be considered: efficacy, safety, cost/effect ratio, etc. Intranasal and oral administration are commonly used, and the efficacy may vary among patients. There is no long-term sustained efficacy after discontinuation of medication, so maintenance therapy is required for persistent allergic rhinitis. Prolonged treatment does not result in rapid drug resistance. Intranasal administration has many advantages. The high concentration of the drug acts directly on the nose, avoiding or reducing systemic side effects. However, for patients with other allergic diseases, the drugs need to act on different target organs, intranasal administration is not the best choice, and systemic drug therapy is recommended. Various drugs should be used with caution in patients during pregnancy.
(1) Antihistamines oral or nasal 2nd generation or new H1 antihistamines can effectively relieve symptoms such as nasal itching, sneezing and runny nose. It is suitable for mild intermittent and mild persistent allergic rhinitis, and combined with nasal glucocorticoids for moderate-to-severe allergic rhinitis.
(2) Glucocorticoids Nasal glucocorticoids can effectively relieve symptoms such as nasal congestion, runny nose and sneezing. Severe patients who do not respond to other medications or cannot tolerate nasal medications can be treated with oral glucocorticosteroids for a short period of time.
(3) Anti-leukotrienes are effective in allergic rhinitis and asthma.
(4) Chromones are effective in relieving nasal symptoms, and eye drops are effective in relieving ocular symptoms.
(5) Intranasal decongestants are effective in relieving nasal congestion caused by nasal congestion, and the course of treatment should be controlled within 7 days.
(6) Intranasal anticholinergic drugs can effectively inhibit runny nose.
(7) Some herbal medicines are effective in relieving symptoms. The treatment principles for children and the elderly are the same as those for adults, but special attention should be paid to avoid the adverse reactions of drugs.
3.Immunotherapy
Immunotherapy induces clinical and immune tolerance with long-term effects and can prevent the development of allergic diseases. Allergen-specific immunotherapy is commonly administered by subcutaneous injection and sublingual administration. The course of treatment is divided into a dose accrual phase and a dose maintenance phase, with a total duration of not less than 2 years. Standardized allergen vaccines should be used.
(1) Indications are mainly for patients with allergic rhinitis for whom conventional drug therapy is ineffective.
(2) Contraindications.
(i) Period of asthma exacerbation.
(ii) Patients are using beta-blockers.
(iii) Combination of other immune diseases.
④Women during pregnancy.
(5) Patients are unable to understand the risks and limitations of the treatment.
Immunotherapy may have local and systemic adverse effects.
4.Surgical treatment
The indications are no improvement of nasal congestion symptoms by drug or immunotherapy, with obvious signs that affect the quality of life; obvious anatomical variation of the nasal cavity with dysfunction; combined with chronic rhinosinusitis, nasal polyps and ineffective drug treatment. Surgical treatment is not used as a routine treatment for allergic rhinitis.