1.Modern pathological mechanism of allergic rhinitis
Allergic rhinitis (AR) is an IgE-mediated inflammatory response to environmental allergens in the nasal mucosa; the main clinical manifestations are nasal itching, sneezing, runny nose, and nasal congestion. Allergic rhinitis is a global health problem, common worldwide, with a global prevalence of 10-25%, and the number of sufferers is still increasing.
The two basic factors that contribute to the development of the disease are.
(1) hereditary allergies.
(2) Repeated inhalation of environmental allergens.
The clinical manifestations of allergic rhinitis are mainly characterized as follows.
(1) Seasonal, mainly in spring (tree pollen allergy) and autumn (weed pollen allergy) seasons, but also in all seasons.
(2) Rapid onset, rapid changes and rapid onset and offset.
(3) Nasal itching → sneezing as a group of symptoms (may also see itching on the palate, itching in the ears, itching in the eyes, etc.)
(4) Nasal congestion and runny nose as a group of symptoms.
(5) The disease is located in the nasal mucosa of the respiratory system.
The current Western medical treatment is mainly to.
(1) Avoidance of inhalation of allergens that have been sensitized.
(2) medication (antihistamine cetirizine, loratadine, decongestant ephedrine, anti-inflammatory sodium cromoglycate, leukotriene receptor antagonists, hormones, etc.)
(3) Immunotherapy.
Among them, drug therapy is the most commonly used treatment method, the advantage is that the recent efficacy is obvious, the disadvantage is that the action target is single, can only improve the symptoms, and can not change the allergic constitution, therefore, the course of treatment is unpredictable, long-term efficacy is uncertain.
2.Chinese medicine’s understanding of allergic rhinitis
Although Chinese medicine does not have the name of “allergic rhinitis”, the “Suwen Xuanji Original Disease Style? The “congested nose, the nose out of clear snot; sneeze, the nose because of itching and gas sneezing in the sound. Therefore, modern Chinese medicine believes that congested nose includes modern allergic rhinitis, allergic rhinosinusitis and vasodilatory rhinitis.
It can be seen from the above that Chinese medicine has a long history of treating allergic rhinitis (congested nose), and the understanding of the etiology and pathogenesis of congested nose in Chinese medicine has been distinguished from cold and heat since ancient times: (1) the main cold, such as the
(1) the main cold, such as the “source of diseases”: “the fluid snot and saliva, the heat is dry, the cold is overflowing, can not be collected. The lung Qi is connected to the nose, and it contains cold. The cold follows the gas into the nose, so the fluid cannot collect itself”. (2) For those who have heat, such as “The key to the treatment of evidence”, “clear snot is caused by cold brain and cold lung”.
(2) the main heat, such as “Suwen Xuanji original disease style”: “or say congested lung cold is wrong, but they see congested nose and nasal congestion, cold is very, so thought, do not know that cold injury to the skin and hair is the coup dense, heat, and the disease is more and more depressed”.
According to modern medicine, it is inferred that those who are cold in Chinese medicine may be those who develop in autumn; those who are hot may be those who develop in spring.
The author combined the prescriptions of Chinese medicine for the treatment of allergic rhinitis in the past ten years and found that the 36 prescriptions involved a total of 82 Chinese herbs, of which those appearing more than 4 times were Astragalus 27 times, Atractylodes 24 times, Bupleurum 24 times, Sinapis 23 times, Caulis 22 times, Glycyrrhiza 18 times, Radix et Rhizoma 16 times, Dahurica 12 times, Scutellaria 10 times, Radix Codonopsis 9 times, Schisandra 8 times, Ephedra 7 times, Cyperus 6 times, Cicada 8 times. Gui Zhi 6 times, Cicada 8 times, Jujube 5 times, Angelica 5 times, Radix et Rhizoma Pseudostellaria 4 times, and Xian Ling Spleen 4 times. Among these 18 herbs, there were 4 herbs for strengthening the spleen and tonifying the qi (Radix Astragali, Atractylodes Macrocephala, Radix Ziziphi, Radix Codonopsis Pilosulae), 9 herbs for wind (Fructus Anemarrhenae, Fructus Sinensis, Fructus Cangrei, Radix Angelicae Sinensis, Radix Angelicae Sinensis, Radix Angelicae Sinensis), 1 herb for clearing heat (Radix Scutellariae Sinensis), 1 herb for tonifying the blood (Radix Angelicae Sinensis), 1 herb for tonifying the kidney (Radix Angelicae Sinensis), and 1 herb for collecting astringency (Fructus Schisandrae). From the above statistics, it can be seen that the largest number of occurrences are of wind herbs, which are found in all 36 prescriptions (even though the full formula is not given in 13 prescriptions). Clinical studies on either warming Yang and tonifying Qi method, or combining Cold and Heat or clearing Heat method, all achieved good clinical efficacy. Different treatments and prescriptions for the same disease have achieved good results, and the common feature of these different prescriptions is that they all have wind medicine.
According to the author, congested nose is located on the head and face, the nose is the lung’s orifice and is a place where wind is easily offended; the attacks come and go quickly, the symptoms change quickly, and nasal itching is the main manifestation, and itching is one of the clinical features of wind diseases. Therefore, it is proposed that congested nose belongs to the category of wind disease in Chinese medicine, and the main etiology is: external wind evil, cold and heat are both the evil, or the evil born of change, and combined with literature and personal experience to establish the method of dispelling wind and clearing heat to win dampness in the treatment of congested nose, which has achieved better clinical results.
Expelling wind and clearing heat: it is to dispel the external wind and dispel the internal heat, so as to stop itching and sneezing.
Sheng dampness: It is based on “Su Wen? It is based on the theory of “wind overcoming dampness” in the “Five Runs of the Great Treatise”, with the power of wind medicine overcoming dampness to achieve the effect of stopping snot and clearing congestion.
Modern research has also confirmed that the commonly used wind medicine has many pharmacological effects such as inhibiting metaplasia, reducing the infiltration of mast cells in inflammation, improving local mucosal congestion and edema, and relieving local symptoms.
A large number of modern researches and clinical practice have proved that Chinese medicine has good role and prospect in the treatment of allergic rhinitis.