With the approach of autumn this year, the number of outpatient clinics for this disease has increased again, in response to the misconceptions of patients about this disease and new advances in the treatment of this disease.
Allergic rhinitis.
It is a common and frequent disease, the incidence of which has been increasing year by year. It is a chronic inflammatory disease of the airways and is a type I allergic reaction, when the human body is repeatedly exposed to allergens, such as: house dust mites, animal fur, cockroaches, pollen, mold, etc., it leads to nasal congestion, sneezing, nasal itching, clear snot, watery eyes, accompanied by itchy throat, itchy eyes, nasal bleeding, headache, dry throat, pus, difficulty sleeping, etc.
Allergic rhinitis has the highest incidence of all kinds of allergic diseases. Although this disease is rarely life-threatening, there are many people who suffer from it, and it is a big headache because it is not cured for a long time. The reasons for this, in addition to the fact that the pathogenesis of the disease is not completely understood, there are also misconceptions about the treatment of patients.
1, only cure allergic rhinitis but not prevention. Many patients in the treatment process “only treatment not prevention”, such as only care about the doctor to prescribe drugs to treat, but neglected the existence of a variety of allergens, resulting in repeated attacks of allergic rhinitis. In fact, as long as the patient and the doctor work well together, the symptoms of allergic rhinitis can be well controlled so that they can maintain a normal life.
The onset of allergic rhinitis is related to many factors, for example, if someone in the family suffers from allergic rhinitis, he or she is allergic and is more likely to be stimulated by the allergic environment. In addition, environmental factors, such as polluting gases, the use of chemicals (detergents, etc.), pet fur, parasites, flowers and plants; smokers or stressed people are also prone to break their immune system, which can easily trigger allergic rhinitis.
Patients with allergic rhinitis should pay attention to staying away from allergens and controlling environmental factors while treating them, such as not keeping pets or flowers, quitting smoking, regularly removing mites from the home, including air conditioners, and closing windows at the right time are all good preventive measures. Another aspect of preventing allergic rhinitis is to pay attention to the prevention before the onset of the disease, especially seasonal allergic rhinitis patients have a relatively fixed onset, if you do a good job of recording the major onset of the disease, and start medication 1 to 2 weeks before the onset of the disease, you can avoid the onset.
2. Treat rhinitis as a cold. Some patients in the spring and autumn itchy nose, sneezing, runny nose, nasal congestion and other symptoms, mistaken for the seasonal dressing, improper diet caused by the “stubborn cold” or “heat typhoid”, and afraid to go to the hospital to spend time and money, simply take their own cold The cold is actually an acute rhinitis.
Cold is actually an acute rhinitis, and the onset of allergic rhinitis is very similar, accompanied by itchy nose, sneezing, runny nose, nasal congestion and other symptoms, as long as you distinguish carefully.
Allergic rhinitis and colds can be distinguished from each other.
(1) Colds are usually accompanied by systemic symptoms, such as dizziness, headache, weakness, etc., while allergic rhinitis is not, and allergic rhinitis mostly develops in the morning, so the symptoms are usually most obvious in the morning.
(2) The duration of the cold is usually about a week, while allergic rhinitis has no time limit and usually has a longer duration, sometimes lighter and sometimes heavier. Some allergic rhinitis patients have temporary improvement after taking cold medicine, because some cold medicine contains paracetamol and other anti-allergic effect. In addition, there is a distinction to be made with vasomotor rhinitis, which does not belong to allergic diseases.
3, treatment abuse of drugs, not standardized course of treatment. First of all, the abuse of decongestants, especially in rural patients, due to long-term nasal congestion, the simple application of local decongestant therapy, and the application is more arbitrary, up to 5 to 10 times a day cumulative. As such nasal drops usually have a strong vasodilatory rebound effect, is the most common cause of drug rhinitis, such drugs must indeed, then the course of treatment should not exceed three days, at most not more than a week, the number of daily nasal drops can not exceed three times. The second is premature discontinuation of medication. The normative treatment medication should not be stopped at will. Many patients only use medication when they are ill, and stop taking it as soon as their symptoms are relieved, resulting in allergic rhinitis getting better and worse, or even getting worse.
We suggest that for perennial allergic rhinitis, treatment should be continued for l to 2 months for each attack, and some patients even need to be treated for half a year; and for seasonal allergic rhinitis, medication should be used 2 to 3 weeks in advance, and after the season, medication should not be stopped immediately, but continued for about two weeks. For according to the course of treatment more need to adhere to the standardization of treatment.
4, gullible some allergic rhinitis can cure the exaggerated propaganda, allergic rhinitis is the type I of allergic reactions, when the body first contact with allergens after the body produces inflammatory transmitters, when again in contact with allergens occurs when the clinical manifestations of allergic reactions.
Nevertheless, the specific pathogenesis of the disease is not completely clear, at the same time, the occurrence of this disease requires the existence of a neural reflex arc, that is, the allergen contact with the receptors of the body, resulting in the receptor response, the information is transmitted to the nerve center, and then the nerve center through the nerve fibers to the effector, resulting in nasal congestion, sneezing, nasal itching and other symptoms, and the existence of this reflex arc of the body is numerous, and some of them are physiological and cannot be completely blocked. Completely blocked, so it is impossible to achieve good results by a certain method.
5, allergic rhinitis and asthma treatment is completely unrelated diseases, allergic rhinitis and asthma are allergic diseases that seriously affect people’s quality of life, the past that the two are two independent diseases, but in recent years more and more research results confirm that allergic rhinitis and asthma is actually the same airway in the same persistent inflammatory disease, the two have a very close relationship.
Epidemiological data show that people with allergic rhinitis are three to four times more likely to develop asthma than the general population, and people with common rhinitis are twice as likely to develop asthma. In the past, the two were often treated separately, with the respiratory department responsible for treating asthma and the ear, nose and throat department responsible for treating allergic rhinitis, leaving both sometimes poorly controlled. Therefore, it is particularly important to actively intervene and treat both allergic rhinitis and asthma at the same time, and even simple allergic rhinitis must be actively treated to prevent it from triggering asthma.
So, what are the current prevention and treatment methods for this disease?
1. Avoid contact with allergens. Here we are talking about those allergens that have been identified and can be avoided, such as pet hair, cockroaches, pollen, some foods, etc.
2.Medication. This kind of treatment is effective, simple and relatively convenient. Oral medications include western and traditional Chinese medicines, generally lighter ones have better efficacy, such as oral rhinitis, vitamin C, diclofenac, etc., and nasal application of Reynocort, co-solvadex, endosulfan, etc. Must adhere to the correct use method.
3.Surgical operation treatment. These treatments are called physical therapy in medical terms. The principle is that through the physical effects of cautery, freezing and ablation, the nasal mucosa is scarred, the sensitivity of the nasal mucosa is reduced, and the receptors and effectors on the nasal mucosa are destroyed to a certain extent, so that the condition can be controlled in a relative period of time.
However, due to the continuous metabolism of the human nasal mucosa, it tends to recover on its own. Therefore, most patients can only obtain short-term results, and some may be longer, but often cannot be “cured”. It is also difficult to grasp the degree of treatment. Clinically, there are patients with excessive physical therapy, resulting in nasal dryness and loss of sense of smell, resulting in atrophic rhinitis, so both doctors and patients need to choose carefully.
The principle is to block the afferent and efferent nerve fibers of allergic reactions through surgery, so that the nasal cavity can be unblocked to reduce the attachment of allergens and destroy the receptors and effectors, thus reducing or eliminating allergic reactions to a certain extent, but the total efficiency is about 80%.
4. Immunotherapy. With the standardization of allergens, satisfactory diagnostic reagents are available for most inhalant allergens, so that the level of diagnosis of allergic diseases is greatly improved, including allergen skin prick test, serum allergen-specific IgE assay, allergen nasal mucosa or bronchial excitation test and other methods. These specific immunoassays not only provide evidence for the diagnosis of allergic rhinitis-asthma syndrome, but also help to determine the type of allergen and the degree of allergy in patients.
Immunotherapy can change the autoimmune system of patients with allergic rhinitis, thus reducing allergy symptoms, and is the closest treatment to cure allergic rhinitis. The more reliable is the subcutaneous injection of immune medication, which is given on a regular outpatient basis and maintained for 2 years before being discontinued, which is effective in most patients and can be maintained for a longer period of time after discontinuation, as much as 15 years. This treatment has the disadvantages of painful injections and a long treatment course.
Who is suitable for immunotherapy? The first is to identify clear allergens (such as dust mites), but there is no way to completely remove the allergen patients; the second is to receive long-term drug treatment but the results are not satisfactory patients; third is the long-term use of drug therapy concerns, worry about the impact on liver and kidney function patients.
5. Daily homework. To prevent and control allergic rhinitis and other rhinitis, in addition to away from allergens, prevention and health care is also important, such as regular physical exercise to increase resistance; pay attention to warmth to prevent colds; frequent ventilation in the living room to maintain a certain humidity; regular diet and living, avoid smoking, alcohol, spicy food, eat more vegetables and fruits; maintain an optimistic and cheerful mood, avoid mental stimulation and excessive fatigue; avoid frequent in and out of the temperature difference between environment.
In addition, nasal health care is also very important, such as attention to nasal hygiene, change the nose and other bad habits; swimming posture to correct, to prevent the nasal cavity into the water; frequent massage Ying Xiang point, nasal pass point (pinch the nose, rub the nasal wings for 1 to 2 minutes, once a day in the morning and evening, when there is disease can be increased by 1 to 2 times a day); master the correct method of blowing the nose; saline nasal wash: the best use of injectable saline, one clean, the second The concentration is suitable.
If you prepare your own saline, you can add 4.5 grams of salt to 500 ml of water to get 0.9% saline. Commercially available pure salt without iodine should be used, and pure or distilled water should be used for the water. If the edema of the nasal mucosa is severe, you can use 2%-3% high concentration saline. High-concentration saline rinse can promote the rapid exudation of fluid from the edematous nasal mucosa, eliminating edema and relieving nasal congestion.
High-concentration saline rinse should not be used for more than 7 days in general. People without nasal congestion, with very dry nose and symptoms of nasal bleeding should not use highly concentrated saline. When flushing, first put your head down, taking care that your nose is not lower than your mouth. Let the left nostril be under and pour the saline water through the right nostril, the water will flow out of the left nostril and repeat several times. Turn your head and rinse the other nasal cavity. Open your mouth to breathe during the nasal wash. If water comes out of your mouth, do not swallow it and let it flow down naturally. Saline nasal wash therapy is safe for children and pregnant women and can be used for a long time. Generally speaking, nasal washing 1-2 times a day is sufficient.