Allergic rhinitis, also known as allergic rhinitis, is an allergic disease of the nasal mucosa and can cause a variety of complications. The incidence of allergic rhinitis has been increasing in recent years. According to statistics, allergic rhinitis accounts for about 40% of all rhinitis. Clinically, it is generally divided into perennial and seasonal types.
Allergic rhinitis is mainly caused by inhalation allergens such as indoor and outdoor dust, dust mites, fungi, animal fur, feathers, cotton wool, etc., which mostly cause perennial attacks, with mites being the main cause in Nanjing; plant pollen causes seasonal attacks. Food allergens and contacts are less common.
The main manifestations of allergic rhinitis are (a) nasal itching and continuous sneezing: there are often several paroxysmal attacks every day, followed by nasal congestion and runny nose, especially obvious in the morning and at night. Nasal itching is seen in most patients, sometimes itching outside the nose, soft palate, face and external ear canal, etc. Seasonal rhinitis is more obvious with eye itching. (b) A large amount of clear watery nose. (C) Nasal congestion. (iv) Olfactory disorder: those caused by mucosal edema and nasal congestion are mostly temporary. Those caused by persistent mucosal edema leading to olfactory nerve atrophy are mostly persistent.
Allergic excitation test: Generally, skin test (scratch, intradermal and contact method, etc.) is used. The principle is that there are various hypothetical allergic substances, so that after contact with the organism, depending on the presence or absence of reaction, it can assist in the diagnosis. The allergens can also be applied for desensitization after the diagnosis of allergens is clear.
Treatment of allergic rhinitis: Although the disease is not fatal, it can affect the patient’s quality of life (sleep, study, work, social and recreational activities) and can induce bronchial asthma, rhinosinusitis, nasal polyps, otitis media and allergic conjunctivitis, etc. Especially chronic long-term hypoxia has a greater impact on pediatric patients. Children suffering from allergic rhinitis, due to long-term nasal congestion, often breathing through the mouth can lead to maxillary dysplasia, zygomatic arch is not obvious, the face looks dumb, called adenoid face.
1, drug treatment: antihistamines, such as paracetamol, loratadine E; mast cell stabilizers, such as sodium cromoglycate; adrenocorticosteroids, ketotifen, decongestants, etc. are mainly used to control symptoms, need long-term application, often with drowsiness, cause drug rhinitis, arrhythmia and other side effects. The systemic side effects of hormones should not be ignored.
2. Pre-screening nerve block with plasma/radiofrequency technology and reduce the sensitivity of nasal mucosa. Because recent studies have shown that allergic rhinitis is associated with increased parasympathetic excitability and Class C intra-neurofibrillary peptides. If operated under a nasal endoscope, it has the advantages of clear vision, accurate treatment site, and minimal damage. Patients with nasal polyps should undergo endoscopic surgery for nasal polyps; 3, desensitization therapy, using the identified allergens as desensitizers, starting with a small dose for subcutaneous injection, and gradually increase the dose to the maximum tolerated amount to the maintenance amount, until the symptoms disappear. Patients treated by this method can produce a large amount of specific IgG antibody, which can block the combination of antigen and IgE antibody and prevent the occurrence of nasal allergic reaction.
Another type of allergic rhinitis is induced by non-specific stimuli, without the participation of specific allergens, and is not an immune reaction process, but the clinical manifestations are similar to those of allergic rhinitis, called vasomotor rhinitis or neuroreflex rhinitis. Therefore, even if it is seen as allergic rhinitis, desensitization therapy, hormonal or immunotherapy are not effective because there is no antigen-antibody reaction in the body. A more appropriate treatment is pre-septal nerve block with plasma/radiofrequency techniques and reduction of nasal mucosal sensitivity.