1. Avoid allergen attacks.
This method is of great importance for seasonal allergic rhinitis. Since seasonal allergic rhinitis is mainly allergic to the pollen of the plants that bloom in this season, the occurrence of allergic rhinitis can be avoided by leaving the area during the blooming season of these plants. For patients with perennial allergic rhinitis, they can only take the method of transferring away from the region to work and live.
2, internal medication: mainly the use of anti-allergic drugs, of which the most commonly used are three types.
(1) cell membrane stabilizers or inflammatory mediators blockers: such as sodium cromoglycate, ketotifen, Topost;
(2) antihistamines: such as paracetamol, reserpine (Astemizole), desloratadine (Enzyme, Flibrium, Dexamethasone), loratadine (Keratan, Dasenrei), Minky (Nostatin), levocetirizine hydrochloride tablets (Uzer), levocetirizine hydrochloride tablets (Dilute);
(3) Leukotriene receptor antagonists: such as zallustat, montelukast, etc. Clinically, antihistamines are generally used more often, and one is usually sufficient. The main characteristic of these drugs is that they are fast-acting and can quickly control nasal itching, sneezing, clearing and other episodic symptoms, and levocetirizine hydrochloride tablets (Youze) and levocetirizine hydrochloride tablets (Ditto) also have a significant effect on improving nasal congestion. However, these drugs do not have a curative effect on allergic rhinitis. The main side effect of such drugs is to cause a dozing sensation, so it can be taken only once before bedtime.
However, many patients can have “drug resistance” to these drugs, that is, after taking them for a period of time, the effect is getting worse. In this regard, you can choose another one.
3, nasal drops (spray) medication: the main nasal medication for the treatment of allergic rhinitis are three types.
(1) decongestant nasal drops (spray) agent: use one can. Such as ephedrine nasal drops (furosemide liquid), selorazoline nasal spray (norton), hydroxymetazoline hydrochloride nasal drops, naphthazoline hydrochloride nasal drops, and so on. The main role of these drugs is to quickly relieve nasal congestion, and control the symptoms of runny nose, but long-term use may cause drug rhinitis (if the use of -2 times a day, four weeks of continuous use, that may form a drug rhinitis), the gains are not yet lost. Therefore, the use of such drugs, should pay attention to the interval between the 2 use of at least 6 hours, and it is best to use a few days, stop using a few days, not heavy nasal congestion, do not easily use, so that you can extend the use of this type of drug safety period, in order not to cause drug rhinitis.
When the nasal congestion is heavy, decongestants can be used, the first week of starting treatment can be used continuously (if necessary), but only intermittently thereafter, not every day without continuous use (when using, it is best to use only once in a day, not more than 2 times, and as little as possible.) . Only when there must be other treatment methods mainly, can we consider the cooperative application of blood reducing agents, and must not be used as the main treatment method.
(2) Topical hormone: one can be used. The commonly used ones are coleus (fluticasone propionate nasal spray), Berkner (beclomethasone propionate), tretinoin nasal spray (Starrick, Jend), etc. These drugs have anti-metabolic effects and their effects are maintained for a longer period of time, but many patients believe that their effects become less and less effective after a period of use. According to many research reports, no obvious side effects were found, and some people clinically found Jend to be difficult to accept because of the obvious irritation in the nose.
(3) Other anti-allergic rhinitis drugs: there is one can. Such as interferon nasal drops, nostatin nasal spray (Minqi), ketotifen nasal drops, sodium cromoglycate nasal drops, can be used for a longer period of time, but the side effects of ketotifen nasal drops are more obvious, mainly causing drowsiness, dry mouth, or gastrointestinal reactions. I am not sure whether the effect is diminished after using for a long time.
The above three types of nasal drops (nasal spray), decongestants are generally mandatory, choose one of them; for the other two types of drugs, you can use one each, or just one.
In addition, if there is eye itching, you can drop sodium cromoglycate eye drops.
4.Nasal turbinate injection.
Injections of drugs within the nasal turbinates (or nasal mound) can use Chinese medicinal preparations, but more often use Western medicinal preparations, commonly used hormonal drugs, such as tretinoin injection, or prednisone injection prednisolone injection. Prednisone, prednisolone injection has a very good effect, the effect can be maintained for up to six months, but the drug is not a local hormone, there are certain side effects. In addition, according to some reports in recent years, the inferior turbinate injection of such drugs, there are reports of at least 5 cases of central retinal artery obstruction, as well as abducens nerve palsy (1 case).
5. Desensitization therapy: There are two types of desensitization therapy.
The first type of method is non-specific desensitization (such as histamine phosphate, nasal infection bacteria made into vaccine, etc.), administered by intramuscular injection, the course of treatment is long, and some patients have difficulty in adhering to it. In addition, placental lipopolysaccharide and Skikon injections are also used, which have the effect of enhancing immunity.
The second category is specific desensitization therapy (see question 7), which is the only method recommended by the World Health Organization for the treatment of allergic rhinitis with a radical effect. The course of treatment is at least one to one and a half years, preferably three to four years, with a maintenance period of more than 10 years or even for life.
The current clinical use of Changdi, mainly for those who are allergic to mites, belongs to perennial allergic rhinitis, rather than seasonal allergic rhinitis.
6.Physiotherapy.
There are mainly laser, freezing, iontophoresis, radiofrequency treatment, etc. The purpose is to change the hypersensitivity of the nasal mucosa. Since the elevated local sensitivity of the nasal mucosa is only a local pathological state of this disease, and the most fundamental factor of allergic rhinitis is the overall allergic constitution, such methods have some effect, but there is still a possibility of relapse.
7, surgery: surgical treatment of allergic rhinitis has different needs targeted.
One is to change the nasal variation, but also may improve the hypersensitivity of the nasal cavity: such surgical methods are: nasal polyp removal, nasal septum correction, nasal septum submucosal correction, nasal septum submucosal dissection, sinus opening, etc. Sometimes these procedures may need to be applied in combination.
Second, cutting the nerve (also by minimally invasive methods), or mucosal scratching: the aim is to block nerve conduction, thus stopping allergic rhinitis from occurring. Since allergic rhinitis is a local reaction to an overall disease, and surgery only solves the local problem, surgical treatment can also be effective, but there is inevitably the possibility of recurrence (the validity period is usually more than six months).
Third, to change the pathological state of the nasal mucosa, as well as to eliminate the “trigger point”: “trigger point” is located in the front of the nasal cavity, when this area is stimulated, it is easy to cause allergic rhinitis or asthma attacks, so called “trigger point The “trigger point” can be treated with laser, microwave, low-temperature plasma radiofrequency ablation (all will destroy the nasal mucosa), as well as nasal threshold (the front of the lateral wall of the nasal cavity) “well” surgery, which can achieve certain results (valid for about six months or more). Among these different surgical methods, “well” surgery does not cause the sequelae of “empty nose syndrome” that damages the nasal mucosa, but other surgeries that destroy the mucosa of the turbinates may cause this complication (of course, the cases that cause this complication are, after all, only a few. Otherwise, this type of surgery would not be carried out. But if you encounter it, you are out of luck).
It is worth stating that pediatric patients are not suitable for surgical treatment: first, because children are in the developmental stage and are not suitable for destructive surgical treatment; second, general anesthesia is not necessary for these procedures, and children have difficulty cooperating with the therapeutic operation of local anesthesia. Western medicine surgery treatment if the indications are not strictly mastered, or surgical errors, too much destruction of the turbinate mucosa, easy to cause surgical complications (the so-called “empty nose syndrome”, mainly characterized by the inferior turbinate becomes very small, nasal cavity is wide, excessive ventilation in the nose when breathing, causing dry discomfort in the nose, headache dizziness and other symptoms.
8.Other treatment: If the allergic symptoms are accompanied by itchy eyes, you can use sodium cromoglycate eye drops. However, if the ear itches, there is no need for special medication, just use anti-allergy drugs orally; if there is skin gas, there is no need to use local medication, just take anti-allergy drugs orally, but of course, you can also consider using anti-skin allergy drugs applied topically.