Some time ago, my friend Zhang told me that he always had a bad cold, sneezing, clear nose and nasal congestion. I suspected that he had allergic rhinitis, but when he came to me for a checkup, it was not a cold, but a typical allergic rhinitis, and one side of the nasal cavity already had a small polyp. Now, spring has arrived, the spring season is getting closer and closer, this time is also the high season of allergic rhinitis, here I give you a brief introduction to how to diagnose allergic rhinitis and how to avoid allergic rhinitis infestation of general knowledge. Allergic rhinitis is a non-infectious inflammatory disease of the nasal mucosa mediated mainly by IgE after the body has been exposed to allergens. With the development of social economy and the enrichment of material life, many diseases, such as malnutrition, parasitic diseases and various infectious diseases, are decreasing or even eliminated, while various allergic diseases are increasing. Over the past 40 years, the prevalence of allergic rhinitis has increased significantly, and the global average prevalence of allergic rhinitis is around 10-25%, while China currently lacks national epidemiological surveys and statistics in this regard. From the pathogenesis point of view, allergic rhinitis belongs to IgE-mediated type I allergic reaction. When the allergen enters the atopic individual, the body produces the corresponding immunoglobulin E (IgE) antibodies, which attach to the surface of the mediator cells (mast cells, basophils), and the body is in a sensitized state. When the same allergen enters the body again, this allergen “bridges” with IgE on the surface of the media cells and stimulates a series of biochemical changes in the cell membrane, rupture and degranulation. These mediators cause pathological changes such as capillary dilation, increased vascular permeability, smooth muscle contraction and increased glandular secretion, and the body is in a state of sensitization, which is clinically manifested by typical symptoms such as sneezing, clear mucus, nasal congestion and nasal itching. So how is allergic rhinitis diagnosed and how can it be distinguished from a cold? Patients with cold have dryness and burning sensation in the nose, or foreign body sensation and itching, sometimes chill and general discomfort a few hours or 1~2 days before the onset of cold. After that, nasal congestion appears in about 2~7 days, which gradually worsens, with frequent sneezing, clear water-like nasal discharge, accompanied by reduced sense of smell, occlusive nasal sound when speaking, and possible rhinorrhea; at the same time, systemic symptoms reach their peak, such as fever (mostly low fever), lethargy, loss of appetite, headache, etc. The nasal mucosa is diffusely congested and swollen, and the common nasal passage or the floor of the nasal cavity is filled with watery or mucus-like secretions. Finally, clear nasal discharge decreases and gradually becomes mucopurulent, and systemic symptoms gradually decrease. If there is no complication, it will be cured in 7~10 days. In contrast, allergic rhinitis has no systemic symptoms such as fever, and is mainly characterized by nasal itching, paroxysmal sneezing, profuse watery nasal discharge and nasal congestion. Most patients feel itchy inside the nose. Some patients may have itchy eyes and conjunctival congestion, and itching in the external ear canal and soft palate. Sneezing, a reflex action. Several paroxysmal episodes of more than 3 or even 10 or more in a row occur several times a day. Mostly in the morning or at night or immediately after contact with allergens. Runny nose, with a large amount of clear watery nasal discharge, sometimes dripping unconsciously from the nostrils. Nasal congestion, varying in severity, intermittent or persistent, alternating unilaterally, bilaterally or bilaterally, with different manifestations. In allergic rhinitis, nasal congestion is often obvious due to the obvious edema of the nasal mucosa. In addition, due to the obvious edema of nasal mucosa, some patients still have hyposmia. The nasal mucosa is pale and edematous, and the nasal discharge is like clear water; it can be combined with other type I allergic diseases such as bronchial asthma. Cytological examination of nasal secretions, skin test, excitation test and specific IgE antibody assay can help to identify. Currently, most of the cold medicine products on the domestic market are a combination of oral antihistamines and decongestants, which can relieve nasal congestion while controlling allergic symptoms. Clinically, we can see many patients complaining that they have had a cold for more than a month, and that they get better when they take cold medicine, but they get worse when they don’t. It is very easy to confuse the two. Since cold is a self-limiting disease, if the patient’s “cold” symptoms do not heal in 7-10 days, he should go to the hospital for a specialist examination to exclude allergic rhinitis. So how can we avoid allergic rhinitis? The main thing is to avoid contact with allergens. Professor Ye Shitai summarized four words: avoid, avoid, replace, and move. Avoid: Avoid all suspected or identified allergens, including all allergenic inhalants, foods and contacts. Avoid: Avoid taking or using all suspected or known allergenic foods and drugs; Replace: Replace foods and drugs that may or are known to cause allergies with foods and drugs that have the same or similar effects and are not allergenic. Removal: is to remove the allergen from the patient’s living environment, or the patient is removed from the unfavorable living environment. 1. Keep away from allergens – pollen Pollen species among trees: starts in mid-March and reaches its peak from April to June, the main allergenic pollen is elm, poplar, willow, etc.; grass pollen starts in late July and reaches its peak from August to September, the main allergenic pollen is Artemisia, Gramineae, etc. After identifying allergens, try to reduce outdoor activities in the meantime, wear glasses and masks when possible if unavoidable, and shower promptly after returning home. If you are indoors, close the windows and use air conditioners with air cleaning and filtering functions. 2. Keep away from allergens – dust mites Spring and autumn are the two peak densities of dust mite populations, with higher densities in autumn than in spring. Air-conditioned rooms can reproduce year-round, and bedroom bedding and carpets are the most suitable breeding grounds for dust mites. To reduce the breeding of dust mites, first of all, the bedroom should be kept clean and dust-free, well-lit, with windows frequently opened to keep the air fresh and avoid humidity, and secondly, flooring materials should be easy to clean, such as wood and stone, without carpets. Cleaning and disinfection of bedding: bedding, pillows, clothes, curtains and other diligent washing and sunbathing; bed bedding, etc., the dust, dander and mites, etc. will be exposed to the sun and beat out; about 10 days with 55 ℃ hot water scalding, 100 ℃ hot water can make allergenic protein denaturation, the effect is better. 3, away from allergens – mold control indoor mold and mildew occurrence: first of all, keep the room dry, ventilation to avoid long-term dark and humid, clothing mold as soon as possible to throw away, food reasonable preservation, to prevent mold. If mold is found, immediately disinfect with bleach. 4, away from allergens – pets (1), do not contact pets is the best way, so as to prevent not only the body is allergic, but also to prevent the onset of allergic diseases. (2), can feed animals without fur, such as sea turtles, fish, etc. (3), regularly clean the animal, you can ask someone without allergic diseases to bathe for you. Other treatments, such as medication, immunotherapy, surgery, must be carried out in the hospital, under the guidance of a specialist, just like the friend I mentioned at the beginning, finally in the hospital I removed the polyps through surgery, and then through standardized medication to solve his pain, so it is not terrible to have allergic rhinitis, what is terrible is that you do not know, or even carry out the wrong The “treatment”, of course, the result is the more treatment the heavier, and ultimately will seriously affect their quality of life.