Many patients with bronchial asthma also have allergic rhinitis, and there is a clinical consensus that “the same airway, the same disease”. However, there are still many asthma patients who do not know they have rhinitis at the same time, although they do have symptoms such as sneezing, runny nose and nasal congestion, but if the doctor does not mention it, the patient may ignore it. Therefore, when dealing with bronchial asthma patients, respiratory physicians should take the initiative to ask patients whether they usually have symptoms of allergic rhinitis, and if so, they should treat them at the same time, which is of great significance to the patients. Allergic rhinitis and bronchial asthma are symbiotic, not separate diseases, but “one airway, one disease (total airway metaplasia)”, a syndrome manifested in two parts of the respiratory tract. Asthma can be fatal in severe cases, and it is often shown in TV shows and commercials, and promoted by doctors, so patients have a deeper impression of asthma and pay more attention to its treatment. On the contrary, in the patient’s opinion, allergic rhinitis is at most an unpleasant nose, which is not a big problem, so they do not take it to heart. This is a serious misconception. Research has proven that effective treatment of allergic rhinitis (nasal hormones or antihistamines) can significantly reduce the severity and frequency of acute exacerbations of bronchial asthma. There is also a subset of patients who may have only allergic rhinitis and no asthma, which is more likely than the normal population to develop asthma and requires attention. If necessary, pulmonary ventilation function tests can be completed to assess the presence of concomitant bronchial asthma. How to treat both? We need to treat patients with allergic rhinitis – bronchial asthma as a whole and treat both rhinitis and asthma at the same time. The most important drug for asthma treatment is inhaled hormone, which needs to be treated according to the ladder approach for asthma treatment, with inhaled hormone combined with long-acting β2 agonist preferred for severe cases; while the treatment of allergic rhinitis should also follow the ladder approach, with antihistamines and glucocorticoids being used in order of treatment from mild to severe, with antihistamines (oral or nasal) preferred for mild rhinitis and nasal hormones for moderate to severe cases. In mild rhinitis, antihistamines (oral or nasal) are preferred, while in moderate to severe cases, nasal hormones are preferred. Currently, glucocorticoids and leukotriene receptor antagonists are used to treat both bronchial asthma and allergic rhinitis with clear efficacy. Commonly used glucocorticosteroids include budesonide, fluticasone, tretinoin, mometasone, etc. Inhalation preparations are preferred. Commonly used inhaled hormones (or containing hormone ingredients) for the treatment of bronchial asthma include: salmeterol ticarbone powder inhaler, budesonide formoterol powder inhaler, budesonide aerosol, fluticasone propionate inhalation aerosol, etc. The intranasal hormones commonly used in the treatment of allergic rhinitis include budesonide nasal spray, fluticasone propionate nasal spray, mometasone furoate nasal spray, tretinoin nasal spray, etc. In addition, there are antihistamines for the treatment of allergic rhinitis. These drugs are mainly used for patients with milder conditions, such as loratadine, cetirizine, ketotifen and paracetamol, but these drugs are not very helpful for the treatment of asthma and need to be noted. Moreover, the first generation antihistamines such as ketotifen and paracetamol have significant adverse effects of drowsiness. Most of the above drugs are domestically produced and imported, and it is generally believed that imported drugs (original drugs) have better efficacy and high price; while domestically produced drugs (generic drugs) have relatively poor efficacy and low price; however, many times it is not necessary to choose imported drugs, for example, if the symptoms of rhinitis are not very serious, you can try domestically produced ones, and then consider imported drugs if the efficacy is not good. However, salmeterol ticlosone powder inhaler and budesonide formoterol powder inhaler for asthma treatment are only imported drugs (trade names are Shuriday and Shinbiq), and there are no generic drugs in China yet. Leukotriene antagonists mainly include montelukast and zallust. These drugs are important drugs for the treatment of moderate to severe allergic rhinitis, especially for patients with airway hyperresponsiveness and bronchial asthma, and are often used in combination with nasal spray or inhaled glucocorticoids. Patients with asthma in combination with rhinitis may be treated with intranasal hormones (such as budesonide or fluticasone) or antihistamines, or oral montelukast tablets, in conjunction with asthma control therapy (e.g., with sulforaphane or Cymbalta). When nasal spray and inhaled glucocorticosteroids are used together, initial therapy should be at the usual recommended doses for the respective diseases, with attention to possible adverse effects associated with the combination, especially in pediatric patients. This is especially true for pediatric patients. In some cases, patients who are on both inhaled airway hormones and nasal hormones find it troublesome and their compliance is not good. In this case, we should fully explain the patient’s condition and explain the need for such treatment, or depending on the condition, we can replace the nasal hormones with oral leukotriene receptor antagonists or antihistamines. How do I educate my patients? The course of treatment for asthma and rhinitis needs to be clearly explained to the patient, because at present both diseases (which are actually one and the same) are not completely curable. The course of treatment for bronchial asthma is uncertain, but it is generally believed that the medication should be adhered to for a long time, and the dosage can be gradually reduced or even discontinued according to the condition, which can be referred to the guidelines for the prevention and treatment of bronchial asthma. …… The course of nasal hormone therapy is at least 4 weeks. This must be corrected, especially in the case of asthma, where the medication must be administered regularly. The specific course of treatment should be adjusted at the clinician’s discretion according to the actual situation.