The basic principle: allergic rhinitis is a disease triggered by contact with allergens. The current treatment means are to alleviate or control the symptoms of human allergy to allergens through drugs, not to eradicate external allergens, and only when the cause of allergy should be sought as far as possible and completely avoided is it possible to completely stop attacks. The treatment of allergic rhinitis by one-time eradication and surgical eradication are fundamentally against the principle. For patients who cannot avoid allergens (e.g., fungus) only continuous medication can be used, so it is important to use medication rationally, avoid long-term systemic medication, and prefer topical medication. The following is the WHO (International Health Organization) recommended treatment plan for allergic rhinitis.
1. Avoid contact with allergens.
Try to avoid or reduce contact with allergens, such as: no indoor carpeting, no suede sofas, frequent removal of house dust and bed dust, do not eat suspected allergic food, try not to use insecticides, air fresheners, etc., avoid contact with cigarette smoke, etc. However, because some allergens are ubiquitous and hidden, it is very difficult to avoid them completely.
2.Specific immunotherapy.
Also known as desensitization therapy, it is one of the only treatments for the cause of allergic rhinitis and asthma. The advantages are: ① significant improvement in allergy symptoms; ② significant reduction in the amount of allopathic medication (hormones and antihistamines, etc.) for patients, and even discontinuation of allopathic medication; ③ continuous control of allergy symptoms during desensitization therapy; ④ efficacy that still exists after the termination of desensitization therapy; ⑤ prevention of the occurrence of new allergies and deterioration of the disease (such as effective prevention of allergic rhinitis developing into asthma, or effective prevention of asthma deterioration, etc.).
3. Drug therapy.
Antihistamine usage (cetirizine, loratadine, imipramine, ibastine ……) is used until the histamine-related symptoms disappear. It should not be taken orally for a long period of time, but only for the initial treatment of attacks and control of histamine-related symptoms (nasal itching, sneezing, runny nose etc.).
Nasal glucocorticosteroid usage (Norocort, coleus, mometasone furoate) nasal hormone has significant improvement on all four symptoms, especially on nasal congestion which is more effective than antihistamines, and can be used to prevent the onset of allergic rhinitis. In 2008, nasal hormones were recommended by the World Health Organization as the first choice for the treatment of allergic rhinitis because of their ease of use, precise efficacy, low side effects and long duration of use.
Topical decongestants should be used with caution! (Rhinotec spray, ephedrine nasal drops, nasal drops ……) can effectively improve nasal blockage, but are not effective for other symptoms. These drugs, in general, should not be used for more than seven days in a row, long-term use may lead to irreversible drug rhinitis.
Chinese patent medicines (Genotone, Nasal Abyss Tongkou, Nasal Abyss Shu ……) are used as auxiliary medicines to eliminate mucosal edema, improve nasal ventilation and promote the recovery of mucus cilia function.
4.Surgical treatment.
Surgical operation is only used for those who still have nasal blockage and seriously affect life and workers after regular drug or immunotherapy for a few. The purpose of surgical treatment is to improve ventilation, not to treat allergies. Commonly used methods include radiofrequency treatment of the inferior turbinates and correction of poor nasal framework structure to improve nasal ventilation.
Can allergic rhinitis be cured?
The development of allergic rhinitis depends on the patient’s allergic constitution and the allergens in the environment, one without the other. Allergic constitution is genetically related and the current medical level cannot change the allergic constitution from the genetic level, nor is it possible to remove external allergens. . Atopic immunotherapy is the only “curative” treatment in a sense, as it induces tolerance to allergens to achieve long-term clinical symptom relief and disappearance.
If the treatment is not effective, the first thing to do is to review whether your medication and method are correct and reasonable.
The correct use of nasal glucocorticoids
(1) Spraying method: Spray the right nose with the left hand and the left nose with the right hand.
(2), alternate dosing.
Adjustment of the minimum maintenance dose.
After the symptoms are completely controlled, continue to maintain this dose for 1 month, then reduce the dose to every other day or alternate nasal spray, maintain this dose for 1 month, if the symptoms are still completely controlled, reduce the dose again, such as every other day, every second day, every third day, and so on to maintain the symptoms as the minimum maintenance dose, but do not stop the drug. Discontinuation may be considered for seasonal or intermittent allergic rhinitis. Resistance is usually rare with long-term treatment. The initial treatment regimen may be repeated in case of recurrence.