Allergic rhinitis Allergic rhinitis, also known as allergic rhinitis, is an allergic disease of nasal mucosa, which can cause various complications. The other type is induced by nonspecific stimulation without specific allergens, which is not an immune reaction process, but its clinical manifestations are similar to the above two types of allergic rhinitis, called vasomotor rhinitis or neuroreflex rhinitis. Stimulation can come from in vitro (physical and chemical aspects) or in vivo (endocrine and mental aspects), so some people regard it as allergic rhinitis, but because there is no antigen-antibody reaction, desensitization therapy, hormones or. Etiology: allergic rhinitis can occur at any age, including men and women, and is easy to see in young people. Typical symptoms are itchy nose, paroxysmal sneezing, profuse runny nose and stuffy nose. See a doctor's guide: 1. Understand the etiology of allergic rhinitis and avoid contact as much as possible. (1) Inhalable allergens: such as indoor and outdoor dust, dust mites, fungi, animal fur, feathers, cotton wool, etc. This usually leads to perennial attacks; Plant pollen causes seasonal attacks. (2) Food allergens: such as fish and shrimp, eggs, milk, flour, peanuts, soybeans, etc. In particular, some drugs, such as sulfonamides, quinine and antibiotics, can cause diseases. (3) Contacts such as cosmetics, gasoline, paint, alcohol, etc. 2, when necessary, can do nasal secretion smear examination, allergic provocation test, etc. 3. Desensitization therapy. 4. Drug therapy: including 1. Antihistamine drugs: This kind of drugs include cimetidine, chlorpheniramine and so on. Sodium cromoglycate, 3. Ketotifen, 4. Topical application of steroid hormones has better effects, such as Burke sodium and Renault. 5. Microwave and laser can be used for local treatment to reduce the sensitivity of nerve endings, which is partly effective. 6. Surgical treatment: pterygoid neurotomy or superficial petrosal neurotomy to reduce the excitement of parasympathetic nerves. The latest treatment methods include plasma therapy, please refer to the topic of allergic rhinitis. Allergic rhinitis My father often has a runny nose when he gets up in the morning for more than a year, but not much at ordinary times. Occasionally there will be a little bloodshot. I don't know what to do. Dr Julia from the Department of Otolaryngology, Shanghai Changzheng Hospital is concerned about this problem, which can be regarded as allergic rhinitis. To put it mildly, it's nothing. Winter should be common, but summer is usually nothing, isn't it? Because the climate in winter is dry, the nasal mucosa will bleed a little at night because of dryness. Allergic rhinitis I am 28 years old this year. I have suffered from allergic rhinitis and asthma for more than ten years. There is nothing wrong with asthma now, but rhinitis is really annoying. It's always stuffy and runny. If you don't get it, you will still suffer from insomnia, headache and irritability. It is especially serious when inhaling dust for hygiene. I sneezed dozens of times in a row and my eyes cried. Sometimes it affects work. I have been to many hospitals and used many medicines, such as Biyankang, Biyankang drops and Baiqian Biyan tablets. I have also received laser and cauterization treatment. But it didn't work at all. I started inhaling Berkner a year ago, inhaling it four times a day and spraying it twice each time. It worked well for a while, but I gave up after catching a cold and returned to my previous style. Excuse me, Dr. Ye, is there any good way to treat my problem? Dr Julia, Department of Otolaryngology, Shanghai Changzheng Hospital: Allergic rhinitis is caused by your allergic constitution, so it can't be cured in theory, but it can be controlled with proper medication. Berkner This medicine is specially used to treat allergic rhinitis with asthma, so you used the right medicine. In addition, you can also use traditional Chinese medicine granules such as Qin Xin granules as conditioning. Use it when you find the right medicine, and find a new medicine when it doesn't work. Fortunately, new drugs for allergic patients come out almost every year. Talking about allergic rhinitis A mother wrote that her son 18 years old is in the third grade of high school. At the turn of spring and summer every year, people suffer from allergic rhinitis, often sneezing, a lot of runny nose, and stuffy nose at night, which makes it difficult to spread. My son has been suffering from allergic rhinitis since he was 3 years old. As he grew older, his symptoms became more and more serious. He received medication this year, but now many drugs don't work. She is worried that her son's allergic rhinitis attack will seriously affect the college entrance examination preparation. She is very anxious and wants to tell her the causes of allergic rhinitis and the ways to alleviate it. After receiving her letter, I wrote back and told her that we should do more household cleaning before and after the Spring Festival, keep the air circulation at home in winter, and then cut off contact with the cause of allergic rhinitis. This may reduce the attack of allergic rhinitis and do more physical activities to relieve the symptoms of rhinitis. Allergic rhinitis, also known as allergic rhinitis in medicine. Why can allergic rhinitis occur? Let me start with the physiological function of the nose: 1. The physiological function of the nose is the passage of air in and out. Its main function is to filter, moisten and warm the inhaled air, and clearly inhale particles with a diameter greater than 10UM. However, even substances as small as 2UM can be filtered out when passing through the nasal cavity. Generally speaking, the bigger and heavier the particles, the faster the filtration and deposition on the nasal mucosa. In addition, the nose has special olfactory nerve to provide sense of smell. The response of nasal mucosa to external stimuli is mainly manifested in four aspects: obstruction of airflow caused by nasal congestion, runny nose, sneezing and nasal itching caused by increased secretion of nasal mucosa. ① Nasal congestion is caused by mucosal congestion and edema, increased viscous secretion or adenoid hyperplasia; ② When the local nerve endings are stimulated, the central nerve will reflexively cause sneezing; ③ Increased secretion, runny nose and sneezing are simple and important nasal reflexes. Any irritation to the nasal mucosa, including allergic, autonomic and psychological factors, may lead to runny nose and sneezing, which helps to eliminate foreign bodies. ④ Nasal itching is caused by inflammatory mediators, such as histamine released by mast cells and basophils. In addition, S-IgA secreted by nose can inactivate virus, and its solution can prevent bacteria from invading. If microorganisms have invaded, they are mainly eliminated by phagocytosis and immune response. Second, the cause of allergic rhinitis It is now known that allergic rhinitis is caused by the combination of allergic children exposed to allergens (mainly inhaled allergens (such as dust mites, fungi, pollen, etc.). ) and specific IgE that has combined with mast cells, eosinophils, platelets and other cells, causing these cells to release real disease vectors, thus causing nasal mucosa inflammation. The inflammatory process includes the infiltration of inflammatory cells, eosinophils and neutrophils, the release of primary and secondary solid media such as histamine, LTS and PG, and the early and late reactions caused by the activation of eosinophils. The local tissue showed vasodilation, edema and increased secretion of soft tissue in nasal mucosa. Dust mites, animal dander and food are the most common allergens that induce nasal allergy within one year old, and pollen is usually induced after three years old. Mites in house dust are very easy to breed on beds, dead corners of houses, carpets and other places. Children crawl on the bed or carpet and inhale a lot of allergens to induce or aggravate diseases. Babies often catch a cold in winter, which is probably allergic rhinitis caused by dust mites. Indoor animal dander and saliva can induce allergic symptoms, and even if animals are removed for up to 6 months, animal-related allergens will still play a role indoors. Among infants and young children, eggs and milk are the most common nasal allergic reactions caused by food, but eating allergic foods is generally accompanied by other organ system symptoms, such as measles, swelling of face and lips or bronchospasm. However, people who only have nasal allergy symptoms are rarely caused by food. In addition to pollen, there are also some irritants that will aggravate the symptoms of allergic rhinitis. These irritants include perfume, smoke, paint, newspaper ink, deodorant or other sprays, and pollutants in the air (sulfur dioxide, carbon monoxide, nitrogen dioxide, ozone, etc.). ). Third, classification From the perspective of onset duration, allergic rhinitis is often divided into the following categories: 1, seasonal rhinitis. Pollen is the most common cause, and the types of pathogenic pollen vary with time and place, and are generally more common in spring and/or autumn. Fungi is another important reason. This kind of rhinitis has an acute onset, severe symptoms, paroxysmal sneezing, itchy nose, a lot of watery nose and stuffy nose. Often accompanied by conjunctivitis, sometimes accompanied by measles and asthma. 2, perennial rhinitis. The so-called perennial means that symptoms last for more than 9 months every year, mostly caused by indoor allergens, such as dust mites or their feces. Although the symptoms are perennial, when mites breed, the patient's condition will deteriorate, and the severity of symptoms varies from day to day. Generally, the bedroom is the heaviest because there are the most dust mites. At night, nasal congestion leads to nasal congestion, and sneezing continues in the morning. The situation often gets worse when children play with pillows or touch other dusty bedding. Animals at home, especially cats and dogs, are another important cause of perennial rhinitis. Perennial rhinitis rarely sneezes in the morning, and symptoms of conjunctivitis rarely appear. Perennial rhinitis will also worsen seasonally, which is probably the reason why patients are allergic to indoor and outdoor allergens at the same time. 3, intermittent rhinitis. Occasional contact with allergens, such as contact with dust storage rooms and study rooms, or contact with other people's cats and dogs, can lead to sudden attacks and intermittent attacks. Nasal mucosa is an extension of nasal mucosa. Therefore, any allergic inflammation of the nose may spread to the sinuses. In the past, people thought that the sinus developed late, so there were fewer complications in infants. But in fact, ethmoid sinus and maxillary sinus can be seen in the third and fourth months of the fetus, and they already exist at birth. Frontal sinus can be seen from 6 to 12 months after birth, and sphenoid sinus appears later, about three years old. Therefore, sinusitis may occur over 1 year. Because of the small sinus outlet and poor drainage, it is easy to get secondary infection. Four. Incidence and clinical manifestations The disease can occur at any age, including infancy, and most patients appear before the age of 20. This is a common disease. According to domestic and foreign literatures, as many as 65,438+00% children and 20% teenagers suffer from perennial rhinitis, most of which are allergic rhinitis. About 75% of children with asthma also suffer from this disease. Because people with nasal congestion have to breathe through their mouths, they inhale more allergens directly from their mouths, which makes asthma worse. There is no gender difference in the incidence of allergic rhinitis. Its pathogenesis is related to genetic factors, environmental factors and allergen exposure. Sneezing, itchy nose, runny nose and stuffy nose are the four most common symptoms. Sneezing is the most important thing in the morning and when you wake up. Older children sneeze more than five times at a time. When the nasal congestion is serious, open your mouth to breathe and clear your throat, because nasal discharge to the nasopharynx at night will lead to repeated coughing. Nasal congestion often changes with the change of body position. For example, lying on the left side leads to left and right nasal congestion, while lying on the right side leads to right and left nasal congestion, which is a characteristic manifestation of rhinitis. It can be seen that children constantly wipe the front of the nose with their fingers or palms, which is called "allergic grooming". There are a few children who often make strange actions such as crooked mouth and shrug their noses because their noses are itchy. Older children complain of a lack of sense of smell. Snuff is clear as water, and it can also be thickened by nasal congestion or secondary infection. Children can also see gray-blue annular shadows and wrinkles under the orbit, which are called "allergic coloring" or "Dennie—Mergan suborbital wrinkles". This is caused by periorbital edema and venous stasis, and it is also a characteristic manifestation of atopic children's eye and nose allergy. Eye symptoms, including itchy eyes, are more common in animal allergens and seasonal pollen, and children usually have a family history of allergic reactions. Internal examination of the nasal cavity showed edema of turbinate, usually called white or purple, covered with a thin layer of watery mucus. In severe cases, swollen turbinates can completely block the nasal passages. V. Treatment of degenerative rhinitis (1) Non-drug treatment 1. Avoid allergens and irritants. Children spend more than half their time in the bedroom, so we should change the indoor environment, remove animals, clean furniture, don't lay carpets, and don't buy plush toys to reduce pathogenic allergens and irritants. Installing air conditioners is especially useful for people who are allergic to pollen. Windows can be closed all summer to prevent pollen from entering, and dry air will aggravate nasal congestion in winter. The relative humidity should be kept at about 40%-50%. If it is caused by a certain food, you should completely avoid touching the food. 2, steam inhalation or salt water atomization inhalation. Steam can temporarily relieve nasal congestion and increase airflow. Salt water can dilute viscous secretions, improve the sense of smell, remove allergens from the nose and relieve symptoms, and also reduce the blood flow in the nose, so it can be used as a mild blood-lowering drug. And both can prevent dry mouth. 3. Exercise. Exercise can reduce nasal airway resistance and enhance physical fitness. (2) Drug therapy For many patients with allergic rhinitis, it is not enough to use one drug to eliminate symptoms, which requires a variety of treatment methods. Antihistamine drugs are the first choice, which can inhibit sneezing, itchy nose and runny nose caused by histamine. Congestive agents, such as pseudoephedrine and metazoline, should be supplemented for nasal congestion. If it is chronic, because the local mucosa has been inflamed (allergic inflammation), anti-inflammatory drugs should be used, and local corticosteroids can reverse the existing inflammation. Sodium cromoglycate can prevent nasal symptoms. Generally speaking, injecting corticosteroids into the turbinate is not recommended because there are some reports that there is a risk of vision loss. (3) Other therapies 1, immunotherapy. Originally called desensitization therapy, it was later found that the body of effective cases would undergo immune changes after treatment. Caused by a small amount of pollen, other methods are ineffective and can be applied to strictly selected patients. Immunotherapy is not to cure allergic rhinitis, but to obviously improve the symptoms of 80%-85% patients. Children younger than 5 years old should not use it because of skin complications caused by continuous injection. 2. Surgical treatment. Surgical resection is not a radical method for this disease, but it can be used as an auxiliary treatment, such as nasal septum distortion. The effect of cryotherapy is also temporary. 3. Chinese medicine therapy. Acupoint sticking therapy is an external therapy that combines acupoints with drugs and gives full play to the specificity of acupoints and drugs. This method is simple, effective and widely used in clinic. The basic prescription of medicine is Xiaochuan ointment. The timing of treatment is based on the principle of "treating winter diseases in summer", and it is treated every 1 time in early summer, middle summer, late summer (dog days) or Xia Hou, and generally three times is a course of treatment. We need to hold on 1-3 years. The mechanism of action is that the application therapy mainly regulates the immune function and endocrine function of the body, and has certain anti-inflammatory, reducing airway hyperresponsiveness and improving lung function, thus preventing and relieving the symptoms of allergic rhinitis.