Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa that is caused by IgE-mediated mediators of atopic individuals exposed to allergens, mainly histamine release, and involved in a variety of immunologically active cells and cytokines, with nasal itching. , Sneezing, nasal hypersecretion, and swelling of the nasal mucosa are the main features. Although allergic rhinitis is not a serious disease, it can affect the daily life, study and work efficiency of the patient, and cause a heavy burden on the economy. It can induce bronchial asthma, sinusitis, nasal polyps, otitis media, etc., or be related to allergies Conjunctivitis occurs at the same time.
Classification of allergic rhinitis diseases
1. the Perennial allergic rhinitis
It means that the symptoms of allergic rhinitis last for more than 9 months every year, and are mostly caused by indoor allergens, such as dust mites or their feces. Although the attacks are perennial, the severity of symptoms varies among patients throughout the day.
2. Seasonal allergic rhinitis
The disease begins to occur every pollen season, and the onset season is basically the same every year.
What is the main cause of allergic rhinitis?
Allergen
Inhalation of allergens, indoor allergens mainly include dust mites, animal fur or allergens derived from plants, etc.; outdoor allergens include pollen.
Genetic factors
Allergic disease is a chronic development process and is related to heredity. From a clinical point of view, patients with allergic rhinitis often have an obvious family history. In addition, this genetic phenomenon is more obvious in single-fertilized twins than double-fertilized twins, and children with certain genes may be particularly sensitive.
Envirnmental Factor
Air pollution, outdoor pollution mainly comes from motor vehicles and air pollution components, such as ozone, nitrogen oxides and SO2. Indoor pollution mainly includes formaldehyde and toluene.
Infectious factors, that is, the increase in allergic diseases is the result of the decrease in infectious diseases. The theoretical basis is that bacterial infection or contact with bacterial products stimulates the response of T-helper type 1 cells, thereby producing a reaction force that inhibits Th2, so as to reduce the incidence of allergic diseases and asthma. In addition, reports have found that viral infections can also produce similar effects.
What’s the common people with allergic rhinitis?
Deviated nasal septum
Due to the abnormal physiological structure, the normal function of the nasal cavity is restricted and it is prone to allergic infection.
People with a family history of allergies
Most of the patients’ families have a history of asthma, urticaria or drug allergy. In the past, this patient was called an atopic individual, and his body’s ability to produce IgE antibodies was higher than that of normal people.
Poor occupational living environment, long-term or repeated inhalation of dust.
The antigenic substance that stimulates the body to produce IgE antibodies is called allergen. The allergenic substance re-enters the nasal mucosa and then combines with the corresponding IgE to cause an allergic reaction.
Complications of allergic rhinitis
Bronchial Asthma
Allergic rhinitis is an independent risk factor for asthma attacks, and 40% of patients with allergic rhinitis will develop asthma. Allergic rhinitis and bronchial asthma have many similarities in epidemiology and pathological changes. Bronchial asthma can occur at the same time as allergic rhinitis, but most of them occur after rhinitis, and the symptoms of rhinitis are significantly reduced after the onset. Sometimes it only manifests as chest tightness and cough, which is another type of asthma.
Allergic pharyngitis
Allergic pharyngitis mainly manifests as itchy throat and cough, and may also have mild hoarseness.
Allergic conjunctivitis
When patients with allergic rhinitis are accompanied by allergic conjunctivitis, they may have symptoms such as itchy eyes, watery eyes, and red eyes. Especially in patients with seasonal allergic rhinitis, the incidence of allergic conjunctivitis can be as high as 85%. The survey shows that the incidence of ocular symptoms in patients with allergic rhinitis is 32% to 59%. The diagnosis of allergic conjunctivitis is not difficult, but it should be distinguished from other common conjunctival lesions.
Upper respiratory tract cough syndrome
Allergic rhinitis and sinusitis are common causes of chronic cough in children and adults. Nasal secretions flow back from the nose and throat, and direct or indirect irritation can cause coughing. Upper respiratory tract cough syndrome is most frequently associated with allergic rhinitis.
What is the treatment of allergic rhinitis?
1. Avoid contact with allergens
(1) Reduce the number of dust mites indoors; maintain the relative humidity of the living space below 60%, but too low (such as less than 30%-40%) will cause discomfort; clean carpets; clean bedding, curtains, and mite allergens Soluble in water, washing textiles can remove most of the allergens; use air purifiers, vacuum cleaners, etc. with filters.
(2) Corresponding pollen allergy season, avoid allergens.
(3) Patients who are allergic to animal fur avoid allergens.
2. Medication
The following factors should be considered: efficacy, safety, cost/effect ratio, etc. Intranasal and oral administration are commonly used, and the efficacy may vary between different patients. There is no long-term sustained effect after stopping the drug, so maintenance treatment is needed for persistent allergic rhinitis. Prolonging the treatment time does not develop rapid drug resistance. Intranasal administration has many advantages. High-concentration drugs can directly act on the nose, avoiding or reducing systemic side effects. However, for patients with other allergic diseases, drugs need to act on different target organs, and intranasal administration is not the best choice. Systemic drug therapy is recommended. Patients during pregnancy should use various drugs with caution.
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