Autumn is in a hurry, and with it, the number of patients with allergic rhinitis has surged. Many patients will consult a variety of questions, but due to the limited outpatient time, doctors often cannot communicate effectively with patients. The most common questions will be summarized and answered below for your reference.
1. I have been sneezing continuously and clearing my nose for more than 1 week. Is it because of a cold?
Many patients will say, "Doctor, I have been having a cold for a long time, and it is not good to take any medicine."
After a careful question, it turned out that their symptoms were sneezing, clearing the nose, and some people may also have symptoms such as sore throat, itchy eyes, and even mild fever. Many people think they have a cold, but similar symptoms of a cold usually last only 3 to 5 days. Therefore, when sneezing and clearing of nasal discharge for more than 1 week does not relieve it, you should go to the ENT department to check whether it is allergic rhinitis.
Some people will ask: "Doctor, don't fool me. My symptoms will be cured as soon as I take cold medicine. If I stop the medicine, I will suffer. Why isn't this a cold?" Our common cold medicines include ingredients similar to primmin . It is actually an anti-allergic drug. It is completely reasonable for patients with allergic rhinitis to improve their symptoms after taking them.
In a word, sneezing and clearing of nasal discharge may not be a common cold, but may also be allergic rhinitis.
2. Why do you suffer from rhinitis in spring/autumn every year?
Allergic rhinitis is divided into two types: seasonal and perennial, and seasonality is divided into spring allergies and autumn allergies.
Spring allergies usually start around March 20, and autumn allergies usually start around August 7th. Perennial allergic rhinitis is not obviously seasonal, and may occur when you wake up in the morning, encounter cold and cold air or dust.
3. Should I check for allergens?
Some patients said: "Doctor, I don't want to check allergens because I think it's not cured, and it's useless if I check it."
Currently, there are two most commonly used methods for testing allergens in the clinical practice of otolaryngology:
Skin prick test : Local pricks of allergens are performed on the skin of the forearm, observe the size of the pichu, and screen for possible allergens. This method is relatively convenient, and results can be obtained in 30 to 40 minutes of outpatient examination. The advantage is that the examination is convenient and has high sensitivity; the disadvantage is that it is easily affected by drugs. It is generally recommended that patients need to stop the medicine for 1 week before they can undergo the examination.
serum IgE detection : blood draw to test various allergens. The advantage is that the results are specific and are not affected by drugs; the disadvantage is that blood collection is required on an empty stomach, the waiting time for the test results is longer, and the test sensitivity is not as good as the skin prick test.
Then why do these checks?
has several reasons: First, you can find the types of allergens and determine whether they are seasonal or perennial allergies; second, avoid possible allergens in life, such as animal hair; finally, for certain special types of allergens, such as dust mites, desensitization treatment can be performed.
4. How can patients with allergic rhinitis spend the spring and autumn smoothly?
Outpatient clinic encountered a patient who had been treated last year and came to the hospital again this year. As soon as they met, they felt bitter: "This disease occurs every year, it is too painful!" Indeed, it is recommended that patients start using anti-allergic drugs one week before the onset of symptoms in March every year. In this way, when the pollen concentration increases, the nasal drug reaches the onset concentration at the same time, which can effectively relieve the symptoms.
5. What are the common drugs used to treat allergic rhinitis?
Oral Anti-allergic drugs : loratadine , cetirizine hydrochloride , montelukast sodium tablets, etc. The first generation of antihistamine drugs, such as Xismin, have obvious drowsiness and effects, and have now gradually withdrawn from clinical frontline medication.
Nasal spray: hormones include budesonide nasal spray, fluticasone propionate nasal spray and mometasone furoate nasal spray, while non-hormonal ones are mainly azetstin hydrochloride nasal spray.
6. Is nasal spray hormone really that scary?
Many patients feel chilled when they hear nasal spray hormone and think they don’t use it. Especially when children are allergic, parents are particularly resistant to it. In fact, nasal spray hormone is relatively safe in clinical practice. For example, the age of using mometasone furoate is 3 years old, while the age of using nasal spray drugs that are not hormones is 12 years old. It goes without saying which of the two is safer. In addition, compared with oral drugs, the advantage of nasal spraying is that it has high local drug concentration and less systemic absorption, so it is better to have safety.
7. Is Chinese medicine effective?
It is recommended that patients with allergic rhinitis should follow the doctor's advice and should not take medicine blindly by themselves. Nothing has been heard of as long as possible which Chinese medicine or patent medicine can cure allergic rhinitis.
8. What is desensitization treatment?
If the allergen test indicates that the dust mite result is positive, then desensitization treatment can be considered. The principle is to start injection from the minimum concentration of allergen (or take sublingually), so that the body's immune system gradually accepts a certain type of allergen without causing allergic reactions. The treatment time is about 1 and a half years to about 2 years.
Co-author of this article/Zeng Jin (Deputy Chief Physician of the Department of Otolaryngology, Third Hospital of Peking University)
Edited/Shaguo
Original article, please do not reprint
