Hello, audience friends! This is the live program of CCTV's Road to Health. Today we will talk about the treatment of allergic rhinitis in spring.
Moderator: Spring is the time when people go out to enjoy the sunshine, but some people can't go out because of allergies. Why?
Wang: With the coming of spring, patients with allergic rhinitis mean the beginning of pain, because with the blooming of spring, the air is full of pollen, and many patients are allergic to pollen. Once you touch it, you will sneeze, have a runny nose and have a stuffy nose. This seasonal allergic rhinitis is called hay fever. In addition to the onset in spring, there are patients who develop the disease all year round. The allergens of these patients are related to dust, animal fur and various foods. This kind of rhinitis is called perennial allergic rhinitis.
Moderator: Why do these people have allergic symptoms?
Xiao Shuifang: 1, the patient's own factors are called allergic constitution, which may be brought by himself or acquired; 2. There are a lot of allergens in the environment, including pollen and dust. Allergic rhinitis will have a series of reactions after inhaling allergens.
Patient: The symptoms are obvious in spring, mainly because I am allergic to dust. Especially when books are opened for a long time, I will be very allergic to that kind of dust. After smelling it, you will sneeze continuously, clear your nose and sometimes have a stuffy nose.
Patient 2: Itching. My nose was particularly uncomfortable at first. I can probably sneeze 10 times in a row and then start clearing my nose. I have to stay away from places with lots of pollen and can't go to places with flowers.
Moderator: Are sneezing and runny nose the main symptoms of patients with allergic rhinitis?
Wang: The most typical thing is sneezing continuously, hitting more than 3 times or even 10 times at a time, and then there will be a clear-water runny nose, stuffy nose, itchy nose and tears in your eyes.
Moderator: After these symptoms appear, can you judge that you have allergic rhinitis?
Xiao Shuifang: No, besides these symptoms, there will be other diseases, such as vasomotor rhinitis. Patients with these symptoms are advised to go to the hospital to find a special doctor for examination.
Moderator: Is there any cure for allergic rhinitis?
Wang: The treatment of allergic rhinitis is divided into three parts: 1, drug treatment; 2. Immunotherapy mainly refers to allergen desensitization therapy; 3. Surgical treatment and other auxiliary treatment.
Moderator: What is antiallergic desensitization therapy?
Xiaoshuifang: Extract the effective components of allergens and inject them into patients, and gradually increase the dose from low dose to make patients gradually adapt to allergens. Finally, when the patient encounters the allergen again, there will be no symptoms, or the symptoms will be very mild. If they often take anti-inflammatory drugs, the effect will not be very good after a period of time, because bacteria have developed tolerance to anti-inflammatory drugs.
Moderator: How do patients choose treatment methods?
Xiao Shuifang: Patients should avoid contact with allergens as much as possible, but it is more difficult because pollen is everywhere. Patients with mild symptoms are advised to take antihistamines, and patients with severe symptoms are advised to add steroids. Local decongestion, combined with freezing, microwave and laser treatment will be better. If the effect is still not good after using the above treatment methods, it is recommended to go to the hospital for detailed examination. Whether there are nasal polyps, sinusitis, congenital or acquired nasal septum deviation is necessary in some cases. Patient 1: I spray Berkner about 20 days in advance every spring and autumn, and then I take kemineng, which is very effective. I don't sneeze much, but I also pay attention to controlling my nose and not going to places with a lot of pollen. It's good.
Patient 2: Allergic rhinitis has occurred frequently for such a long time, especially in the later period. Almost every day, Lacrimosa has a runny nose and tears. Colleagues around me seem to be miserable all day, and everyone cares about and even affects their work. So after going to the hospital, the doctor found that besides allergic rhinitis, there was nasal septum deviation. After the diagnosis, he suggested surgery. At first, I felt that a simple allergic rhinitis could not be serious enough to require surgical treatment. Later, after the doctor explained, I was able to.
Moderator: Will long-term use of hormone spray have side effects?
Xiao Shuifang: Hormone drugs have been used clinically for many years, with obvious effects and small side effects, and can be used for a long time.
Moderator: Why does the second patient need surgery?
Xiao Shuifang: This patient has a deviated nasal septum and needs surgery. Deviation of nasal septum: people have two nasal cavities like two rooms with a partition in the middle. If this partition deviates, it is nasal septum deviation, which is a pathological state. If the pathological state is not treated, allergic rhinitis is difficult to treat. For this kind of patients, it is recommended to do endoscopic surgery, and the treatment effect is good.
Moderator: Do other conditions also require surgical treatment?
Xiao Shuifang: Surgery is necessary if the drug treatment effect is not good, such as rhinitis ventilation and turbinate hypertrophy, and the postoperative effect is very good. There are also cases of rhinitis with sinusitis and nasal polyps. The treatment time is long and the drug treatment effect is not obvious. As shown in the figure: left: normal nasal cavity, right: allergic patients such as nasal polyps and sinusitis, such as nasal polyps: Figure 1: normal nasal cavity, Figures 2 and 3: nasal polyps, Figure 4: polypectomy.
Patient: My nose often sneezes. At first, sneezing wasn't that bad. When I sneezed, I sneezed four or five times in succession. It got worse and worse. To what extent, I live on the fifth floor and want to sneeze at the 1 building, but my vocal cords hurt. It got worse and worse. After repeated bleeding, I went to the otolaryngology department to see a doctor. Director Wang said that I had sinusitis. This is my situation.
Moderator: Is this patient's condition getting worse and worse because he didn't get timely treatment?
Wang: This patient started with allergic rhinitis and later developed into allergic fungal sinusitis. This kind of situation must be operated, and the effect is very good after the operation.
Moderator: Mr. Feng from Henan, I am an allergic rhinitis patient. Usually busy, often on business trips, can not be systematically treated. Is there a specific medicine that can cure the disease at one time?
Xiao Shuifang: No medicine can cure rhinitis at one time. There are good methods to improve the symptoms of patients with allergic rhinitis. The treatment of rhinitis is a gradual process.
Moderator: Can Mr. Ren allergic rhinitis in Liaoning be eradicated? Will it become malignant without treatment?
Wang: Allergic rhinitis cannot be eradicated. Active treatment can obviously relieve symptoms without getting sick. Although allergic rhinitis will not become malignant, it is recommended to go to the hospital for timely treatment when recurrent episodes are accompanied by nosebleeds.
Moderator: Ms. Yuan from Yichang heard that there is an allergen desensitization needle that can cure allergic rhinitis. Is it effective?
Xiao Shuifang: This method is more effective. Our hospital has treated 5000-6000 patients with this method, and the effect is good. We can desensitize repeatedly until the symptoms are relieved.
Moderator: Mr. Hu of Xuzhou has been treating rhinitis with a medicine for a long time. Will it produce drug resistance like anti-inflammatory drugs?
Wang: The drugs used to treat allergic rhinitis are not as resistant as antibiotics, but it is often seen in clinic that the effect is good when starting to use a drug. After a period of time, the effect is not obvious because different treatment methods are chosen with the different stages of the disease development. It is recommended to go to the hospital for examination and choose the treatment method that suits you.
Moderator: What are the drugs for treating allergic rhinitis?
Wang: The most common drugs: antihistamines: loratadine and terfenadine, and topical steroid drugs: bock sodium, levofloxacin, NeiShu Da and Raynaud's point.
Compere: Are the side effects of these drugs great?
Wang: There are some side effects. The first generation of antihistamines had symptoms of dry mouth and drowsiness, but the second generation of antihistamines no longer had these symptoms. Long-term use will lead to cardiovascular complications. Long-term use of steroids (hormones) is not good for heart disease, diabetes and hypertension, but as long as the drugs are used properly, there will be no problem.
Moderator: Ms. Yunnan Tian, I sneezed repeatedly, and my nose was itchy and clear, but I had an allergic skin test in the hospital and the result was negative. Can allergic rhinitis be ruled out?
Xiao Shuifang: Not excluded. Intradermal injection of allergen cortex will not cause systemic reaction.
Moderator: Mr. Yuan from Shanxi, my wife and daughter both have allergic rhinitis, which occurs during the season exchange and is accompanied by bronchial asthma. what can I do?
Wang: In one case, they are allergic to pollen in spring, summer and autumn. On the other hand, it is not allergic rhinitis, but common rhinitis or sinusitis and vasoconstrictive rhinitis in winter or alternate seasons of winter and spring. It is recommended to go to the hospital for examination. Bronchial asthma is common. It is a disease, but it is not the same as allergic rhinitis. These two diseases can be treated together.
Moderator: How to treat asthma complicated with allergic rhinitis?
Wang: Use local steroid drugs in advance before the spring, and the symptoms can be completely controlled after long-term use. The effect of using drugs in advance is better than after the attack.
Moderator: Teacher Chen from Jiangsu, is it inevitable that allergic rhinitis will cause asthma, and will ephedrine nasal drops produce drug resistance?
Xiao Shuifang: Allergic rhinitis does not necessarily cause asthma. Only 20-30% of patients will cause asthma. Patients with allergic rhinitis should be treated in time. Ephedrine is resistant to long-term use, so it is not suitable for long-term use.
Moderator: Ms. Zheng from Beijing, I have allergic rhinitis. I have a runny nose, sneezing and tears in spring. The effect of taking antiallergic drugs is not obvious. The effect of microwave treatment is only 1 month. What should I do? Will it be passed on to my son? What should I pay attention to?
Wang: Choose different treatment methods at different stages of the disease, and the symptoms will not be relieved after standardized treatment. Are there any other diseases? Consider surgery. Inheritance is very obvious, 1, genetic factors, family tendency; 2. Environmental factors, such as environmental pollution; 3, drugs, diet allergies.
Xiao Shuifang: The inheritance is very obvious. For example, a pair of twin brothers, one of whom has allergic rhinitis, and the other will definitely have it. Mother has allergic rhinitis, so does her son.
Moderator: Mr. Mou from Yunnan, my child 10 years old. He often rubs his nose and sucks it, but he doesn't sneeze much. He was accompanied by asthma when rhinitis broke out. How to treat it?
Xiao Shuifang: It is recommended to go to the hospital to diagnose allergic rhinitis. Asthma can be treated with drugs.
Moderator: Ms. Xu from Ningxia. My mother has allergic rhinitis, polyps and sinusitis. She had an operation. How should she insist on treatment now?
Wang: At present, endoscopic sinus surgery is generally used to treat nasal aspiration and sinusitis. Before endoscopic sinus surgery, medication is needed. After endoscopic sinus surgery, it is necessary to visit once a week in the first month, once every two weeks in the second month and once every six months to ensure the ideal effect of the operation. Endoscopic surgery greatly reduces the recurrence rate of allergic rhinitis.
Xiao Shuifang: Allergic rhinitis is the primary disease, and antiallergic treatment is needed after surgical treatment.
Moderator: Does Mr. Wang in Jilin need anesthesia for surgery? Will it affect the brain?
Xiao Shuifang: Narcotic drugs are needed. There are two kinds of anesthesia: 1, local anesthesia, and 2, general anesthesia, which will not affect the brain.
Moderator: Just now, many patients asked about the treatment, but sometimes they didn't follow the doctor's instructions. What should I do?
Xiao Shuifang: A patient came to the hospital and said that the cold symptoms had been bad. They asked the doctor to prescribe some medicine for treating a cold, but after the doctor checked, the patient developed typical symptoms of allergic rhinitis. After we treated according to this situation, the patients' symptoms were obviously relieved.
Moderator: Is there any way to prevent the onset of allergic rhinitis in advance?
Wang: It is very difficult to prevent allergic rhinitis. Patients with severe symptoms can choose avoidance therapy, such as staying indoors and wearing a helmet, but this method is not suitable for most patients. The best way is to take medicine in advance. If you are very sensitive to allergens, desensitization therapy can be used.
Moderator: Ms. Lu from Tianjin heard that allergic patients often avoid talking about it. Can't you eat seafood and beef and mutton?
Xiao Shuifang: No, if you have diarrhea, stomachache and rash after eating a certain food, you may be allergic to this food. You can go to the hospital for a food allergy test. If you are really allergic to this food after the test, don't eat it. Other foods can be eaten.
Moderator: My son in Hunan is 6 years old this year. He often sneezes after getting up early. A dry climate can lead to nosebleeds. Is this allergic rhinitis?
Wang: There are two situations: one is allergic rhinitis after getting up in the morning, and the other is vasoconstrictive rhinitis. Nosebleeds are a common condition in children. It is recommended to go to the hospital for examination.
Moderator: Every time Mr. Chen from Fujian sprays medicine on his nose, he feels irritable and feverish. Will it burn my nose?
Wang: No, this situation is a stimulus. If the nose is dry and nosebleeds after long-term use, it is recommended to slow down, use intermittently or go to the hospital.
Moderator: Mr. He Nanguo, my child is 5 and a half years old and has allergic rhinitis. When getting up in the morning or inhaling a chill, he is prone to sneezing and runny nose. What medicine is better for treatment?
Xiaoshuifang: There is a spray for treating children's rhinitis, which is suitable for children over 4 years old. The side effects are small, and the symptoms will be alleviated after use. In addition, there are oral medicines.
Moderator: Ms. Ye from Shenzhen, a 7-year-old child with allergic rhinitis for two years. After the cure, the nasal cavity was blocked because of the recurrence of the cold. What's so good about it?
Wang: Recurrence after treatment is a common phenomenon. Allergic rhinitis sometimes leads to colds. Allergic rhinitis is accompanied by yellow nose, headache and fever. Antibiotics are needed to control bacterial infection and antiallergic treatment, and the effect is good. If it is chronic, it needs surgery.
Xiao Shuifang: There are new varieties of nasal drops, such as Fu Liang Shu, which can not only solve nasal allergy, but also ventilate, and the effect is very good.
Moderator: Mr. Sun from Beijing, do you need to be hospitalized for nasal surgery?
Wang: I need to be hospitalized. Nasal surgery is mostly endoscopic surgery. This is a very delicate operation. Surgical anesthesia is divided into local anesthesia and general anesthesia. Our hospital recommends that patients use general anesthesia, which is less painful and safer.
Moderator: Ms. Li from Hunan, I am an elderly patient. Besides allergic rhinitis, there are hypertension and diabetes. Will these diseases affect each other? What should we pay attention to when we treat them?
Wang: Allergic rhinitis does not cause hypertension and diabetes. There is no connection between the two, but there is an indirect influence. For example, 8% of patients taking reserpine for a long time will cause nasal allergy. When the nose is normally stimulated by the outside world, the nasal hypersensitivity will be blocked and runny. People with diabetes and allergic rhinitis should pay attention to glucocorticoids (steroids). Steroid drugs may aggravate the symptoms of diabetes and raise blood pressure, so there are two diseases when taking drugs.
Moderator: Mr. Dalian Zuo, I am a chef. I am very upset because I sneeze and have a runny nose every time I cook taro. What should I do?
Xiaoshuifang: 1, desensitization therapy, 2, drug therapy, 3, passive method is not to touch taro or cook this dish.
Moderator: Ms. Wei from Jinan, I have been allergic rhinitis for 2 years, and I take paracetamol as soon as I commit it. Are there any side effects?
Wang: There are side effects. Long-term use will make you fat and even cause arrhythmia, but the incidence is very small. It is recommended to use them in combination.
Moderator: Allergic rhinitis is difficult to prevent through the introduction of two experts. We really hope that patients with allergic rhinitis can go out and enjoy sunshine, air and flowers on sunny days in spring.
Moderator: Visiting hours: Wang: Monday afternoon, Wednesday morning, Xiao Shuifang: admitted to the hospital on Monday and Friday morning.
Tel: 0 10-63037026, 6617122-2315.
Drug therapy is the most important and effective method for allergic rhinitis at present, which can effectively prevent recurrence and relieve symptoms, including: local medication: local regular and quantitative nasal use of hormonal drugs such as (Botshner, Frizonase) can effectively relieve symptoms. Because it is a local drug spray, there will be no systemic adverse reactions. If the nasal congestion is serious, you can consider using ephedrine nasal drops for a short time.
In addition, for reference only:
Systemic antiallergic drugs: mainly histamine drugs, which have quick effect and good effect, can quickly relieve symptoms such as itchy nose, sneezing and runny nose. Leukotriene antagonists, such as chlorpheniramine, sitamin and kairuitan, are relatively new antiallergic drugs, which can effectively relieve nasal congestion, runny nose and eye symptoms.
Physical therapy-effective but not sufficient
Some physical therapies such as freezing, laser and microwave can improve allergic symptoms, but allergic rhinitis is a local manifestation of systemic immune diseases after all, and these are only temporary treatments.
Desensitization therapy-fundamentally eliminating allergic rhinitis
After the allergen is determined, the effective components of the allergen are extracted and injected into the allergic human body, and the dose is gradually increased from the low dose, so that the patient can gradually adapt to the tolerance of the allergen and fully tolerate the substance after treatment. This treatment will last for 2 to 3 years. Although the time is long and the curative effect is slow, the effect is very positive. It is the fundamental method to treat allergic rhinitis.