Klemens A, Grevers G
HNO-Klinik, Klinikum Starnberg.
MMW Fortschr Med. 2003 Mar 6;145(10):30-3.
Two types of allergic rhinitis are differentiated: seasonal rhinitis caused in particular by pollen allergens, and the perennial form caused by such year-round allergens as house dust (mites), moulds and animal hair. The diagnosis is based on a comprehensive history (family/occupation/environment), clinical symptoms, a rhinoscopic examination, and testing for allergens, e.g. conjunctival tests, prick test or nasal provocative test. The treatment of choice is elimination of the allergens as completely as possible. An additional causal therapeutic option is specific immune therapy (SIT) which, however, is contraindicated in the presence of intercurrent infections, use of beta blockers and immunodeficiency. Available medications include mast cell stabilizers, antihistaminic agents and corticosteroids, which are applied in stepped fashion, depending upon severity. In addition, adjuvant surgical measures may improve obstructive symptoms.
一种是主要由花粉过敏原引起的季节性鼻炎,另一种是由常年性过敏原如屋尘(螨)、霉菌和动物毛发引起的常年性鼻炎。诊断基于全面的病史(家族史/职业/环境)、临床症状、鼻镜检查以及过敏原检测,如结膜试验、点刺试验或鼻激发试验。首选的治疗方法是尽可能彻底地消除过敏原。另一种病因治疗选择是特异性免疫疗法(SIT),然而,在并发感染、使用β受体阻滞剂和免疫缺陷的情况下,该疗法是禁忌的。可用药物包括肥大细胞稳定剂、抗组胺药和皮质类固醇,根据病情严重程度分阶段使用。此外,辅助性手术措施可能会改善阻塞性症状。