Wheeler Patricia W, Wheeler Stephen F
Department of Family and Geriatric Medicine, University of Louisville School of Medicine, Louisville, Kentucky 40218, USA.
Am Fam Physician. 2005 Sep 15;72(6):1057-62.
Vasomotor rhinitis affects millions of Americans and results in significant symptomatology. Characterized by a combination of symptoms that includes nasal obstruction and rhinorrhea, vasomotor rhinitis is a diagnosis of exclusion reached after taking a careful history, performing a physical examination, and, in select cases, testing the patient with known allergens. According to a 2002 evidence report published by the Agency for Healthcare Research and Quality (AHRQ), there is insufficient evidence to reliably differentiate between allergic and nonallergic rhinitis based on signs and symptoms alone. The minimum level of diagnostic testing needed to differentiate between the two types of rhinitis also has not been established. An algorithm is presented that is based on a targeted history and physical examination and a stepwise approach to management that reflects the AHRQ evidence report and U.S. Food and Drug Administration approvals. Specific approaches to the management of rhinitis in children, athletes, pregnant women, and older adults are discussed.
血管运动性鼻炎影响着数百万美国人，并导致明显的症状。血管运动性鼻炎的特征是包括鼻塞和流涕在内的一系列症状，它是在仔细询问病史、进行体格检查，并在某些情况下用已知变应原对患者进行检测后，通过排除法做出的诊断。根据医疗保健研究与质量局（AHRQ）2002年发表的一份证据报告，仅根据体征和症状，尚无足够证据可靠地区分变应性鼻炎和非变应性鼻炎。区分这两种类型鼻炎所需的最低诊断测试水平也尚未确定。本文提出了一种基于针对性病史和体格检查的算法，以及一种反映AHRQ证据报告和美国食品药品监督管理局批准情况的逐步管理方法。还讨论了儿童、运动员、孕妇和老年人鼻炎管理的具体方法。
