Division of Clinical Immunology and Allergy, University of Mississippi Medical Center Jackson, MS, USA.
Ther Clin Risk Manag. 2007 Jun;3(2):327-32. doi: 10.2147/tcrm.2007.3.2.327.
Allergic rhinitis is the most common atopic disorder seen in the outpatient clinic setting diagnosed by history, physical exam and objective testing. According to the Allergic Rhinitis and its Impact on Asthma (ARIA) document, it is classified by chronicity (intermittent or persistent), and severity which is based on symptoms and quality of life (mild, or moderate/severe). It has enormous socioeconomic costs and significant reduction in quality of life. Allergen avoidance should be implemented, particularly in children, to reduce level of exposure; unfortunately efforts are often inadequate. Montelukast, a novel medication, is an antagonist to the leukotriene receptor. It is nonsedating, dosed once daily, and has a safety profile similar in adults and children with approval down to 6 months of age. A review of the literature undoubtedly establishes montelukast as a viable alternative for the treatment of seasonal allergic rhinitis. Its benefits are equivalent to antihistamines, when used as monotherapy, but less than intranasal corticosteroids. The addition of an antihistamine to montelukast does appear to have added benefits and at times is reported to be equivalent to intranasal corticosteroids.
变应性鼻炎是门诊最常见的特应性疾病，通过病史、体格检查和客观检查进行诊断。根据变应性鼻炎及其对哮喘的影响（ARIA）文件，它根据慢性程度（间歇性或持续性）和严重程度（基于症状和生活质量）进行分类（轻度、中度/重度）。它具有巨大的社会经济成本，并显著降低生活质量。应采取过敏原回避措施，特别是在儿童中，以减少暴露水平；不幸的是，这种努力往往是不够的。孟鲁司特是一种新型药物，是白三烯受体拮抗剂。它是非镇静剂，每日一次给药，在成人和儿童中的安全性相似，批准用于 6 个月以下的儿童。对文献的回顾无疑确立了孟鲁司特作为治疗季节性变应性鼻炎的可行替代药物。其作为单一疗法的疗效与抗组胺药相当，但不如鼻内皮质类固醇。抗组胺药联合孟鲁司特似乎确实有额外的益处，有时报告与鼻内皮质类固醇等效。
