Shah Shahid Ali, Sajid Tahira, Asif Muhammad, Khan Farida, Haroon Tahir, Malik Sohail, Ghani Rehman
Department of Ear, Nose & Throat and Head & Neck Surgery, Ayub Medical College & Teaching Hospital, Abbottabad.
J Ayub Med Coll Abbottabad. 2007 Jul-Sep;19(3):6-9.
Allergic rhinitis represents a global health issue affecting between 10% to 25% of the world population, with increasing prevalence, resulting in a significant impact on quality of life, multiple comorbidities and the considerable socio-economic burden. Majority of the patients are younger than 30 years and it may be inherited. Symptoms typically occur as a result of exposure to dust, dander or certain seasonal pollen. Lack of standardized management protocol is one of the major factors responsible for poor control of this condition. This study was designed to evaluate the patients suffering with allergic rhinitis and manage them with a protocol based on the pathogenesis of the condition.
This prospective study was conducted in the Department of Ear, Nose & Throat and Head & Neck Surgery, Ayub Teaching Hospital, Abbottabad, over a period of two years (2005 - 2006), to assess the efficacy of a standard protocol of treatment developed and followed in the department. 1167 patients, clinically diagnosed as suffering with allergic rhinitis, were evaluated and managed. Age ranged from 08 months to 64 years. All the patients were prescribed medical treatment, divided into initial phase of 10 days to two weeks duration followed by a maintenance phase, and a regular follow-up schedule was maintained upto two years.
634 (54.32%) patients were male and 533 (45.67%) were female. Age ranged from 08 months to 64 years, 85% being between 05 and 45 years. 91% of patients had symptom duration of 06 months to 03 years. 96% of the patients were getting treated on as required basis, whereas 98% had no educational sessions with the treating doctor, especially regarding preventive measures. Typical presentation in most of the patients was nasal obstruction, runny & itchy nose, post nasal drip and bouts of sneezing. 90.57% patients reported improvement in symptoms. 53.21% patients had a relapse of symptoms at some stage during the study period. 37.53% patients had surgery done for associated pathologies, mostly a DNS. Compliance regarding medication was more than 90% in the initial phase of treatment that dropped to 50% in the maintenance phase. 93% of the patients tolerated the treatment well.
Allergic rhinitis is a growing problem worldwide. Optimal treatment protocol is still lacking especially in the developing countries. Patient's education on avoidance of allergens must be stressed. Associated problems that may need surgical treatment. Regular follow-up must be ensured to monitor the progress of treatment as well as to identify patients who might be candidates for immunotherapy. Newer modalities of treatment need to be further explored. A team approach is mandatory in the presence of symptoms related to lower respiratory tract.
变应性鼻炎是一个全球性的健康问题，影响着世界10%至25%的人口，且患病率不断上升，对生活质量、多种合并症以及巨大的社会经济负担产生重大影响。大多数患者年龄小于30岁，且可能具有遗传性。症状通常是由于接触灰尘、皮屑或某些季节性花粉而出现。缺乏标准化的管理方案是导致该病控制不佳的主要因素之一。本研究旨在评估变应性鼻炎患者，并根据该病的发病机制采用一种方案对其进行管理。
这项前瞻性研究在阿伯塔巴德阿尤布教学医院的耳鼻喉科和头颈外科进行，为期两年（2005 - 2006年），以评估该科室制定并遵循的标准治疗方案的疗效。对1167例临床诊断为变应性鼻炎的患者进行了评估和管理。年龄范围为8个月至64岁。所有患者均接受药物治疗，分为为期10天至两周的初始阶段，随后是维持阶段，并维持定期随访计划直至两年。
634例（54.32%）患者为男性，533例（45.67%）为女性。年龄范围为8个月至64岁，85%的患者年龄在5岁至45岁之间。91%的患者症状持续时间为6个月至3年。96%的患者按需接受治疗，而98%的患者未与治疗医生进行过教育课程，尤其是关于预防措施的课程。大多数患者的典型表现为鼻塞、流涕、鼻痒、鼻后滴漏和阵发性喷嚏。90.57%的患者报告症状有所改善。53.21%的患者在研究期间的某个阶段症状复发。37.53%的患者因相关病变接受了手术，主要是鼻中隔偏曲。治疗初始阶段的药物依从性超过90%，在维持阶段降至50%。93%的患者对治疗耐受性良好。
变应性鼻炎在全球范围内是一个日益严重的问题。最佳治疗方案仍然缺乏，尤其是在发展中国家。必须强调对患者进行避免过敏原的教育。可能需要手术治疗的相关问题。必须确保定期随访，以监测治疗进展以及识别可能适合免疫治疗的患者。需要进一步探索新的治疗方式。对于存在与下呼吸道相关症状的情况，团队协作方法是必不可少的。
