Capital Allergy and Respiratory Disease Center, Sacramento, California, USA.
Allergy Asthma Proc. 2009 Nov-Dec;30(6):589-94. doi: 10.2500/aap.2009.30.3287.
Allergic rhinitis is one of the most common chronic disorders in the United States, causing patients significant discomfort and interfering with quality of life and functioning. Histamine is the primary mediator in the development of allergic rhinitis symptoms and is a primary therapeutic target. Guidelines, both in the United States and globally, recommend antihistamines as first-line therapy of allergic rhinitis. This article discusses the outcomes associated with intranasal versus oral administration of antihistamines. Both oral and intranasal antihistamines are approved for the first-line treatment of allergic rhinitis and both formulations result in a reduction in symptoms and an improvement in quality of life. Intranasal agents may be preferred in patients in whom nasal congestion is particularly bothersome or in cases where a more rapid onset of action is desired. Oral agents would be a better choice in young children (especially children who are at risk of developing asthma), in cases of poor medication compliance, and in patients who are bothered most by histamine-associated symptoms, such as itching or red and watery eyes. Both oral and intranasal antihistamines are safe and well tolerated and meet the needs of patients with allergic rhinitis, especially those with mild to moderate disease.
变应性鼻炎是美国最常见的慢性疾病之一，给患者带来严重不适，并影响生活质量和功能。组胺是变应性鼻炎症状发展的主要介质，也是主要的治疗靶点。美国和全球的指南都推荐抗组胺药作为变应性鼻炎的一线治疗药物。本文讨论了鼻内和口服抗组胺药的治疗效果。鼻内和口服抗组胺药均被批准用于变应性鼻炎的一线治疗，两种制剂均可减轻症状，改善生活质量。对于鼻塞特别严重的患者，或希望更快起效的患者，可能更倾向于选择鼻内制剂。对于儿童（尤其是有哮喘风险的儿童）、药物依从性差的患者，以及受组胺相关症状（如瘙痒或眼红、流泪）困扰最严重的患者，口服制剂可能是更好的选择。口服和鼻内抗组胺药均安全且耐受良好，能满足变应性鼻炎患者的需求，尤其是那些病情较轻至中度的患者。
