Wang Y N, Luan Z L, Wang H T
Department of Otorhinolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Nov 7;52(11):872-875. doi: 10.3760/cma.j.issn.1673-0860.2017.11.019.
Rhinitis medicamentosa (RM) refers to nonallergic inflammation in the nasal mucosa which is caused by the abuse of nasal decongestant and it often occurs in patients with allergic/nonallergic rhinitis along with nasal congestion. RM is characterized by nasal congestion based on long-term use of nasal decongestant, without rhinorrhoea or sneezing. The signs of RM include nasal swelling, thickening, loss of elasticity, and loss of sensitivity to the decongestant. The histological changes of RM are loss of nasal mucosa cilia, squamous epithelium metaplasia, edema of epithelium cell, hyperplasia of goblet cell, increased expression of epidermal growth factor receptor and infiltration of inflammatory cells, etc. There is no precise diagnosis standard for RM, making it even harder for its objective diagnosis. Patients with RM should immediately stop using nasal decongestant, in stead of using nasal glucocorticoid spray for the recovery of the nasal mucosa's function.
药物性鼻炎(RM)是指因滥用鼻减充血剂引起的鼻黏膜非过敏性炎症,常发生于过敏性/非过敏性鼻炎伴鼻充血患者中。药物性鼻炎的特征是基于长期使用鼻减充血剂而出现鼻充血,无流涕或打喷嚏症状。药物性鼻炎的体征包括鼻肿胀、增厚、弹性丧失以及对减充血剂敏感性丧失。药物性鼻炎的组织学变化为鼻黏膜纤毛丧失、鳞状上皮化生、上皮细胞水肿、杯状细胞增生、表皮生长因子受体表达增加以及炎性细胞浸润等。目前尚无药物性鼻炎的确切诊断标准,这使得其客观诊断更加困难。药物性鼻炎患者应立即停用鼻减充血剂,而应使用鼻用糖皮质激素喷雾剂来恢复鼻黏膜功能。