Noble S L, Forbes R C, Woodbridge H B
University of Mississippi, University.
Am Fam Physician. 1995 Mar;51(4):837-46.
Allergic rhinitis commonly manifests for the first time in childhood or adolescence with seasonal or perennial sneezing, rhinorrhea, nasal congestion, and pruritus of the nose, eyes and throat. The nasal mucosa are pale blue and boggy, with a clear discharge. Patients should be instructed to avoid breathing tobacco smoke, to remove bedroom carpeting, to use foam pillows, to enclose mattresses and box springs in plastic covers, to keep house windows closed and to reduce indoor humidity by using air conditioning. If these avoidance procedures, together with oral and ocular antihistamines and/or decongestants, do not provide relief of symptoms, intranasal corticosteroids and cromolyn may be prescribed. Pharmacotherapy is more effective if it is used prophylactically. Second-generation antihistamines may reduce sedative and anticholinergic side effects. Intranasal decongestants should be used for only three to four days. Immunotherapy is appropriate for patients who remain unresponsive to therapy. Intranasal cromolyn should be the first drug considered in the treatment of pregnant women.
变应性鼻炎通常首次出现在儿童期或青春期，表现为季节性或常年性打喷嚏、流涕、鼻塞以及鼻、眼和咽喉瘙痒。鼻黏膜呈淡蓝色，肿胀，有清亮分泌物。应指导患者避免吸入烟草烟雾，去除卧室地毯，使用泡沫枕头，用塑料罩包裹床垫和弹簧床垫，关闭房屋窗户，并使用空调降低室内湿度。如果这些避免措施，连同口服和眼部抗组胺药和/或减充血剂，不能缓解症状，可开具鼻内用皮质类固醇和色甘酸钠。预防性使用药物治疗效果更佳。第二代抗组胺药可能会减少镇静和抗胆碱能副作用。鼻内用减充血剂仅应使用三至四天。免疫疗法适用于对治疗无反应的患者。鼻内用色甘酸钠应是治疗孕妇时首先考虑使用的药物。
