On April 13, during the "National Nose loving Day", the otolaryngology head and neck surgery department of the Sino Japanese Friendship Hospital of Jilin University held free clinic and health education activities, attracting many citizens to participate. Photographed by Wang Jingjing

In the alternation of seasons, patients with allergic rhinitis will always be unable to restrain sneezing, runny nose, stuffy nose, itchy nose, and tears, which seriously affect their work and life. What mistakes do patients have when treating allergic rhinitis? How should patients with different symptoms respond scientifically? Recently, the reporter went to the Otolaryngology Head and Neck Surgery Department of the Sino Japanese Friendship Hospital of Jilin University, which participated in the formulation of the 2022 new version of the guidelines for the diagnosis and treatment of allergic rhinitis in China, to seek answers from clinical front-line doctors and subject experts.

Patient: sneezing, runny nose, unbearable interference

"Doctor, my nose is very uncomfortable these days. I keep sneezing and runny nose. Is there any medicine that works quickly?" Mr. Jia, 52, has been troubled by allergic rhinitis for nearly 30 years. In recent days, he could not bear to be disturbed and went to the otolaryngology head and neck surgery department of the hospital to seek help from doctors.

"When does nose discomfort often occur? What medicine has been used? What kind of examination has been carried out?" Meng Zida, deputy director of otorhinolaryngology head and neck surgery of the hospital, interviewed the patient in detail. "When encountering cold air stimulation, he sneezes and has a runny nose. Wearing a mask is better." Mr. Jia admitted that he used to take some cold medicine when he sneezed. After taking the medicine, his symptoms could be alleviated. Cold medicine has also become a "common medicine" for relieving nasal discomfort.

"According to your symptoms, it may be allergic rhinitis. It is recommended that you carry out allergen detection to understand the real allergen and avoid contact with it. If you can not avoid contact, you can use medicine according to the characteristics of allergy." After listening to the patient's chief complaint, Meng Zida also gave nursing advice to keep the nasal cavity warm at ordinary times and reduce adverse irritation. Nasal anti allergic drugs can be used to effectively control allergic symptoms, and nasal glucocorticoids can be used together to alleviate nasal inflammation in a long term.

In the consulting room, there are many allergic rhinitis patients like Mr. Jia who "use drugs in an emergency". Blind drug use, hormone abuse, low age of illness... For patients of different ages and different symptoms, doctors give personalized diagnosis and treatment programs and nursing guidance.

Misunderstanding of treatment: most of the "effective drugs" for one year are long-acting hormones

In the group of rhinitis patients, there is a "special drug for one year". Can such a "specific drug" really completely improve the uncomfortable symptoms of rhinitis? With this question in mind, the reporter interviewed Professor Zhu Dongdong, Vice President of China Japan Friendship Hospital of Jilin University, an authoritative expert in the field of otolaryngology head and neck surgery in China.

"The 'special drugs' that can be administered for one year are usually long-acting hormones." Zhu Dongdong said that as early as the 1970s and 1980s, he did use this method to treat allergic rhinitis. Later, it was found that this treatment method had a large side effect on the human body, so it was listed as a prohibited treatment by regular medical institutions.

Zhu Dongdong further explained that at present, the nasal hormone used clinically has largely solved the patients' concerns about the side effects of drugs. This local hormone spray has little systemic absorption and will not affect the hormone secretion of normal human body. It can be used by pregnant women and children over 2 years old under the guidance of doctors. Nasal glucocorticoid is generally used once a day, which not only does not affect the hormone secretion, but also can well control clinical symptoms.

"The pathogenesis of allergic rhinitis is complex and cannot be cured. However, through standardized drug use and effective nursing, the symptoms of discomfort can be greatly improved." Zhu Dongdong said that the use of drugs for allergic rhinitis should follow scientific principles, with local drugs preferred, followed by oral drugs. If conditions permit, it is better to use immunotherapy, which is commonly known as desensitization treatment. For patients with difficulty in conventional drug control, biological agents can also be used.

Disease prevention: prevention should be done in advance in spring and autumn

"In 2005, the incidence of allergic rhinitis in our city was 9%, and the monitoring data rose to 16.8% in 2011." Meng Zida believes that scientific protection is very important to alleviate the symptoms of allergic rhinitis.

"Allergic rhinitis has obvious seasonal characteristics. Every year in the middle of April and around the beginning of autumn, the number of patients will decline significantly after the pollen period or frost fall." Meng Zida said that most seasonal allergic rhinitis is closely related to pollen dissemination. It is suggested that the detection should be carried out in the hospital in the middle of April and 1~2 weeks before the beginning of autumn to determine the season of pollen allergy before targeted medication.

Meng Zida suggested that allergic rhinitis patients, especially those allergic to pollen, should first pay attention to meteorological information. If the pollen concentration is too high, try to reduce outdoor activities. When going out, you should wear a mask. When coming back from going out, you should change outdoor clothes, clean your face and nose, and reduce pollen inhalation into the nose, causing allergen deposition on your body. In the season with high pollen concentration, allergic people should reduce indoor ventilation. It is recommended to use fresh air system if conditions permit to reduce the deposition of pollen indoors.