曲安奈德喷雾剂对变应性鼻炎的作用

目的研究曲安奈德鼻腔局部给药对实验性变应性鼻炎动物模型的治疗作用及对组胺致大鼠鼻气道阻力增加的缓解作用。方法以实验性变应性鼻炎模型豚鼠和组胺致鼻气道阻力增加模型大鼠为试验对象 ,以豚鼠鼻腔分泌物量、喷嚏次数、搔鼻次数、鼻组织学及大鼠鼻气道阻力为指标 ,全面考察曲安奈德喷雾剂对变应性鼻炎的作用。结果曲安奈德鼻喷雾剂 (5 0、10 0、2 0 0 μg·kg-1,对卵蛋白致敏实验性变态反应性鼻炎豚鼠模型的各种变应性鼻炎的症状和体症均有明显改善作用 ;与模型对照组比较 ,各给药组动物鼻腔分泌物量、喷嚏次数、抓鼻次数明显减少 ,并可对抗组胺所致大鼠鼻气道阻力的增加。结论曲安奈德鼻喷雾剂鼻腔局部给药对实验性变应性鼻炎有显著改善作用     

儿童变应性鼻炎的诊治及护理体会

变应性鼻炎是发生在鼻黏膜的变态反应性疾病，其发病与遗传及环境密切相关，是小儿常见鼻病之一，季节变换时发病率增高，儿童变应性鼻炎的主要症状有挖鼻、揉鼻、鼻出血、打喷嚏、鼻塞、流清涕、合并支气管哮喘。     

鼻用皮质类固醇激素的临床价值

鼻用皮质类固醇激素（Intranasal steroids,INS）的临床使用可追溯至20世纪70年代,Mygind应用二丙酸倍氯米松（Beclomethasone Dipropionate,BDP）治疗变应性鼻炎,取得了满意的效果。近年来,其适应证从用于治疗变应性鼻炎扩展到治疗非变应性鼻炎以及急、慢性鼻-鼻窦炎等疾病,本文围绕INS的药理学基础及临床应用进展作一综述。     

鼻敏感方结合针刺治疗肺脾虚寒型变应性鼻炎临床疗效观察

<正>变应性鼻炎是机体接触吸入性过敏原后由IgE介导、Th2细胞驱动的鼻黏膜炎症性反应性疾病~([1])。严道南教授从事变应性鼻炎的中医治疗三十余载,其创鼻敏感方治疗变应性鼻炎肺脾虚寒证疗效显著。针刺治疗变应性鼻炎的有效性及安全性更是得到了国内外学者的一致认同,其已被美国最新制定的变应性鼻炎诊疗指南所纳入。本研究采用鼻敏感方结合针刺治疗肺脾虚寒型变应性鼻炎30例,并设西药组30例作为对照组,以探讨针     

组胺H1受体拮抗剂比拉斯汀

比拉斯汀（bilastine）为西班牙FAES制药公司开发的第2代组胺H1受体拮抗剂,目前正在欧洲进行其治疗变应性鼻炎及慢性特发性荨麻疹的注册前准备工作,同时在美国进行Ⅱ期临床研究,考察其对季节性变应性鼻一结膜炎的疗效。在健康受试者和鼻炎患者中进行的研究表明：本品安全性良好,无常用抗组胺药物存在的镇静作用及心脏毒性。     

IL-5、ET及CGRP在变应性鼻炎中的表达

目的：测定变应性鼻炎（allergic rhinitis,AR）患者血中白细胞介素-5（IL-5）、内皮素（ET）及降钙素基因相关肽（CGRP）水平的变化,观察它们在变应性鼻炎中的作用及相互关系,为变应性鼻炎的发病机制、发展及治疗提供依据。方法：选择变应性鼻炎患者36例,慢性鼻-鼻窦炎（chronic rhinosinusitis,CRS）32例,健康对照组30例。分别测定血清IL-5、血浆ET及CGRP水平。结果：IL-5、ET及CGRP含量在变应性鼻炎患者血中较慢性鼻-鼻窦炎患者有明显增高,IL-5、ET及CGRP含量分别为（88.25±33.47）、（77.81±8.26）、（45.32±7.35）ng/L,显著高于慢性鼻-鼻窦炎组[（44.34±16.32）、（72.53±8.34）、（40.07±7.13）ng/L]及健康对照组[（31.24±8.43）、（66.12±7.73）、（35.53±8.02）ng/L]。慢性鼻-鼻窦炎与健康对照组比较亦有明显差异。结论：IL-5、ET及CGRP在变应性鼻炎患者血液中含量较高,它们可能参与了变应性鼻炎的病理生理过程,其变化可能与变应性鼻炎的发生、发展有关。     

鼻用皮质类固醇激素对变应性鼻炎患者鼻腔灌洗液中白细胞介素-4的影响

变态反应性鼻炎（allergicrhinitis,AR）简称变应性鼻炎或过敏性鼻炎。已被人们描述为“21世纪的流行病”,其患病率每20年增加1倍。变应性鼻炎是鼻黏膜组织的一种非感染性炎症．是特应性个体接触致敏原后,各种细胞因子、炎症介质对血管、神经和腺体的刺激诱导变应性鼻炎的症状产生如：频繁发作的喷嚏、过量的鼻分泌物和显著鼻塞等,     

辛芩颗粒治疗变应性鼻炎疗效观察

辛芩颗粒是由多味中药材加工提炼而成的新一代低糖型制剂。具有益气固表、祛风通窍之功能,改善鼻腔阻塞,解除流涕、喷嚏、鼻痒等症状之功效。主治变应性鼻炎、慢性鼻附窦炎等。用辛芩颗粒治疗变应性鼻炎５０例,效果满意。１材料与方法随机选择门诊就诊的变应性鼻炎８０...     

鼻内窥镜下Nd：YAG激光治疗变应性鼻炎

鼻腔副交感神经敏感度增高是变应性鼻炎发病的重要环节。翼管神经是岩浅大神经和岩深神经组成。其副交感纤维发自上延核，经面神经走行支配鼻腔及鼻窦粘膜区域四分之三的血管舒缩和腺体分泌。因此，阻断鼻管神经在治疗变应性鼻炎中占有重要地位。我科应用Na：YAG激光在鼻内窥镜的引导下．治疗变应性鼻炎，其疗效显。     

鼻内镜下聚焦超声治疗变应性鼻炎

目的观察鼻内镜下聚焦超声治疗变应性鼻炎的临床疗效。方法在鼻内镜下运用CZB型聚焦超声治疗仪对55例常年变应性鼻炎患者进行治疗,按照2004年兰州会议＂变应性鼻炎的治疗原则和推荐方案＂,用记分法评定其疗效。结果术后平均随访6个月进行疗效评价,其中显效为38.2%（21/55）,有效56.4%（31/55）,无效5.5%（3/55）,总有效率为94.5%（52/55）。结论鼻内镜下聚焦超声治疗变应性鼻炎近期效果显著,且具有操作方便、创伤小、可重复性等优点,值得广泛推广。     

Fluticasone furoate: intranasal use in allergic rhinitis

Fluticasone furoate nasal spray is a new topical intranasal corticosteroid with enhanced affinity for the glucocorticoid receptor and low systemic exposure, which was recently approved in the US for the treatment of seasonal or perennial allergic rhinitis in adults and in children aged >or=2 years. Fluticasone furoate nasal spray employs a novel delivery device with a unique side-actuated design, a short nozzle and a new trigger mechanism designed for ease of use. In well controlled clinical trials, intranasal fluticasone furoate 110microg once daily for 2 weeks in adults and adolescents with seasonal allergic rhinitis reduced nasal and ocular symptoms, and improved health-related quality of life to a significantly greater extent than placebo. Similarly, treatment with intranasal fluticasone furoate 110microg once daily for 4-6 weeks in adults and adolescents with perennial allergic rhinitis was superior to placebo in reducing nasal symptoms and with respect to overall response to therapy. In children aged 6-11 years, fluticasone furoate nasal spray was shown to be effective in reducing the nasal symptoms of seasonal and perennial allergic rhinitis following treatment for 2 and 4 weeks, respectively. Fluticasone furoate nasal spray was well tolerated in adults, adolescents and children aged 2-11 years, with an overall incidence of adverse events similar to that with placebo.     

Open-label evaluation of azelastine nasal spray in patients with seasonal allergic rhinitis and nonallergic vasomotor rhinitis

OBJECTIVE: The objective of the study was to evaluate the effectiveness of azelastine (Astelin) nasal spray, a topical second-generation antihistamine, in the treatment of symptoms of seasonal allergic rhinitis, seasonal allergic rhinitis with nonallergic triggers (mixed rhinitis), and nonallergic vasomotor rhinitis. RESEARCH DESIGN AND METHODS: A total of 2343 primary care physicians, allergists, ENT specialists, and other health professionals participated in this 2-week, open-label evaluation of azelastine nasal spray. Data were collected through a physician questionnaire that included patient demographics, rhinitis diagnosis, medication history, and inclusion/exclusion criteria; and two patient questionnaires that included symptom history, response to previous rhinitis medications, symptom control, and level of satisfaction with azelastine nasal spray. A completed physician questionnaire and two completed patient questionnaires were required for each patient to be included in the analysis. Patients who qualified for enrollment were given open-label azelastine nasal spray and instructed to administer 2 sprays per nostril twice daily for 2 weeks. RESULTS: A total of 1225 health professionals enrolled 7864 patients into the study. Completed physician and patient questionnaires were returned by 1081 health professionals and 5073 patients, 4364 of whom used azelastine nasal spray as their only rhinitis medication during the 2-week study period. The patients were predominantly caucasian (82.6%) and female (61.1%), with a mean age of 50 years. The majority had a diagnosis of mixed rhinitis (51.5%), followed by seasonal allergic rhinitis (32.3%), and nonallergic (vasomotor) rhinitis (16.2%). After 2 weeks of treatment, the percentage of patients reporting some control or complete control of individual symptoms ranged from 78% for postnasal drip in patients with nonallergic vasomotor rhinitis to 90% for sneezing in patients with seasonal allergic rhinitis. More than 85% of patients who reported difficulty sleeping or impairment of daytime activities due to rhinitis symptoms had improvement in these parameters. Azelastine nasal spray was well tolerated, the discontinuation rate due to adverse events was 2.3%. CONCLUSIONS: Azelastine nasal spray was reported to control all rhinitis symptoms, including nasal congestion, regardless of rhinitis diagnosis during the 2-week study period. Patients with seasonal allergic rhinitis and patients with seasonal allergic rhinitis plus nonallergic triggers were identified as patient types most likely to respond to azelastine nasal spray.     

Evaluation of nasal barrier dysfunction at acute- and late-phase reactions in a guinea pig model of allergic rhinitis

Allergic rhinitis is a common disease characterized by the symptoms of pruritus, sneezing, hypersecretion and nasal blockage. Increased mucosal barrier permeability has been suggested to be an indicator for the severity of allergic rhinitis. This study investigates the passage of radiolabelled albumin from the nasal mucosal circulation into the lumen in guinea pigs intraperitoneally sensitized and intranasally challenged with antigen. In order to characterize the allergic rhinitis model, we evaluated a number of potential influencing factors in nasal plasma exudation, including antigen doses, volumes of antigen solution used, and animal position during the nasal lavage, and the conditions of nasal lavage. The number of eosinophils and levels of histamine and leukotriene B4 in the nasal lavage and eosinophils in the nasal mucosa were determined at the early and late phases after antigen challenge. We also compared the effects of topical nasal treatments for allergic rhinitis on nasal inflammatory responses. Our results demonstrate that, in the guinea pig nasal mucosa, topical challenge with antigens induces plasma exudation and histamine release at the acute-phase reaction, and plasma exudation and eosinophil infiltration at the late-phase reaction. These changes are similar to those reported in human allergic rhinitis. Alterations of nasal plasma exudation, histamine release and eosinophil influx were dependent upon the concentrations and volumes of antigens. An antihistamine inhibited the acute-phase reaction partially, whereas budesonide inhibited effects at the late-phase reaction. We suggest that this model of guinea pig allergic rhinitis with the early and late responses may be useful for high-throughout screening of new drugs.     

敏停喷鼻剂对TDI致豚鼠过敏性鼻炎模型的影响

目的研究敏停喷鼻剂对豚鼠过敏性鼻炎模型的影响。方法用TDI致豚鼠过敏性鼻炎造模型，观察敏停喷鼻剂对过敏性鼻炎模型的鼻部过敏症状以及鼻黏膜病理组织形态学的影响。结果敏停喷鼻剂能明显减轻豚鼠过敏性鼻炎模型鼻部过敏症状以及鼻黏膜上皮炎细胞的浸润。结论敏停喷鼻剂对过敏性鼻炎可能具有较好的疗效。     

Effect of mucosal TRPV1 inhibition in allergic rhinitis

Abstract: Transient receptor potential vanilloid‐1 (TRPV1) has been implicated as a mediator of itch in allergic rhinitis. To address this possibility, we synthesized a TRPV1 blocker (SB‐705498) for nasal administration in patients with seasonal allergic rhinitis. The pharmacological activity of SB‐705498 was confirmed on human TRPV1‐expressing HEK293 cells, using fluorometric calcium imaging, and in patients with allergic rhinitis subjected to nasal capsaicin challenges. The effect of SB‐705498 was studied in patients with seasonal allergic rhinitis subjected to daily allergen challenges for 7 days, using a double‐blind, placebo‐controlled, randomized and cross‐over design. SB‐705498 was delivered by nasal lavage 2 min. before each allergen challenge. Primary end‐point was total nasal symptom score on days 5–7. Nasal peak inspiratory flow (nPIF) and eosinophil cationic protein (ECP) content in nasal lavages were also monitored. Daily topical applications of SB‐705498 at a concentration that inhibited capsaicin‐induced nasal symptoms had no effect on total symptom score, nPIF and ECP levels in allergen‐challenged patients with seasonal allergic rhinitis. The individual symptoms, nasal itch or sneezes, were also not affected. These findings may indicate that TRPV1 is not a key mediator of the symptoms in allergic rhinitis. However, additional studies, using drug formulations with a prolonged duration of action, should be conducted before TRPV1 is ruled out as a drug target in allergic rhinitis.     

补气固表制剂对变应性鼻炎鼻黏膜细胞凋亡指数的双向调节作用

目的：探讨补气固表制剂对变应性鼻炎鼻黏膜细胞凋亡指数的双向调节作用。方法：制作变应性鼻炎豚鼠模型，观察黏膜上皮细胞，黏膜下腺体细胞凋亡指数的变化和细胞凋亡与嗜酸细胞数量的关系，观察黏膜上皮细胞、黏膜下腺体细胞凋亡指数比值对补气固表制剂的反应，并与对照组比较。结果：变应性鼻炎模型组上述指标均异常，与正常对照组相比差异有统计学意义（P〈0．01）。补气固表制剂干预后恢复正常。与正常对照组相比差异无统计学意义（P〉0．05）。结论：变应性鼻炎鼻黏膜细胞的凋亡具有双重性，其凋亡特性与细胞种类相关，并与嗜酸细胞的数量有关，补气固表制剂能双向调节凋亡指数，保持鼻黏膜的生理稳态。有效地治疗变应性鼻炎。     

Studies on the experimental allergic rhinitis induced by Japanese cedar pollen--role of cysteinyl leukotrienes in nasal allergic symptoms

Cysteinyl leukotrienes (CysLTs: LTC4, LTD4, and LTE4) are a family of potent inflammatory mediators that appear to contribute to the pathophysiologic features of allergic rhinitis. Because treatment with a CysLT1 receptor antagonist and a 5-lipoxygenase inhibitor modified allergen-induced nasal blockage in patients with allergic rhinitis, and CysLTs were detected in nasal cavity lavage fluid, it has been suggested that CysLTs act as significant inflammatory mediators in allergic rhinitis. The role of CysLTs was evaluated in our experimental allergic rhinitis model in sensitized guinea pigs which shows biphasic nasal blockage, sneezing and nasal hyperresponsiveness to LTD4 induced by repetitive inhalation challenge with Japanese cedar pollen. In this model, the CysLT1 receptor antagonist pranlukast suppressed the late-phase nasal blockage but not early blockage and sneezing. Nasal hyperresponsiveness (nasal blockage) to LTD4 was largely blocked by pranlukast, naphazoline, and N omega-nitro-L-arginine-methyl ester. The results demonstrate that nasal blockage induced by CysLTs is mainly due to dilatation of nasal blood vessels, which can be induced by the nitric oxide produced through CysLT1 receptor activation. On the other hand, when pollen inhalation challenge was performed in the presence of nasal hyperresponsiveness, antigen-induced biphasic nasal blockage and sneezing were considerably enhanced and CysLTs contributed to both symptoms, suggesting that nasal hyperresponsiveness induces aggravation of antigen-induced nasal symptoms. The results presented in this study further suggest that our model is a good representative of human allergic rhinitis and offer evidence that CysLTs are chemical mediators mainly responsible for allergic nasal symptoms.     

Novel treatments for allergic rhinitis: An investigation into the role of bradykinin in the human nasal airway

This paper presents a review of the current literature concerning bradykinin and allergic rhinitis and presents novel data investigating the role of bradykinin in the human nasal airway. Studies are being carried out at the present time to investigate the effect of L-NAME on challenge with antigen in subjects with seasonal and perennial allergic rhinitis. No final data are yet available but initial results indicate that, in seasonal allergic rhinitis, L-NAME antagonizes the increase in vascular permeability induced by grass challenge. Future advances in understanding allergic rhinitis will be targeted at a number of inflammatory mediators; however, this paper demonstrates the role bradykinin plays in inflammation of the nasal tissues.     

水通道蛋白5在变应性鼻炎鼻黏膜的表达及意义

目的 证实水通道蛋白5(aquaporin5,AQP5)在人变应性鼻炎鼻黏膜与正常鼻黏膜中的表达及分布,进一步探讨AQP5与变应性鼻炎的关系.方法 应用免疫组化技术对30例变应性鼻炎患者下鼻甲黏膜(变应性鼻炎组)和10例正常人鼻中隔前下部黏膜(对照组)标本中AQP5的表达进行检测,并进行统计学分析.结果 AQP5的表达在变应性鼻炎组和正常对照组鼻黏膜中的分布部位基本一致,均表达于鼻黏膜表面柱状上皮细胞及黏膜下腺的腺上皮细胞;统计学分析显示,AQP5在变应性鼻炎组鼻黏膜中的表达明显高于正常对照组,两组间差异有统计学意义(P＜0.01).结论 在变应性鼻炎中,AQP5的高表达与腺体过度分泌密切相关.     

A new model of allergic rhinitis in rats by topical sensitization and evaluation of H(1)-receptor antagonists

An animal model of chronic allergic rhinitis was developed by repeated local booster sensitization into the nasal cavity in sensitized rats. The severity of allergic rhinitis was assessed by determining the extent of two markers of nasal allergic symptoms (sneezing and nasal rubbing) after antigen challenge. The number of incidents of sneezing and nasal rubbing was markedly increased during intranasal instillation of antigen in sensitized rats. The PCA titers were also markedly elevated by intranasal sensitization. Some histamine H(1)-receptor antagonists such as chlorpheniramine, ketotifen, astemizole and epinastine inhibited the increase in antigen-induced nasal symptoms in a dose-related manner. Nasal rubbing was more potently inhibited by H(1)-receptor antagonists than sneezing.In conclusion, we developed a chronic allergic rhinitis model showing nasal symptoms in rats, and this model may be useful for evaluating the effects of drugs on allergic rhinitis.