治疗过敏性鼻炎药物的临床应用

目的介绍过敏性鼻炎的治疗药物研究进展。方法查阅大量国内外代表性文献,进行分析,整理和归纳。结果近几年来治疗过敏性鼻炎的药物有减充血剂、抗胆碱药、皮质激素类药物、抗组胺药、肥大细胞稳定剂、白三烯受体拮抗剂、IgE抗体等。结论各类治疗过敏性鼻炎的药物疗效各有不同,临床应用这些药物时要针对过敏性鼻炎不同的症状选用不同的药物,以达到更好的疗效。过敏性鼻炎是一种常见病,我国每年至少有3～4千万人患病。过敏性鼻炎分为常年性和季节性。目前国际上治疗过敏性鼻炎的方法主要有远离过敏源、药物疗法、免疫疗法等。本文将就过敏性鼻炎的药物疗法进行综述。     

影响粉尘螨滴剂治疗过敏性鼻炎疗效的相关因素分析

目的 探讨影响粉尘螨滴剂治疗过敏性鼻炎疗效的相关因素。方法 采用回顾性方法分析2012年1月~2014年6月在本院门诊就诊的过敏原为尘螨的过敏性鼻炎患者326例,采用粉尘螨滴剂舌下含服脱敏治疗,根据患者鼻炎症状、体征进行评分,采用单因素及多因素方法进行统计学分析。结果 年龄、多重过敏原、病程、对症药物治疗、规则用药、伴发鼻窦炎、疗程为粉尘螨滴剂治疗过敏性鼻炎疗效的影响因素(P<0.05),年龄、规则用药、疗程是影响粉尘螨滴剂治疗过敏性鼻炎疗效的独立因素(P<0.05)。结论 应用粉尘螨滴剂治疗过敏性鼻炎应尽早、规则、足够疗程用药,同时对症治疗过敏性鼻炎、鼻窦炎等症状,均能提高脱敏治疗的效果。     

妊娠期过敏性鼻炎的治疗

妊娠期常见鼻炎,妊娠又加重鼻塞症状。妊娠的最后3个月可出现持久性鼻炎,但在分娩时症状消失。过敏性鼻炎的治疗方法包括避开过敏原、药物治疗、特殊免疫疗法和教育。由于大多数药物均可通过胎盘,故对用药孕妇总要提醒:头3个月妊娠用药最易引起胎儿畸形。市售控制过敏性鼻炎的药物　(1)糖皮质类固醇:鼻内给糖皮质类固醇药(倍氯米松、布地奈德、氟替卡松等)是现今过敏性与非过敏性鼻炎包括妊娠鼻炎的最佳治疗药物。它们抑制过敏性鼻炎过程的各个阶段。合理使用鼻内给药替代全身给药,使鼻粘膜受体获得药物高浓度,而全身副作用相对危险最小。鼻…     

变应原注射免疫治疗过敏性鼻炎

背景：过敏性鼻炎是最常见的过敏性疾病。尽管对过敏性鼻炎的病理生理有了深入了解并在药物治疗上取得进展,但是全世界过敏性鼻炎的患病率仍有增高。对于药物治疗不能控制症状的患者,建议采用变应原免疫疗法。变应原治疗可减轻症状,减少用药,缩短病程。     

治疗儿童过敏性鼻炎的药物选择

1.概述与许多其他的过敏性疾病一样,过敏性鼻炎的首选治疗是避免接触过敏原,这一治疗措施的实现依赖于过敏原的类型,如果是环境中普遍存在的过敏原,则很难避免,因而这类患者需要药物来减轻他们的症状。2001年由世界各国专家制定了过敏性鼻炎及其对哮喘的影响(The AllergicRhinitis and its Impact on Asthma ARIA)指南[1],该指南对于过敏性鼻炎的治疗提出了分级处理的方法,目的是在最大发挥药物治疗作用的同时,尽可能的减少不良反应的发生。针对儿童的特点,该指南提醒医生对这一群体在选择治疗方案时应充分考虑利益与风险的比例。ARIA…     

过敏性鼻炎的治疗药物研究进展

过敏性鼻炎是一种常见病,全球10%～25%的人受到它的困扰。根据粗略估计,我国每年至少有3千万～4千万人患病。过敏性鼻炎分为常年性和季节性。其四大典型症状为:鼻痒、喷嚏、鼻溢液和鼻阻塞。目前国际上治疗过敏性鼻炎的方案主要有远离过敏源、药物疗法、免疫疗法等。现就过敏性鼻炎的药物疗法进行综述。1减充血剂鼻内充血是过敏性鼻炎最严重的症状之一,减充血剂具有拟交感活性,引起鼻黏膜血管收缩而缓     

孟鲁司特钠片联合布地奈德鼻喷雾剂治疗过敏性鼻炎临床探讨

<正>过敏性鼻炎即变应性鼻炎,是变应原引发的一种局部过敏反应,属于鼻黏膜非感染性炎性疾病。过敏性鼻炎极易反复发作,且呈季节性发作特征,对于患者正常工作和学习影响较大,因而必须探索一种可靠的临床疗法[1]。白三烯受体拮抗剂及激素类鼻喷雾剂是过敏性鼻炎治疗的常用药物,两者联用逐渐增多[2,3]。为进一步探明白三烯受体拮抗剂     

阿罗格脱敏治疗过敏性鼻炎的临床疗效观察

目的：总结在临床试验中使用阿罗格脱敏对入院治疗的40名过敏性鼻炎患者的效果观察。方法：对2010年3月～2011年1月在我院进行过敏性鼻炎治疗的患者的临床特征进行原因分析,并相应的给予阿罗格脱敏的药物治疗。结果：症状减轻或消失的36人,占90%;无效4人,占10%。结论：阿罗格脱敏对过敏性鼻炎的治疗具有显著效果,是临床上治疗过敏性鼻炎的首选药物。     

过敏性鼻炎的专家看法

由于鼻内类固醇药物直接针对病因、疗效确切,因而能有效缓解过敏性鼻炎的鼻痒、打喷嚏、流鼻涕和鼻塞等症状.鼻内类固醇药物是目前治疗过敏性鼻炎的一线药物.     

内镜下射频治疗常年性过敏性鼻炎的研究进展

内镜下射频治疗逐渐发展,过去常用于肥厚性鼻炎等增生性疾病。过敏性鼻炎由于鼻腔黏膜敏感性较高,接触过敏原产生一系列过敏反应导致。因此,内镜下对鼻腔黏膜射频治疗,可以达到治疗过敏性鼻炎的目的。常年性过敏性鼻炎,病程较长,病情反复,药物治疗效果不显著。因此,内镜下射频治疗对于常年性过敏性鼻炎患者尤为必要。     

变应性鼻炎及合并哮喘患者吸入性变应原检测结果

目的:明确主要变应原,为变应性鼻炎及合并哮喘患者提供防治指导和帮助。方法:分析吸入性变应原皮肤点刺试验阳性的231例变应性鼻炎患者结果,按是否合并哮喘分为两组,变应性鼻炎组199例,合并哮喘组32例。结果:两组患者的吸入性变应原阳性反应率及总体分布无明显差异,且均以粉尘螨、艾蒿、屋尘螨、热带螨、豚草为主。结论:皮肤点刺试验可作为变应性鼻炎及合并哮喘患者变应原检测的首选方法,但不是预测变应性鼻炎发展的手段。     

变应性鼻炎过敏原检测及流行病学的调查研究

目的探讨深圳特区人群中变应性鼻炎的临床特点和发病情况。方法对19964名到我院行健康体检者进行问卷调查,疑为有变应性鼻炎者作血清过敏原特异度IgE(sIgE)检测。结果19964名健康体检人中诊断变应性鼻炎者2285例(占11.45%);其中吸入组最常见的过敏原是尘螨和霉菌,食物组则为磨菇、虾和混合贝类。结论变应性鼻炎是深圳特区最常见的过敏性疾病之一,常见过敏原以尘螨、霉菌、蘑菇、虾和贝类等为主。     

Allergic rhinitis in children : diagnosis and management strategies

The incidence of allergic rhinitis has been increasing for the last few decades, in keeping with the rising incidence of atopy worldwide. Allergic rhinitis has a prevalence of up to 40% in children, although it frequently goes unrecognized and untreated. This can have enormous negative consequences, particularly in children, since it is associated with numerous complications and comorbidities that have a significant health impact on quality of life. In fact, allergic rhinitis is considered to be a risk factor for asthma. There are numerous signs of allergic rhinitis, particularly in children, that can alert an observant clinician to its presence. Children with severe allergic rhinitis often have facial manifestations of itching and obstructed breathing, including a gaping mouth, chapped lips, evidence of sleep deprivation, a long face, dental malloclusions, and the allergic shiner, allergic salute, or allergic crease. The medical history is extremely important as it can reveal information regarding a family history of atopy and the progression of atopy in the child. It is also important to identify the specific triggers of allergic rhinitis, because one of the keys to successful management is the avoidance of triggers. A tripartite treatment strategy that embraces environmental control, immunotherapy, and pharmacologic treatment is the most comprehensive approach. Immunotherapy has come to be viewed as potentially prophylactic, capable of altering the course of allergic rhinitis. The most recent guidelines for the management of allergic rhinitis issued by the WHO recommend a tiered approach that integrates diagnosis and treatment, in which allergic rhinitis is subclassified both by frequency, as either intermittent or persistent, and by severity, as either mild or moderate to severe. Oral or topical antihistamines and intranasal corticosteroids are the mainstay of pharmacologic therapy for allergic rhinitis, depending upon its severity, and several agents have been approved for use in children aged 5 years old and younger.     

变应性鼻炎主要过敏原检测的分析及研究

目的对变应性鼻炎的主要过敏原种类进行分析。方法在我科门诊就诊的变应性鼻炎患者1835例,采用酶免疫法使用MAST过敏原检测系统进行35种变应原特异性IgE(sIgE)同时检测,并对引起变应性鼻炎发作的主要过敏原进行分析研究。结果1835例变应性鼻炎患者中,有1573例的血清过敏原特异性IgE呈阳性反应,阳性率为85.72%;吸入组最主要过敏原为霉菌类(青霉菌属、芽枝菌属、曲霉菌、交链孢属)和螨(屋尘螨、粉尘螨);食物类过敏原虾和蟹则为最主要的食物性过敏原。结论吸入组霉菌和螨、食物组虾和蟹是诱发变应性鼻炎的主要过敏原之一,对其预防和治疗是当前最为重要的一项工作。     

变应性鼻炎与变应性结膜炎的相关性进展研究

变应性鼻炎与变应性结膜炎均是由外源性抗原引起的免疫性疾病,具有变应性体质的病人与超敏原初次接触后,会使病人处于致敏状态,当再次接触该超敏原时,病人机体便会产生某些蛋白质因子以及细胞因子,促使变应性疾病的发生发展.临床上常见变应性鼻炎病人除鼻塞、喷嚏及清水样鼻涕等典型症状以外,还伴随着变应性结膜炎的症状,例如眼红、眼痒、迎风流泪及水样分泌物等症状.目前国内外专家在多个层面上分别对变应性鼻炎及变应性结膜炎的病因、发生机制以及治疗进行了一定的研究.该研究主要从两者的相关性方面进行概述,希望对临床研究及综合治疗变应性疾病具有指导意义.     

曲安缩松治疗过敏性鼻炎91例的临床疗效

目的：观察小剂量曲安缩松加入呋麻滴鼻液中，在鼻腔内局部应用，对过敏性鼻炎的治疗的临床疗效，方法：帮央安缩松２ｍｇ加入呋麻滴鼻液８ｍｌ中，使其充分混合；对９１例过敏性鼻炎患者局部滴鼻ｔｉｄ－ｑｉｄ；２－３滴／次。结果；小剂量曲安缩松加入呋麻滴鼻液中滴鼻治疗过敏性鼻炎，有效率９３．４０％，显效率５９．３４％。结论；用小剂量曲安缩松局部应用对过敏性鼻炎有明显抗过敏作用，并见效快，应用方便，无不良反应，但     

The economic burden of allergic rhinitis: a critical evaluation of the literature

Although a large number of economic analyses of allergic rhinitis have been published, there are relatively few empirically based studies, particularly outside the US. The majority of these analyses can be classified as burden-of-illness studies. Most estimates of the annual cost of allergic rhinitis range from dollars US 2-5 billion (2003 values). The wide range of estimates can be attributed to differences in identifying patients with allergic rhinitis, differences in cost assignment, limitations associated with available data and difficulties in assigning indirect costs (associated with reduced productivity) of allergic rhinitis. Approximately one-third of burden-of-illness studies include direct and indirect costs of allergic rhinitis, about one-third focus on direct costs only, and the remaining one-third focus exclusively on indirect costs due to reduced productivity. Indirect costs attributable to allergic rhinitis were higher in studies only estimating indirect costs (dollars US 5.5-9.7 billion) than in those estimating both direct and indirect costs (dollars US 1.7-4.3 billion). Although there are many economic evaluations of allergic rhinitis treatments in the published medical literature, very few represent formal cost-effectiveness evaluations that compare the incremental costs and benefits of alternative treatment strategies. Those that are incremental cost-effectiveness analyses have several limitations, including small samples, short study periods and the lack of a standardized measure of effectiveness. To date, the medical literature is lacking a comprehensive economic evaluation of general treatment strategies for allergic rhinitis. In undertaking such an analysis, serious consideration must be given to the study population of interest, the choice of appropriate comparators, the perspective from which the analysis is conducted, the target audience, the changing healthcare marketplace and the selection of a measure of effectiveness that incorporates both positive and negative aspects of treatments for allergic rhinitis. Future work would benefit from the development of a consensus on a summary measure of effectiveness that could be used in cost-effectiveness analyses of therapies for allergic rhinitis as well as additional empirical work to measure the association between severity of disease and its impact on worker productivity.     

辛夷鼻炎丸治疗急、慢性鼻炎及变应性鼻炎多中心随机对照试验

目的通过临床试验客观评价其临床疗效及安全性,进一步考察辛夷鼻炎丸对急慢性鼻炎及变应性鼻炎的疗效,申报国家中药保护品种。方法将452例临床确诊的急慢性鼻炎及变应性鼻炎患者按单纯随机方法分为两组(试验组304例和对照组138例)。急性鼻炎:试验组,口服辛夷鼻炎丸一次3g,3次/d,共5d;对照组,口服芎菊上清丸一次6g,2次/d,共5d;慢性鼻炎及变应性鼻炎:试验组,口服辛夷鼻炎丸一次3g,3次/d,共28d;对照组,开水冲服通窍鼻炎颗粒,一次2g,3次/d,共28d,比较两组疗效并观察药物不良反应。结果急性鼻炎、慢性鼻炎、变应性鼻炎总有效率,试验组分别为98.31%、98.40%、93.44%,对照组分别为98.31%、97.96%、90.00%,说明两组药物治疗慢性鼻炎总疗效相似,未发现明显不良反应及毒副作用。结论辛夷鼻炎丸治疗急性鼻炎(外感风热证)、慢性鼻炎及变应性鼻炎是安全和有效的。     

Rupatadine: a review of its use in the management of allergic disorders

Rupatadine (Rupafin, Rinialer, Rupax, Alergoliber) is a selective oral histamine H(1)-receptor antagonist that has also been shown to have platelet-activating factor (PAF) antagonist activity in vitro. It is indicated for use in seasonal allergic rhinitis (SAR), perennial allergic rhinitis (PAR) and chronic idiopathic urticaria (CIU) in patients aged >/=12 years.Clinical trials show that rupatadine is an effective and generally well tolerated treatment for allergic rhinitis and CIU. It has a rapid onset of action and a prolonged duration of activity. Importantly, it has no significant effect on cognition, psychomotor function or the cardiovascular system. Once-daily rupatadine significantly improves allergic rhinitis symptoms in patients with SAR, PAR or persistent allergic rhinitis (PER) compared with placebo, and provides similar symptom control to that of loratadine, desloratadine, cetirizine or ebastine. In patients with CIU, longer-term use of rupatadine improves CIU symptoms to a greater extent than placebo. It is as well tolerated as other commonly used second-generation H(1)-receptor antagonists. Thus, the introduction of rupatadine extends the range of oral agents available for the treatment of allergic disorders, including allergic rhinitis and CIU.     

鼻内镜下手术加微电脑射频治疗变应性鼻炎的临床研究

目的研究鼻内镜下手术加微电脑射频治疗变应性鼻炎的临床疗效。方法回顾性分析采用鼻内镜下手术加XVC-Ⅱ型微电脑射频治疗仪治疗60例变应性鼻炎患者。结果治疗60例变应性鼻炎患者,经手术加微电脑射频治疗后随访观察1年,显效54例(90%)。有效4例(6.7%),无效2例,总有效率96.7%。结论手术加微电脑射频是治疗变应性鼻炎的有效方法。