Abstract:
This is an updated guideline for the diagnosis and management of allergic and non-allergic rhinitis, first published in 2007. It was produced by the Standards of Care Committee of the British Society of Allergy and Clinical Immunology, using accredited methods. Allergic rhinitis is common and affects 10-15% of children and 26% of adults in the UK, it affects quality of life, school and work attendance, and is a risk factor for development of asthma. Allergic rhinitis is diagnosed by history and examination, supported by specific allergy tests. Topical nasal corticosteroids are the treatment of choice for moderate to severe disease. Combination therapy with intranasal corticosteroid plus intranasal antihistamine is more effective than either alone and provides second line treatment for those with rhinitis poorly controlled on monotherapy. Immunotherapy is highly effective when the specific allergen is the responsible driver for the symptoms. Treatment of rhinitis is associated with benefits for asthma. Non-allergic rhinitis also is a risk factor for the development of asthma and may be eosinophilic and steroid-responsive or neurogenic and non- inflammatory. Non-allergic rhinitis may be a presenting complaint for systemic disorders such as granulomatous or eosinophilic polyangiitis, and sarcoidoisis. Infective rhinitis can be caused by viruses, and less commonly by bacteria, fungi and protozoa.
摘要:
这是过敏性和非过敏性鼻炎的诊断和管理的最新指南,2007年首次出版。它是由英国过敏和临床免疫学学会的护理标准委员会制作的,使用认可的方法。过敏性鼻炎很常见,影响英国10-15%的儿童和26%的成年人,影响生活质量,学校和工作出勤率,是哮喘发展的危险因素。过敏性鼻炎是通过病史和检查来诊断的,由特定的过敏测试支持。局部鼻皮质类固醇是中重度疾病的首选治疗方法。鼻内皮质类固醇加鼻内抗组胺药的联合治疗比单独治疗更有效,并且为单药治疗控制不佳的鼻炎患者提供二线治疗。当特定的过敏原是症状的负责驱动因素时,免疫疗法是非常有效的。鼻炎的治疗与哮喘的益处相关。非过敏性鼻炎也是哮喘发展的危险因素,并且可能是嗜酸性粒细胞和类固醇反应性或神经源性和非炎性的。非过敏性鼻炎可能是全身性疾病如肉芽肿性或嗜酸性粒细胞性多血管炎的表现,和肉瘤。感染性鼻炎可由病毒引起,细菌不太常见,真菌和原生动物。