(1) What is rhinitis sicca? Rhinitis sicca is a special type of chronic rhinitis and also belongs to the early stage of atrophic rhinitis. Clinically, the nasal cavity is dry, the nose has burning and itching sensation, the front end of the inferior turbinate has a little scab adhesion, or the nasal septum mucosa is eroded, which is easy to cause nosebleed.
(2) How does rhinitis sicca occur?
① Environmental factors: the climate is too cold and overheated, and the air in the working or living environment is dry and dusty, which is easy to get sick.
2 Eating habits: Long-term drinking, smoking and eating spicy food are easy to cause this disease.
③ Physical factors and chronic diseases: nutritional deficiency, chronic constipation, chronic uterine diseases, chronic anemia and other systemic chronic diseases are easy to induce this disease.
④ Pathological changes: the nasal mucosa is mainly dry and thin, some epithelial cells lose cilia, and the secretion function is reduced due to the degeneration and atrophy of secretory glands, which is easy to cause dryness and dryness, and in severe cases, superficial mucosal ulcers, capillary rupture and nosebleeds.
(3) How to diagnose rhinitis sicca ① History: The course of disease is long or short, and the symptoms are aggravated every time.
② Symptoms of nasal dryness: consciously dry nasal cavity, less runny nose, and rarely blowing out nasal mucus.
Foreign body sensation in nasal cavity: There are many burning foreign body sensations or burning or itching sensations in the nose, which makes children like to pick their noses, while children like to rub and pick their noses.
Nosebleed: It is mostly located in the vascular plexus area below the anterior nasal septum, which is often easy to stop (such as squeezing the alar to stop bleeding and stuffing clean paper into the anterior nostril). The main causes of bleeding are dryness, scabbing and erosion of mucosa under the anterior nasal septum. If there is a foreign body feeling itchy in the nose after sleep, digging your nose can easily lead to nosebleeds without knowing it, and it is often discovered the next morning.
③ Inspection: No special inspection is required. General endoscopic examination shows that the nasal mucosa is dry and red, with little body fluid, and a little dry scab is often attached to the front end of the inferior turbinate. The nasal septum can be congested, eroded, dry and crusted, and the nasal mucosa has no atrophy. If the nasal septum is damaged due to repeated nosebleeds and burning, or the nasal cavity is dry for a long time, it may be accompanied by perforation of the nasal septum.
(4) How to treat rhinitis sicca by western medicine ① Etiology treatment: eliminate the etiology, improve the environment, adjust the living and eating habits, improve nutrition, keep the stool unobstructed, and actively treat chronic diseases.
② Oral vitamin A, vitamin AD and vitamin C; Or take vitamin B complex.
③ Nasal drops: mainly use wetting agent, such as compound peppermint oil, or cod liver oil drops, or puncture with vitamin E capsules, 3-5 times a day.
④ Other symptomatic treatment: The dry and crusted nasal cavity can be squeezed to the front of the nasal cavity with tetracycline, chlortetracycline and other ointment or eye ointment to moisten the nasal cavity and play an anti-inflammatory role; If there is nosebleed, treat it as nosebleed and stop bleeding if necessary.
(5) How to treat rhinitis sicca with Chinese medicine: Chinese medicine mainly treats this disease based on syndrome differentiation, supplemented by local treatment (external treatment).
① External nasal drip method: vegetable oil (such as cooking vegetable oil, especially sesame oil) can be dripped or coated into the nostrils; Or equally divide Radix Rehmanniae, Radix et Rhizoma Rhei, Cortex Moutan, Radix Paeoniae Rubra and Radix Ophiopogonis, add proper amount of sesame oil to the medicinal surface, soak for one night, fry with slow fire until Radix Paeoniae Rubra turns brown, remove residues, cool, and use nasal oil for three times a day.
There are many kinds of oils, such as cod liver oil, vitamin AD capsules and vitamin E capsules. It can be dripped into the nose after puncture.
Blowing method: For patients with nasal septum erosion, Baiqing powder and Huangshu powder 1-2 times a day can be blown.
Ointment method: erosion of nasal septum, or nasal vestibule (the part with nasal hair on the alar)
The desiccant can be applied externally to coptis ointment and other eye ointment or ointment such as tetracycline, chlortetracycline and erythromycin.
② Syndrome differentiation and treatment of lung and stomach stagnation and heat syndrome: it is more common in young and middle-aged patients. The nose is the opening of the lung and the meridian of Yangming. Young and middle-aged people are full of yang, but excessive alcohol and tobacco, improper diet, or exogenous pathogenic dryness cause lung and stomach stagnation, body fluid consumption, and nasal nutrition loss. Symptoms include dryness in the nose, burning, itching, epistaxis, dry mouth, yellow urine, dry stool, red tongue with yellow coating, slippery pulse or slow but strong string. The examination found that the nasal mucosa was dry and dark red, and there were many nasal septum mucosa erosion and scab. Clear lung and stomach, you can use Yunu decoction or modified Aso Gegen decoction to clear lung and stomach, promote blood circulation and cool blood, and remove body fluid by heat to help nose and nose. Commonly used drugs: Radix Puerariae 15g, Radix Paeoniae Rubra 12g, Scutellariae Radix, Cortex Mori, Cortex Lycii 10g, Radix Rehmanniae, Radix Maimengen 15g, Akebia stem, Cimicifuga rhizome, Radix Glycyrrhizae 6g, and Fructus Passepartout 10g.
Spleen deficiency and lung dryness syndrome: more common in children. Children are based on the spleen and stomach, which is healthy, the yang is clear, and the spleen helps the lung, so the body fluid is always transported and the nose is self-interested. If the nursed back to health is improper, the diet is improper, the spleen and stomach are damaged, and the soil does not produce gold, then the source of clearing yang is insufficient, the nose loses nutrition, or the dryness and evil are heavy, resulting in this syndrome. Often manifested as dry nose, itching, discomfort, foreign body sensation, weakness of limbs, dull complexion, loss of appetite, pale tongue and slow pulse. The examination found that the nasal mucosa was deficient in fluid and there was a little dry scab at the front end of the inferior turbinate. It is advisable to cultivate soil and produce gold, clear profits and dryness, and use Buzhong Yiqi Decoction. Commonly used drugs:
Radix Astragali 10g, Radix Pseudostellariae 4g, Atractylodis Rhizoma 6g, Radix Angelicae Sinensis 3g, Pericarpium Citri Tangerinae 4g, Radix Glycyrrhizae Preparata 4g, Cimicifuga 4g, Radix Puerariae 10g, Radix Scrophulariae 6g, Radix Ophiopogonis 8g and Fructus Schisandrae 3g. Addition and subtraction: Cha Na adds Divine Comedy, malt and the like, and then adds Fructus Aurantii; The tongue root coating is yellowish, and Cortex Phellodendri is added.
Syndrome of lung dryness due to yin deficiency: mostly caused by lung dryness due to yin deficiency, burning body fluid due to deficiency fire, loss of moist and nourishing nose or dry sensation. Often manifested as dry nose, foreign body, itching, epistaxis, dry mouth and pharynx, less desire to drink, or five upset, fatigue, red tongue, less body fluid and rapid pulse. The examination found that the nasal mucosa was dry and red, and there was erosion and scab on the nasal septum mucosa. Treatment should be nourishing yin and moistening lung, clearing away heat and promoting fluid production.
It can be used to nourish yin and clear lung, clear dryness and save lung, or Lily Gujin decoction. Commonly used drugs:
Radix Rehmanniae, Radix Ophiopogonis and Radix Scrophulariae each 65438±05g, Radix Paeoniae Alba and Cortex Moutan each 65438±02g, and Herba Menthae and Radix Glycyrrhizae each 6g. Addition and subtraction: stool knot, add hemp seed.
Liver and gallbladder heat stagnation syndrome: liver meridian follows nose. If the liver and gallbladder are depressed, the wood fire is used to punish the gold, the lung yin is burned, and the nasal orifices are not nourished, it will cause nasal dryness. Symptoms are dry and burning nasal cavity, nosebleed, bitter taste and dry throat, irritability, red tongue, yellow fur and thready pulse. The examination found that the nasal mucosa was dry and red, and there was erosion and scab on the nasal septum. It is advisable to clear the liver and reduce fire, nourish yin and calm the lungs, add and subtract Longdan Xiegan Decoction, and add nourishing yin and promoting fluid production as appropriate. Commonly used drugs: Radix Gentianae 6g, Radix Angelicae Sinensis, Fructus Gardeniae, Scutellariae Radix, Rhizoma Alismatis, Semen Plantaginis 10g, Radix Adenophorae, Radix Ophiopogonis, Radix Rehmanniae 15g, Radix Bupleuri, Radix Glycyrrhizae and Akebiae 6g. Addition and subtraction: dry stool, add hemp seed or raw rhubarb (bubble).
③ Other treatments: acupuncture treatment: acupoint selection, Hegu, Sanyinjiao, Floating Six, Qi deficiency plus Zusanli and reinforcing method; Stagnation-heat syndrome adopts the methods of red ze, inner court, branch groove, point and diarrhea. Once a day, 10 is a course of treatment.
Ear acupuncture: acupoints are selected at the inner nose, screen, lower screen tip, lung, spleen and kidney. Acupuncture, 1 time every day or1time every other day is a course of treatment. Or paste it with melon seeds.
④ Experience: Ophiopogon japonicus and Ligustrum lucidum each 15g, Salvia miltiorrhiza 30g and Eclipta prostrata 20g. Decoct with water, daily 1 dose, 20 days as a course of treatment.
Empirical prescription (Jiawei Cimicifuga Gegen Decoction)
Composition: Cimicifuga rhizome 6g, Radix Puerariae 15g, Radix Paeoniae Rubra 12g, Radix Glycyrrhizae 6g, Scutellariae Radix 10g, Cortex Mori 10g, Cortex Lycii 10g, Radix Rehmanniae 15g, and Radix Ophiopogonis/kloc.
Indications: cooling blood, promoting blood circulation, clearing heat and inducing resuscitation. Suitable for dry rhinitis, atrophic rhinitis, chronic rhinitis and unpleasant smell.
Fang Jie: The nose belongs to the lung orifices and is closely related to Yangming Meridian. The stagnation and heat of nasal diseases are mostly attributed to lung and Yangming. In the prescription, Radix Paeoniae Alba, Radix Rehmanniae, Caulis Akebiae and Fructus Lipuidambaris are used to cool blood, promote blood circulation and dredge collaterals; Help Scutellaria baicalensis Georgi and Cortex Mori clear lung meridian and clear heat; Cortex Lycii and Radix Ophiopogonis clearing away heat, promoting fluid production and moistening dryness; Cimicifuga rhizome and kudzuvine root can relieve depression and Yangming, and also clear nasal orifices; Glycyrrhiza uralensis Fisch blends various drugs.
Press: This prescription is used to treat atrophic rhinitis caused by sinusitis. If constipation is complicated, Fructus Cannabis, Semen Persicae and Semen Armeniacae Amarum are added to moisten the intestine to relieve constipation; Bitter mouth, dry throat, irritability and thready pulse. Adding Radix Gentianae and Indigo Naturalis for clearing liver and purging fire. For those with yellow and turbid purulent nasal discharge, honeysuckle, agastaches and angelica dahurica are added to clear away heat and toxic materials to remove turbid nasal discharge, or modified with Cimicifuga Jiedu Decoction (see sinusitis).
Li Fancheng's Experience in External Treatment (Shao Dan Nasal Drops);
Composition: Radix et Rhizoma Rhei, Cortex Moutan, Radix Paeoniae Rubra and Radix Angelicae Dahuricae each 10g, Borneolum Syntheticum 1g (Radix Rehmanniae, Radix Ophiopogonis and Radix Angelicae Dahuricae can be added for moisturizing).
Methods and usage: Soak the medicine in proper amount of sesame oil on the medicine surface overnight, fry it with slow fire until Paeonia lactiflora turns brown, remove residues, cool it, add borneol and drop oil on the nose.
Indications: cooling blood, promoting blood circulation, detoxicating and nourishing orifices. Can be used for treating atrophic rhinitis or rhinitis sicca.