website xiaobian searched some information on some professional websites about the most common problems encountered by patients with allergic rhinitis, and summarized the following common problems after sorting out. The system answers are as follows:
1. The problem of drug reduction:
Asthma, allergic rhinitis, allergic rhinobronchitis, postnasal drip syndrome and adenoidal hypertrophy usually need to be stable for 3-4 months before the treatment can be reduced, and the reduction is slow. At the same time, we also need corresponding auxiliary methods to adjust allergy. While controlling allergic rhinitis, allergic asthma and allergic rhinobronchitis with drugs, we should supplement Kangminyuan, an anti-allergic probiotic, to correct the immune disorder. Adjusting allergic constitution can help patients easily solve the problem of drug reduction in the treatment of allergic rhinitis and asthma. Kangminyuan, an anti-allergic probiotic, can help reduce drugs from the asymptomatic state with drugs to the asymptomatic state with low doses, and then to the asymptomatic state without drugs. If the reduction is too fast, the disease will recur and all previous efforts will be abandoned. Usually, the condition is evaluated once every three months, and the doctor is consulted or combined with the stable state of allergic rhinitis in remission to decide whether to reduce the dosage. For patients and children with asthma, allergic rhinitis, asthma syndrome and allergic rhinobronchitis, it takes 2-3 years to continuously reduce the dosage and maintain the treatment, while children with simple adenoidal hypertrophy should be treated for at least 4-6 months. Aspirin asthma, chronic obstructive pulmonary disease (emphysema, cor pulmonale), intractable asthma and hormone-resistant asthma take longer.
2. The problem of relapse or poor initial curative effect:
Strictly following the doctor's advice and slowly reducing the amount according to the doctor's advice will not recur. Recurrence of the disease is usually related to contact with allergens (inhalation or food), respiratory infection (or cold), chemical odor or irritating gas, temperature (cold) and humidity changes, and smog. Secondly, the treatment is not standardized or disjointed, such as poor compliance of patients with doctor's advice or insufficient dosage or rapid reduction for some reasons. It may also be related to the failure of immunotherapy (non-drug anti-allergic probiotic Kangminyuan IgE-lowering immunotherapy) or desensitization therapy. There is also a very important link about the easy recurrence of the disease: with the improvement of the disease, the treatment methods of patients or children become irregular, the drug inhalation is not in place and the inhalation dose is insufficient, and auxiliary programs such as the supplement of Kangminyuan, an anti-allergic probiotic, are the most common and important reasons for the recurrence of asthma, rhinitis or adenoidal hypertrophy. Think about it carefully, how can we effectively and comprehensively control the allergic inflammation of the upper and lower respiratory tract when the atomized drugs (microgram drugs) are always inhaled poorly? When inhaling through the nose, it should be inhaled when the nasal cavity is ventilated, and the nasal cavity should be cleaned with physiological seawater nasal irrigator 15 minutes before inhaling. In particular, if there is thick nasal mucus or sticky nasal mucus, it is necessary to rinse the nasal cavity with physiological seawater nasal irrigator to rinse out the nasal mucus, otherwise the inhaled drugs will easily stick to the nasal mucus and obviously affect the drug's contact with mucosa, resulting in poor curative effect.
3. Side effects of inhaled hormones:
Because inhaled trace hormones are the fastest and most effective common method to treat allergic rhinitis and control allergic asthma, and local treatment is the main method to absorb less, so inhaled hormones have few side effects. No inhibition of inhaled budesonide on adrenocortical function and hypothalamus-pituitary-adrenocortical axis was found when the recommended therapeutic dose was used correctly, and no side effects like Cushing's syndrome such as edematous obesity, osteoporosis and hirsutism were found. According to a two-year clinical observation of inhaled budesonide in Britain, the results confirmed that it would not affect the growth and height of children. ① Rinsing your mouth in time after oral inhalation (you should press your mouth once), and spitting out the mouthwash is the key measure to avoid the systemic side effects of oral inhalation of hormones in the treatment of asthma and allergic rhinitis asthma syndrome. A few patients may have hoarseness, so the throat gargle method should be used to gargle. A very small number of children may occasionally have thrush, which is also related to the failure to rinse their mouths in time after inhalation. ② For patients with allergic rhinitis and adenoid hypertrophy treated by nasal inhalation, drugs may be deposited in the throat during slow and deep inhalation, so it is best to rinse their mouths in time after nasal inhalation, and it is also best to wash the nasal vestibule with cotton swab dipped in normal saline (that is, the nostril ③ is used for children under 3 and a half years old <: Infants and young children with mask-type aerosol cans should wash their faces and rinse their mouths in time after inhalation.
4. About the side effects of antiallergic drugs:
Because the first-generation antiallergic drugs such as chlorpheniramine and phenergan have strong central nervous system inhibition, they can't be used in the treatment of asthma, allergic rhinitis and allergic rhinitis asthma syndrome for a long time, while the second-generation antiallergic drugs (such as cismin, loratadine, terfenadine, cetirizine and ketotifen, etc.) have obvious cardiac toxicity and are easy to cause. At present, we use levocetirizine, desloratadine, fexofenadine and other third-generation antihistamines with high safety and few side effects, which are suitable for long-term use and have very few side effects, and are the most commonly used drugs in advanced countries abroad. Attention (levocetirizine is not cetirizine, desloratadine is not loratadine, although there is a word difference, but the side effects are many times worse, so pay attention to identification)
5. Cold problems occur during treatment:
During treatment, if there is yellow phlegm or yellow thick nose or fever, it is usually complicated with respiratory infection or a cold, and children with allergic constitution should try not to use antibiotics (because most of them) Second, children with allergic constitution have more side effects with antibiotics. When they have yellow or sticky nose or feel nasal discharge, they can use physiological seawater nasal irrigation device to wash their nasal cavity and use levofloxacin eye drops to drop their nose (2 drops on each side, 3 times a day). When dripping nose, lie flat at the end of the bed, with the head sticking out of the end of the bed in a backward position, with the nostril upward, and gently drop nose for 2-5 minutes to avoid bitter feeling in the medicine inlet. If you have a fever below 38.5 degrees, you can take an alcohol bath, and if you have a fever above 38.5 degrees, you can take antipyretics. The vast majority of colds can be relieved within a few days after the above non-systemic antibiotic treatment. If there are still no signs of remission after treatment, you should go to the local hospital to check the blood routine, and the white blood cell (WBC) is high, which means that the blood picture is usually high, which may be a bacterial infection. You should consider using antibiotics (such as cephalosporins); Low hemogram and high lymphocytes may be respiratory virus infection, while virus infection only pays attention to drinking more water and rest. Secondly, mycoplasma infection should be considered if the infection is not cured after repeated treatment. If the mycoplasma antibody is positive, erythromycin enteric-coated tablets can be considered for treatment (azithromycin has heart side effects, so be careful). Budesonide or antiallergic drugs should not be stopped at will during the treatment of respiratory tract infection or cold, but immunomodulators (such as jade screen, spleen peptide, chest peptide, Shenqi granule, etc.) can be suspended when there is a fever. Cough or nose symptoms will be aggravated during the recovery period after a cold. One press of budesonide can be added to clear nasal discharge or dry cough, and usually it can be recovered in one week without using too much medicine. The treatment of yellow nasal discharge or sticky nasal discharge is the same as above.
6. Some parents asked about the problem that the adenoids have shrunk, but the tonsils are still large. Because the tonsils are chronic hypertrophy caused by breathing with the mouth open, bacterial viruses or allergens are inhaled through the mouth, they need to recover slowly without breathing with the mouth open for a period of time after the adenoids are treated for atrophy. This chronic tonsil hypertrophy is different from the hypertrophy of acute tonsillitis, and usually the drug effect is not good, but it only takes time to recover.
7. Time and efficacy of desensitization therapy and immunotherapy:
Usually desensitization therapy takes 2-3 years, so persistent treatment is needed. Desensitization therapy and immunotherapy can't cure allergic constitution, but a treatment method to treat allergic diseases by improving allergic constitution. Although it is difficult to cure, it has a radical effect and can effectively improve the condition. Desensitization therapy includes sublingual drop administration and injection administration. Immunotherapy mostly adopts oral therapy. Patients who are usually over 4 years old and are mainly allergic to dust mites are suitable for desensitization treatment. Immunotherapy (including traditional Chinese medicine immunotherapy and biological agents) is suitable for children and adults over 2 years old, and it also needs at least 3 or 6 months of treatment. Immunotherapy for adults takes longer. Immunotherapy drugs usually have no or few side effects. There are few side effects of desensitization treatment.
8. Course of treatment:
Allergic disease is caused by allergic constitution and is a chronic disease, so it needs long-term treatment. Each person's course of treatment varies according to different conditions (severity and complications), such as asthma complicated with allergic rhinitis, adenoidal hypertrophy complicated with allergic rhinitis or bronchitis, and even allergic rhinitis, allergic conjunctivitis, allergic asthma, adenoidal hypertrophy and eczema, so the specific courses are different in length. At present, the international popular treatment schemes are all individualized treatment schemes, the length of each treatment course and several treatment courses vary from person to person due to illness, and this scheme is usually a long continuous process, so it requires close cooperation between doctors, patients and parents of children.
9. The special significance of immune regulation in allergy treatment:
The combination of Lactobacillus salivarius and Lactobacillus Grignard, an antiallergic probiotic, creates a new non-drug antiallergic microecological immune therapy.
Allergy is an invisible killer to destroy the immune system. Repeated allergies can highly activate human immune cells and induce various inflammatory reactions, such as allergic rhinitis, allergic asthma, eczema in children, urticaria and allergic dermatitis caused by drugs, cosmetics, food and pollen allergy. Studies show that the number of Lactobacillus salivarius in people with allergic constitution is much lower than that of healthy constitution, which is the prerequisite for allergic reaction. Lack of Lactobacillus salivarius in human body will increase IgE antibody in serum and insufficient IFN-γ secretion in spleen cells, which will induce various allergic reactions in skin and mucosa. Su Weizhi, a doctor of biotechnology in Dongyu, Taiwan Province, found that the number of Lactobacillus salivarius in human intestine is sufficient, and there will be no allergic reaction after continuous contact with allergens; Supplementation of Lactobacillus salivarius is directly related to the occurrence and severity of allergic reaction.
Four major medical centers in Taiwan Province confirmed that quantitative supplementation of Lactobacillus salivarius for allergic children: 1. It helps to reduce the production of specific IgE antibodies in serum; 2. It is helpful to promote the secretion of IFN-γ in spleen cells. After 3 months of supplementation, the number of Salivary bacilli in allergic children basically reached the normal value, and the follow-up showed that allergic children did not have allergic reactions within 3 years. Lactobacillus salivarius is a native strain extracted from the digestive tract of healthy children, which is safe and efficient and can be supplemented by infants and pregnant women. The health food developed by Dongyu Biotechnology in Taiwan Province: Kangminyuan Probiotics, a compound bacterial granule mainly composed of Lactobacillus salivarius and Lactobacillus Grignard, greatly reduced the individual differences of allergies. This antiallergic probiotic has been listed on the mainland, and this product cannot replace medicines.
1. Exercise:
Exercise is an important measure to increase physical fitness and physical resistance, and it can complement each other with immunization or desensitization therapy to improve allergic physique. Sports suitable for patients with asthma and allergic rhinitis or children include swimming, morning running, Tai Ji Chuan, yoga, Qigong, relaxing badminton, breathing gymnastics and broadcast gymnastics. Swimming is relatively gentle, which can not only exercise the physique, but also adjust the breathing exercise and cold-resistant exercise. However, allergic physique is often allergic to disinfectant, and swimming pools are usually disinfected in the morning, so it is best to swim in the afternoon or evening. Yoga, Qigong and Tai Ji Chuan can also adjust breathing exercise and endurance exercise. Other sports, such as morning running and badminton, should have a moderate heart rate of no more than 1 beats per minute.
11. Dietary problems:
There is no need to strictly avoid food with mild allergy, and the principle of eating less, fresh and heated should be followed. Eating less often (the key is to control the amount of food) can produce tolerance (antibodies) and gradually stop allergies. For example, if you are allergic to milk, you can eat 1 ml a day first, 2 ml a day in the second week, and 4 ml a day in the third week ... If you are allergic to a certain dose, you can reduce one dose and eat more for one stage. The same is true of other foods. Don't eat seafood in the refrigerator, eat it fresh and don't eat it raw. For some foods that can induce severe allergies and are not often eaten, we should avoid them, such as mango, silkworm chrysalis, buckwheat, peaches and so on. Allergic patients should not eat too spicy food. Patients with cough and asthma should not eat sweet, salty and cold food. For children to eat ice cream and sorbet, you can eat it, but you should eat less at first, such as eating 1/8 ice cream or sorbet every day for the first week and 1/4 ice cream or sorbet every day for the second week, so that children can gradually adapt to it and increase their cold tolerance.
12. Conclusion
Parents' patience and long-term careful observation are often needed for the change of children's condition, and the judgment of the severity of the disease and the change and increase or decrease of the dosage of drugs in the treatment plan are often judged and decided by doctors, which requires parents and doctors to have a more effective and fixed communication channel. At present, a patient in most hospitals only sees the disease for a few minutes, and the outpatient department often changes the doctor's mode of seeing a doctor, which is very unfavorable for continuous observation, long-term treatment and accurate reduction of chronic diseases such as asthma, allergic rhinitis and adenoidal hypertrophy. Children with hereditary allergic constitution tendency should begin to pay attention to the adjustment of allergic constitution after allergic symptoms appear. Non-drug immunomodulation can supplement anti-allergic probiotic Kangminyuan on weekdays to adjust allergic constitution, help reduce allergic manifestations, prevent allergies and reduce the occurrence of allergic diseases.