allergic rhinitis Hypersensitive rhinitis, also known as allergic rhinitis (AR), refers to a chronic inflammatory condition of the nasal mucosa primarily characterized by intermittent sneezing, runny nose, and nasal congestion, mediated mainly by immunoglobulin E (IgE) in susceptible individuals upon exposure to allergens, involving immune effector cells and cytokines in the process.

Allergic rhinitis, also known as hypersensitive rhinitis, is a chronic inflammatory disease of the nasal mucosa characterized by intermittent sneezing, runny nose, and nasal congestion, primarily mediated by immunoglobulin E (IgE), immune active cells, and cytokines in susceptible individuals upon exposure to allergens.

Classification based on the seasonality of allergens:

Perennial Allergic Rhinitis

Caused by perennial allergens such as house dust and mites, though symptoms may also worsen seasonally.

Seasonal Allergic Rhinitis

Primarily caused by seasonal pollen dispersion, also known as "hay fever." However, some individuals may be sensitive to multiple types of pollen, and in certain regions, pollen may be present year-round, leading to symptoms throughout the year.

Classification based on the timing of symptom onset:

Intermittent Allergic Rhinitis

Symptoms occur fewer than 4 days per week or less than 4 weeks per year.

Persistent Allergic Rhinitis

Symptoms occur 4 or more days per week or for more than 4 weeks per year.

To adapt to the Chinese national conditions, the traditional classification can be combined with the Allergic Rhinitis and its Impact on Asthma (ARIA) classification system, resulting in four categories: seasonal intermittent, seasonal persistent, perennial intermittent, and perennial persistent.

Classification based on disease severity:

Mild Allergic Rhinitis

Mild symptoms that do not significantly affect quality of life, including sleep, daily activities, work, and study.

Moderate to Severe Allergic Rhinitis

Symptoms are severe and significantly impact quality of life.

These can be further combined with the ARIA-recommended classifications, resulting in mild intermittent, moderate to severe intermittent, mild persistent, and moderate to severe persistent categories.

Itchy nose: Most patients experience nasal itching, sometimes accompanied by itching of the soft palate, eyes, and throat.

Sneezing: Frequent bouts of sneezing, ranging from a few to a dozen or more episodes at a time.

Watery nasal discharge: Increased frequency of nose blowing.

Nasal congestion: Both sides of the nose are congested to varying degrees. Pollen-allergic individuals may experience significant nasal mucosal swelling and severe congestion, with some also experiencing reduced sense of smell.

Treatment in traditional Chinese medicine involves tonifying the kidneys, nourishing the lungs, and invigorating the spleen. Both Chinese herbal medicine and acupuncture have shown certain therapeutic effects.

Complications directly related to allergic rhinitis include the following conditions:

Otitis media with effusion

A non-suppurative inflammatory condition characterized by sensations of ear fullness, ringing in the ears, and decreased hearing, which may fluctuate with changes in nasal symptoms. Allergic rhinitis is a potential risk factor for otitis media with effusion in children.

Sleep-disordered breathing

Severe nasal congestion can lead to a significant reduction in minute ventilation during sleep, resulting in decreased sleep quality.

Chronic sinusitis

Allergic inflammation is a major contributing factor to chronic sinusitis. The prevalence of chronic sinusitis is 30% in allergic rhinitis patients, 23% in asthma patients, and only 6% and 7% in individuals without allergic rhinitis or asthma, respectively.

Help create an environment conducive to controlling the condition, such as maintaining indoor cleanliness and dryness.

Ensure timely medication adherence and regular follow-up appointments.

Provide emotional support and encouragement to help the patient regulate their emotions and maintain an optimistic outlook.

What should allergic rhinitis patients pay attention to in daily life management?

Avoid allergen exposure, such as reducing outdoor activities for pollen-allergic individuals and using masks and eyewear.

Maintain a clean and dry indoor environment to reduce dust mites for those allergic to them.

Do not keep pets if allergic to animal dander.

Adhere to medical advice regarding medication or choose alternative treatment methods.