现代中西医治疗变应性鼻炎的研究新进展

New Progress in Modern Chinese and Western Medicine Treatment of Allergic Rhinitis

摘要: 变应性鼻炎(AR)是IgE介导的I型超敏反应性疾病，以鼻痒、阵发性喷嚏、清水样涕及鼻塞为特征。中国成人患病率从2005年的11.1%升至2021年的17.6%，患者超2.4亿，儿童群体尤为突出。北方地区因蒿属花粉致敏率高，发病率可达34.1%，南方则以尘螨为主要诱因。气候变化加剧过敏风险，花粉季延长与空气污染叠加，进一步加重症状。此病临床症状以鼻塞、流涕、喷嚏为主，常伴眼痒、疲劳、睡眠障碍等全身反应，约40%患者合并哮喘，60%并发结膜炎。传统治疗依赖鼻用激素、抗组胺药及脱敏疗法，但长期用药副作用明显，且仅10%患者接受脱敏治疗，但具有疗程长的缺点。中医将AR归为“鼻鼽”，病机为在肺、脾、肾三脏虚损的基础上，感受风寒异气，鼻窍受邪导致。本文就中西医对于变应性鼻炎的治疗进展进行综述，为此病的防治提供参考。

Abstract: Allergic rhinitis (AR) is a type I hypersensitivity disease mediated by IgE, characterized by nasal itching, paroxysmal sneezing, watery nasal discharge, and nasal congestion. The adult prevalence rate in China has increased from 11.1% in 2005 to 17.6% in 2021, with over 240 million patients, particularly among children. The sensitization rate of Artemisia pollen in the north is high, and the incidence rate can reach 34.1%, while dust mites are the main inducement in the south. Climate change exacerbates the risk of allergies, and the prolonged pollen season combined with air pollution further exacerbates symptoms. The clinical symptoms of this disease are mainly nasal congestion, runny nose, and sneezing, often accompanied by systemic reactions such as eye itching, fatigue, and sleep disorders. About 40% of patients also have asthma, and 60% have conjunctivitis. Traditional treatment relies on nasal steroids, antihistamines, and desensitization therapy, but long-term medication has significant side effects, and only 10% of patients receive desensitization treatment. However, it has the disadvantage of a long treatment course. Traditional Chinese Medicine categorizes AR as “nasal depression” and its pathogenesis as “deficiency of the root and excess of the target”. The main types of deficiency are lung qi deficiency, spleen qi deficiency, and kidney qi deficiency, while the main manifestations are invasion by wind and cold pathogens. This article reviews the progress of traditional Chinese and Western medicine in the treatment of allergic rhinitis, providing reference for the prevention and treatment of this disease.