有鼻后滴流症状的变应性鼻炎的观察与治疗

The clinical feature and treatment of allergic rhinitis in patients suffering from postnasal drip

目的总结具有鼻后滴流症状变应性鼻炎(AR)患者的临床表现和治疗效果。方法应用布地奈德鼻腔喷剂和/或氯雷他定分散片治疗AR患者。比较鼻后滴流症状AR患者和普通AR患者的临床表现和治疗效果。结果鼻后滴流症状AR临床特征:①喷嚏、轻度鼻痒;②咽部瘙痒或可因此引发刺激性咳嗽;③鼻咽部倒流涕(非黄脓涕和黏液涕,从鼻前孔流出的清水涕无或少);④咽部或鼻咽部异物感,总想咯咳或鼻腔倒抽动作或用鼻腔气流冲击鼻咽部以缓解咽部不适;⑤鼻腔黏膜苍白水肿或充血肿胀,内窥镜检查未见鼻腔息肉和窦口鼻道复合体病变;⑥咽部黏膜多苍白,多可见咽后壁清亮涕的反光呈"水晶晶"表现。鼻后滴流AR组中持续性重度患者的比例明显高于普通AR组(P<0.05)。鼻部症状评分2组比较无明显差别。治疗效果2组间无显著性差异(P>0.05)。结论具有鼻后滴流症状的AR患者因仰卧位鼻涕倒流入咽腔引发咽部不适和咳嗽而影响睡眠,给予布地奈德鼻喷雾剂和/或氯雷他啶分散片可取得较好治疗效果。

Objective It is to observe the clinical feature of allergic rhinitis patients suffering from postnasal drip and find a effective therapeutic manner. Methods The patients were treated by budesonide nasal spray and/or Loratadine Dispersible Tablets. Then the clinical manifestation and curative effect were compared between general allergic rhinitis patients and allergic rhinitis patients with postnasal drip. Results The features of symptom in allergic rhinitis patients with postnasal drip： ① sneeze, slightly rhinocnesmus; ②irritabie cough and pharyngeal itching; ③nasopharynx down runny nose; ④pharyngeal and mycteric foreign bodies sensation evoke hawk, tussis, pumpback snot or impact nasal cavity with tachy - air; ⑤the nasal mucosa was pallid oedema or hyperemia swelling and distension without any neoformation to block nasal cavity; ⑥may find some snot adhere in posterior wall of pharynx. There were more patients suffering from allergic rhinitis with postnasal drip than general allergic rhinitis symptom （ P 〈 0.05 ）. There were no significant difference in the value of nasopharynx symptom and curative effect between general allergic rbinitis patients and allergic rhinitis patients with postnasal drip （ P 〉 0.05）. There were more patients suffering from sleep disorders in patients diagnosed allergic rhinitis with postnasal drip than the patients with general allergic rhinitis symptom （P〈 0.05）. Conclusion The patients with postnasal drip can appear difficulty falling asleep causing by irritable cough and pharyngeal itching, and they can be cured by budesonide nasal spray and/or Loratadine Dispersible Tablets.