256例过敏性鼻炎-哮喘综合征问卷调查分析

Questionnaire analysis of 256 cases with combined allergic rhinitis and asthma syndrome

目的了解过敏性鼻炎-哮喘综合征（combined allergic rhinitis and asthma syndrome,CARAS）的诊断及治疗现状,总结CARAS诊疗过程中存在的问题,提高临床医师对CARAS的认识和诊治水平。方法2011年10月至2012年6月,重庆医科大学附属第一医院收集支气管哮喘（bronchial asthma,BA）患者155例,过敏性鼻炎（allergic rhinitis,AR）患者101例,共256例。通过笔答问卷的方式,了解BA和AR患者中合并上呼吸道和下呼吸道症状的比率、两种疾病目前的诊断和治疗情况。结果BA患者中合并AR症状的比率为72.3%（112/155）,确诊为AR的仅占33.5%（52/155）。AR患者中合并BA症状的比率为35.6%（36/101）,确诊为BA的仅占10.9%（11/101）。联合诊断BA和AR的人数仅占调查总人数的25.0%（63/256）,同时合并上、下呼吸道症状的患者进行规范联合治疗患者仅占13.5%（20/148）。导致患者未规律联合治疗最主要的原因是医师未告知患者联合治疗的重要性。结论大部分BA患者都合并有AR,AR患者中也有相当一部分可能合并BA,但绝大部分CARAS患者均未得到准确诊断和规范的联合治疗,治疗现状不容乐观。临床医师应建立“同一气道,同一疾病”的观念,并掌握正确的协同诊治方法,同时加强对CARAS患者的健康教育和随访管理,提高患者的依从性,才能提高治疗效果。

Objective To investigate the current situation of the diagnosis and treatment of combined allergic rhinitis and asthma syndrome （CARAS）, as well as to summarize the questions of diagnosis and treatment of the disease, so as to improve the clinician＇s understanding of the CARAS and the level of diagnosis and treatment. Methods From October 2011 to June 2012, 155 patients with bronchial asthma （BA） and 101 patients with allergic rhinitis （AR） were collected from first affiliated hospital of chongqing medical university, including a total of 256 patients. We use questionnaire to study the patient＇s demographic characteristics, medical history, the ratio of BA patients with upper airway symptoms, the ratio of AR patients with lower airway symptoms, as well as the current situation of the diagnosis and treatment of the CARAS retrospectively. Results 72.3% （112/155） of the BA patients had AR related symptoms hut only 33.5% （52/155） were confirmed. And 35.6 % （36/101） of the AR patients had BA related symptoms but only 10.9% （11/101） were confirmed. Only 25.0% （63/256） of the cases have combined diagnosis. There were 148 cases with combined upper and lower airway symptoms, but only 13.5%（20/148） of the cases on correct combined treatment. The most common reason for patients not taking combined treatment is that doctors did not inform the importance. Conclusions AR is present in the majority of patients with BA, and a significant minority of patients with AR have concomitant BA. But most of the patients have not got correct diagnosis and standard combined treatment, so the current status is disappointed. Clinicians should establish the concept of ＂ one way, one disease＂, master appropriate collaborative diagnosis and treatment methods, and attach great importance to the health education and follow-up management of CARAS patients, so as to improve patient compliance and get better therapeutic effect.