浅谈伴有变应性鼻炎的慢性鼻窦炎的治疗

Opinions on the treatment of chronic rhinosinusitis with allergic rhinitis

慢性鼻窦炎和变应性鼻炎是两种常见的慢性上呼吸道疾病,存在着某些内在联系以及类似炎症机制。有必要完善慢性鼻窦炎、鼻息肉患者的术前变态反应检查以及治疗:包括避免过敏原(环境和食物)、免疫治疗、鼻腔冲洗、鼻用糖皮质激素、针对鼻窦病原体的抗菌药物、抗变态反应(抗组胺药、白三烯受体拮抗剂等)和抗胃食管反流。此外,维生素D诱导细胞分化、参加免疫调节和调节内分泌系统也在慢性鼻窦炎和变应性鼻炎的炎症过程中发挥重要作用。

Chronic rhinosinusitis （CRS） and allergic rhinitis （AR） are both common chronic upper respiratory diseases and they have certain inherent links and similar inflammatory mechanisms. It is necessary to improve preoperative examination and treatment of allergies in patients with chronic sinusitis or nasal polyps including through food and environment allergen avoidance, immuno- therapy, nasal irrigation, administration of nasal steroid hormones, antibiotics against sinus pathogens, and anti-allergy medications such as antihistamines and leukotriene receptor antagonists; and anti-gastroesophageal reflux surgery. Furthermore, vitamin D induces cell differentiation, participates in immune regulation, and regulates other endocrine systems, thus playing an important role in the inflammation involved in CRS and AR.