《儿童过敏性鼻炎诊疗——临床实践指南》治疗部分解读
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摘要
中国医师协会儿科医师分会儿童耳鼻咽喉专业委员会撰写了适合国内情况的《儿童过敏性鼻炎诊疗——临床实践指南》。该文主要对这一指南的治疗部分进行解读。儿童过敏性鼻炎的诊断标准应根据患儿家族史和典型过敏病史、临床表现以及与其一致的过敏原检测结果来制定;儿童过敏性鼻炎的治疗需要防治结合,治疗原则包括环境控制、药物治疗、免疫治疗和健康教育。
Otolaryngology Professional Committee,Pediatrician Branch,Chinese Medical Doctor Association has published Clinical Practice Guideline:Diagnosis and Treatment in Children with Allergic Rhinitis. The article is an interpretationof the ARshouldbebasedonfamilyhistory,typialallergichistory,clinical manifestations and the consistent allergen detection. Its management should combine prevention and treatment. The treatment principles of AR include environmental controls,drug therapy,immunotherapy and patient education.
Otolaryngology Professional Committee,Pediatrician Branch,Chinese Medical Doctor Association has published Clinical Practice Guideline:Diagnosis and Treatment in Children with Allergic Rhinitis. The article is an interpretationof the ARshouldbebasedonfamilyhistory,typialallergichistory,clinical manifestations and the consistent allergen detection. Its management should combine prevention and treatment. The treatment principles of AR include environmental controls,drug therapy,immunotherapy and patient education.
引文
[1]Kong WJ,Chen JJ,Zheng ZY,et al.Prevalence of allergic rhinitis in 3-6-year-old children in Wuhan of China[J].Clin Exp Allergy,2009,39(6):869-874.
[2]乔彤,王智楠.过敏性结膜炎与过敏性鼻炎的关系[J].南京大学学报,2008,22(3):183-187.
[3]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.儿童变应性鼻炎诊断和治疗指南(2010年,重庆)[J].中华耳鼻咽喉头颈外科杂志,2011,46(1):7-8.
[4]中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24.
[5]Seidman MD,Gurgel RK,Lin SY,et al.Clinical practice guideline:allergic rhinitis[J].Otolaryngol Head Neck Surg,2015,152(Suppl 1):1-43.
[6]Bousquet J,Khaltaev N,Cruz AA,et al.Allergic Rhinitis and its Impact on Asthma(ARIA)2008 update(in collaboration with the World Health Organization,GA(2)LEN and AllerGen)[J].Allergy,2008,63(Suppl 86):8-160.
[7]Simons FE,Simons KJ.The pharmacology and use of H1-receptor-antagonist drugs[J].N Engl J Med,1994,330(23):1663-1670.
[8]Okubo K,Kurono Y,Fujieda S,et al.Japanese guideline for allergic rhinitis 2014[J].Allergol Int,2014,63(3):357-375.
[9]Wheatley LM,Togias A.Clinical practice.Allergic rhinitis[J].N Engl J Med,2015,372(5):456-463.
[10]中华医学会变态反应学分会儿童过敏和哮喘学组,中华医学会儿科学分会呼吸学组哮喘协作组.抗组胺H1受体药在儿童常见过敏性疾病中应用的专家共识[J].中国实用儿科杂志,2018,33(3):161-168.
[11]Brozek JL,Bousquet J,Baena-Cagnani CE,et al.Allergic Rhinitis and its Impact on Asthma(ARIA)guidelines:2010 revision[J].J Allergy Clin Immunol,2010,126(3):466-476.
[12]Kaiser HB,Gopalan G,Chung W.Loratadine provides early symptom control in seasonal allergic rhinitis[J].Allergy Asthma Proc,2008,29(6):654-658.
[13]Zhang L,Cheng L,Hong J.The clinical use of cetirizine in the treatment of allergic rhinitis[J].Pharmacology,2013,92(1-2):14-25.
[14]Grimfeld A,Holgate ST,Canonica GW,et al.Prophylactic management of children at risk for recurrent upper respiratory infections:the preventiaI study[J].Clin Exp Allergy,2004,34(11):1665-1672.
[15]王淑芬,徐忠强,许瑞明,等.立复汀喷雾剂治疗小儿变应性鼻炎的疗效观察[J].临床耳鼻咽喉科杂志,2001,15(4):171-172.
[16]孙小青,殷敏,程雷.鼻内糖皮质激素在过敏性鼻炎治疗中的合理应用[J].中华临床免疫和变态反应杂志,2010,4(3):216-220.
[17]Gosepath J,Amedee RG,Mann WJ.Nasal provocation testing as an international standard for evaluation of allergic and nonallergic rhinitis[J].Laryngoscope,2005,115(3):512-516.
[18]Roberts G,Xatzipsalti M,Borrego LM,et al.Paediatric rhinitis:position paper of the European Academy of Allergy and Clinical Immunology[J].Allergy,2013,68(9):1102-1116.
[19]The Allergy Report.American Academy of Allergy,Asthma,and Immunology,Inc.2000[OL].[2018-12-10]http://www.scribd.com/doc/168321953/the-Allergy-Report-The-American-Academic-of-Allergy-Asthma-Immunology-Diseases-of-the-A.
[20]Van Cauwenberge P.European Academy of Allergology and Immunology[J].Allergy,2000,55(2):116.
[21]Borchers AT,Hackman RM,Keen CL,et al.Complementary medicine:a review of immunomodulatory effects of Chinese herbal medicines[J].Am J Clin Nutr,1997,66(6):1303-1312.
[22]沈朝斌,顾珺,林千里,等.玉屏风散与T细胞亚型表达的Meta分析[J].上海中医药杂志,2004,38(11):59-61.
[23]Huang Y,Yang XL,Ni YH,et al.Geraniol suppresses proinflammatory mediators in phorbol 12-myristate 13-acetate with A23187-induced HMC-1 cells[J].Drug Design Development Ther,2018,12(6):2897-2903.
[24]Rabago D,Barrett B,Marchand L,et al.Qualitative aspects of nasal irrigation use by patients with chronic sinus disease in a multimethod study[J].Ann Fam Med,2006,4(4):295-301.
[25]Rabago D,Guerard E,Bukstein D.Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis,asthma,and nasal polyposis:a hypothesis generating study[J].WMJ,2008,107(2):69-75.
[26]Seidman MD,Gurgel RK,Lin SY,et al.Clinical practice guideline:allergic rhinitis executive summary[J].Otolaryngol Head Neck Surg,2015,152(2):197-206.
[27]王成硕,王向东,张伟,等.变应性鼻炎屋尘螨变应原皮下免疫治疗的远期疗效研究[J].中华耳鼻咽喉头颈外科杂志,2012,47(10):804-808.
[28]Max AT,Hermanns A,Adelt T,et al.Side effects during subcutaneous immunotherapy in children with allergy diseases[J].Pediatr Allergy Immunol,2018,5(29):267-274.
[29]Penagos M,Compalati E,Tarantini F,et al.Efficacy of sublingual immunotherapy in the treatment of allergic rhinitis in pediatric patients 3 to 18 years of age:a meta-analysis of randomized,placebo-controlled,double-blind trials[J].Ann Allergy Asthma Immunol,2006,97(2):141-148.
[30]Shao J,Cui YX,Zheng YF,et al.Efficacy and safety of sublingual immunotherapy in children aged 3-13 years with allergic rhinitis[J].Am J Rhinol Allergy,2014,28(2):131-139.
[31]陈志凌,钱亚昇,刘素琴,等.舌下含服粉尘螨治疗儿童变应性鼻炎起效时间和疗效观察//世界中联耳鼻喉口腔专业委员会换届大会暨第七次学术年会、中华中医药学会耳鼻喉分会第二十一次耳鼻喉科学术年会暨辽宁省中医及中西医结合耳鼻咽喉科学术会议论文汇编[C].沈阳,2015:25.
[32]陈实,曾霞,王灵,等.不同疗程舌下含服粉尘螨滴剂治疗螨过敏变应性鼻炎伴哮喘患儿的疗效观察[J].中华耳鼻咽喉头颈外科杂志,2015,50(8):188-189.
[33]Compalati E,Passalacqua G,Bonini M,et al.The efficacy of sublingual immunotherapy for house dust mites respiratory allergy:results of a GA2LEN meta-analysis[J].Allergy,2009,64(11):1570-1579.
[34]Radulovic S,Wilson D,Calderon M,et al.Systematic reviews of sublingual immunotherapy(SLIT)[J].Allergy,2011,66(6):740-752.
[35]Aboshady OA,Elghanam KM.Sublingual immunotherapy in allergic rhinitis:efficacy,safety,adherence and guidelines[J].Clin Exp Otorhinolaryngol,2014,7(4):241-249.
[36]崔珑,王智楠,徐忠强.电话随访对粉尘螨滴剂舌下脱敏治疗变应性鼻炎依从性的评价[J].临床耳鼻咽喉头颈外科杂志,2011,25(8):364-365.
[37]崔珑,王智楠,徐忠强.舌下特异性免疫治疗不同年龄组儿童变应性鼻炎的长期疗效及安全性观察[J].中华耳鼻咽喉头颈外科杂志,2013,48(1):17-21.
[38]崔珑,夏忠芳,王智楠.标准化粉尘螨滴剂治疗单一和多重过敏变应性鼻炎患儿的长期疗效评估[J].临床耳鼻咽喉头颈外科杂志,2015,29(12):1094
[39]Massanari M,Nelson H,Casale T,et al.Effect of pretreatment with omalizumab on the tolerability of specific immunotherapy in allergic asthma[J].J Allergy Clin Immunol,2010,125(2):383-389.
[40]许政敏,王智楠,姚红兵.儿童急性感染性鼻-鼻窦炎诊疗--临床实践指南(2014年制订)[J].中国实用儿科杂志,2015,30(7):512-514.
[41]Holgate RPGCS.World Allergy Organization(WAO)white book on allergy,Update[R/OL][2018-09-10].http://www.word allergy.org/User Files/file/White Book 2-2013-v8.pdf.,2013.
[2]乔彤,王智楠.过敏性结膜炎与过敏性鼻炎的关系[J].南京大学学报,2008,22(3):183-187.
[3]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组.儿童变应性鼻炎诊断和治疗指南(2010年,重庆)[J].中华耳鼻咽喉头颈外科杂志,2011,46(1):7-8.
[4]中华医学会耳鼻咽喉头颈外科学分会鼻科学组.变应性鼻炎诊断和治疗指南(2015年,天津)[J].中华耳鼻咽喉头颈外科杂志,2016,51(1):6-24.
[5]Seidman MD,Gurgel RK,Lin SY,et al.Clinical practice guideline:allergic rhinitis[J].Otolaryngol Head Neck Surg,2015,152(Suppl 1):1-43.
[6]Bousquet J,Khaltaev N,Cruz AA,et al.Allergic Rhinitis and its Impact on Asthma(ARIA)2008 update(in collaboration with the World Health Organization,GA(2)LEN and AllerGen)[J].Allergy,2008,63(Suppl 86):8-160.
[7]Simons FE,Simons KJ.The pharmacology and use of H1-receptor-antagonist drugs[J].N Engl J Med,1994,330(23):1663-1670.
[8]Okubo K,Kurono Y,Fujieda S,et al.Japanese guideline for allergic rhinitis 2014[J].Allergol Int,2014,63(3):357-375.
[9]Wheatley LM,Togias A.Clinical practice.Allergic rhinitis[J].N Engl J Med,2015,372(5):456-463.
[10]中华医学会变态反应学分会儿童过敏和哮喘学组,中华医学会儿科学分会呼吸学组哮喘协作组.抗组胺H1受体药在儿童常见过敏性疾病中应用的专家共识[J].中国实用儿科杂志,2018,33(3):161-168.
[11]Brozek JL,Bousquet J,Baena-Cagnani CE,et al.Allergic Rhinitis and its Impact on Asthma(ARIA)guidelines:2010 revision[J].J Allergy Clin Immunol,2010,126(3):466-476.
[12]Kaiser HB,Gopalan G,Chung W.Loratadine provides early symptom control in seasonal allergic rhinitis[J].Allergy Asthma Proc,2008,29(6):654-658.
[13]Zhang L,Cheng L,Hong J.The clinical use of cetirizine in the treatment of allergic rhinitis[J].Pharmacology,2013,92(1-2):14-25.
[14]Grimfeld A,Holgate ST,Canonica GW,et al.Prophylactic management of children at risk for recurrent upper respiratory infections:the preventiaI study[J].Clin Exp Allergy,2004,34(11):1665-1672.
[15]王淑芬,徐忠强,许瑞明,等.立复汀喷雾剂治疗小儿变应性鼻炎的疗效观察[J].临床耳鼻咽喉科杂志,2001,15(4):171-172.
[16]孙小青,殷敏,程雷.鼻内糖皮质激素在过敏性鼻炎治疗中的合理应用[J].中华临床免疫和变态反应杂志,2010,4(3):216-220.
[17]Gosepath J,Amedee RG,Mann WJ.Nasal provocation testing as an international standard for evaluation of allergic and nonallergic rhinitis[J].Laryngoscope,2005,115(3):512-516.
[18]Roberts G,Xatzipsalti M,Borrego LM,et al.Paediatric rhinitis:position paper of the European Academy of Allergy and Clinical Immunology[J].Allergy,2013,68(9):1102-1116.
[19]The Allergy Report.American Academy of Allergy,Asthma,and Immunology,Inc.2000[OL].[2018-12-10]http://www.scribd.com/doc/168321953/the-Allergy-Report-The-American-Academic-of-Allergy-Asthma-Immunology-Diseases-of-the-A.
[20]Van Cauwenberge P.European Academy of Allergology and Immunology[J].Allergy,2000,55(2):116.
[21]Borchers AT,Hackman RM,Keen CL,et al.Complementary medicine:a review of immunomodulatory effects of Chinese herbal medicines[J].Am J Clin Nutr,1997,66(6):1303-1312.
[22]沈朝斌,顾珺,林千里,等.玉屏风散与T细胞亚型表达的Meta分析[J].上海中医药杂志,2004,38(11):59-61.
[23]Huang Y,Yang XL,Ni YH,et al.Geraniol suppresses proinflammatory mediators in phorbol 12-myristate 13-acetate with A23187-induced HMC-1 cells[J].Drug Design Development Ther,2018,12(6):2897-2903.
[24]Rabago D,Barrett B,Marchand L,et al.Qualitative aspects of nasal irrigation use by patients with chronic sinus disease in a multimethod study[J].Ann Fam Med,2006,4(4):295-301.
[25]Rabago D,Guerard E,Bukstein D.Nasal irrigation for chronic sinus symptoms in patients with allergic rhinitis,asthma,and nasal polyposis:a hypothesis generating study[J].WMJ,2008,107(2):69-75.
[26]Seidman MD,Gurgel RK,Lin SY,et al.Clinical practice guideline:allergic rhinitis executive summary[J].Otolaryngol Head Neck Surg,2015,152(2):197-206.
[27]王成硕,王向东,张伟,等.变应性鼻炎屋尘螨变应原皮下免疫治疗的远期疗效研究[J].中华耳鼻咽喉头颈外科杂志,2012,47(10):804-808.
[28]Max AT,Hermanns A,Adelt T,et al.Side effects during subcutaneous immunotherapy in children with allergy diseases[J].Pediatr Allergy Immunol,2018,5(29):267-274.
[29]Penagos M,Compalati E,Tarantini F,et al.Efficacy of sublingual immunotherapy in the treatment of allergic rhinitis in pediatric patients 3 to 18 years of age:a meta-analysis of randomized,placebo-controlled,double-blind trials[J].Ann Allergy Asthma Immunol,2006,97(2):141-148.
[30]Shao J,Cui YX,Zheng YF,et al.Efficacy and safety of sublingual immunotherapy in children aged 3-13 years with allergic rhinitis[J].Am J Rhinol Allergy,2014,28(2):131-139.
[31]陈志凌,钱亚昇,刘素琴,等.舌下含服粉尘螨治疗儿童变应性鼻炎起效时间和疗效观察//世界中联耳鼻喉口腔专业委员会换届大会暨第七次学术年会、中华中医药学会耳鼻喉分会第二十一次耳鼻喉科学术年会暨辽宁省中医及中西医结合耳鼻咽喉科学术会议论文汇编[C].沈阳,2015:25.
[32]陈实,曾霞,王灵,等.不同疗程舌下含服粉尘螨滴剂治疗螨过敏变应性鼻炎伴哮喘患儿的疗效观察[J].中华耳鼻咽喉头颈外科杂志,2015,50(8):188-189.
[33]Compalati E,Passalacqua G,Bonini M,et al.The efficacy of sublingual immunotherapy for house dust mites respiratory allergy:results of a GA2LEN meta-analysis[J].Allergy,2009,64(11):1570-1579.
[34]Radulovic S,Wilson D,Calderon M,et al.Systematic reviews of sublingual immunotherapy(SLIT)[J].Allergy,2011,66(6):740-752.
[35]Aboshady OA,Elghanam KM.Sublingual immunotherapy in allergic rhinitis:efficacy,safety,adherence and guidelines[J].Clin Exp Otorhinolaryngol,2014,7(4):241-249.
[36]崔珑,王智楠,徐忠强.电话随访对粉尘螨滴剂舌下脱敏治疗变应性鼻炎依从性的评价[J].临床耳鼻咽喉头颈外科杂志,2011,25(8):364-365.
[37]崔珑,王智楠,徐忠强.舌下特异性免疫治疗不同年龄组儿童变应性鼻炎的长期疗效及安全性观察[J].中华耳鼻咽喉头颈外科杂志,2013,48(1):17-21.
[38]崔珑,夏忠芳,王智楠.标准化粉尘螨滴剂治疗单一和多重过敏变应性鼻炎患儿的长期疗效评估[J].临床耳鼻咽喉头颈外科杂志,2015,29(12):1094
[39]Massanari M,Nelson H,Casale T,et al.Effect of pretreatment with omalizumab on the tolerability of specific immunotherapy in allergic asthma[J].J Allergy Clin Immunol,2010,125(2):383-389.
[40]许政敏,王智楠,姚红兵.儿童急性感染性鼻-鼻窦炎诊疗--临床实践指南(2014年制订)[J].中国实用儿科杂志,2015,30(7):512-514.
[41]Holgate RPGCS.World Allergy Organization(WAO)white book on allergy,Update[R/OL][2018-09-10].http://www.word allergy.org/User Files/file/White Book 2-2013-v8.pdf.,2013.