氣喘和過敏性鼻炎之關聯及治療

The Asthma-Allergic Rhinitis Link and It's Relevance to Treatment

吳維峰(Wei-Fong Wu) ； 林應然(Yung-Zen Lin,) ； 吳振龍(Chen-Long Wu,)

《北市醫學雜誌》 1卷3期 (2004/07) Pp. 261-267

https://doi.org/10.6200/TCMJ.2004.1.3.03

摘要

氣喘和過敏性鼻炎的盛行率近三十年來在已開發國家有明顯攀升的現象,而台灣也有相同之趨勢。基於流行病學、病理生理學、免疫學和臨床之研究報告己可證明氣喘和過敏性鼻炎密不可分之相關性。造成兩者之間密切關係的機制有多種的假說包括吸入感染或發炎的分泌物、鼻氣管反射現象、鼻塞之物理效應以及最近的看法認為是病人對過敏原產生全身性反應經由吸收鼻黏膜產生之發炎物質導致整個呼吸道之發炎反應。最新相關之診療指引強調過敏性鼻炎及氣喘有相似之病理理學表現、且經常出現同一病患身上持續性鼻炎的病人要檢查是否有氣喘反之亦然。於治療時必須同時考慮此兩種情況來選擇適當的治療方式包括局部使用類固醇、過敏原異性免疫療法、先自三悔素和抗免疫球蛋白E。

關鍵字

氣喘 ； 過敏性鼻炎 ； 局部使用類固醇 ； 白三烯素受體拮抗劑 ； 抗免疫球蛋白E

並列摘要

The Asthma-Allergic Rhinitis Link and It’s Relevance to Treatment
Wei-Fong Wu, MD. 1 ,2, Yung-Zen Lin, MD.3, Chen-Long Wu, MD. 1,2
Over the past three decades, the prevalence of asthma and allergic rhinitis has increased markedly. This same trend has occurred in Taiwan. Clinical studies document the epidemiological, pathophysiological, and immunological links between asthma and allergic rhinitis. Several mechanisms have been postulated for the close association between the two conditions, including aspiration of infected or inflamed secretions, 1asobronchial reflex, and mechanical effects of nasal blockage. Vet another mechanism involves inflammation of the airways via systemic absorption of inflammatory mediators. A global panel of experts documented the pathophysiological similarities between the two conditions and their frequent co-existence. The panel also developed evidence-based treatment guidelines, which state that patients with persistent rhinitis should be examined for asthma and vice versa. Treatment should consider the presence of both conditions. Recommended therapeutic strategies for both asthma and rhinitis include topical corticosteroids allergen-specific immunotherapy, anti-leukotrienes, and anti-lgE. (Full text in Chinese)

並列關鍵字

asthma ； allergic rhinitis ； topical corticosteroids ； leukotriene receptor antagonists ； anti-lgE