Jin Nan, Department of Pediatrics, Strategic Support Force Characteristic Medical Center (formerly 306 Hospital).
Edited by Liu Yan/Cui Yan, Medical Science Popularization Center
There is no winter that is insurmountable, and there is not a spring that will not come.
In the spring season, more and more people began to wear masks and go out of the house to embrace this sweet spring. However, some people hugged and brought back a pair of itchy and swollen eyes and a nose like a tap. That's right, this symptom is a reminder that you may be guilty of hay fever.
Let's start by looking at what hay fever is.
Patients themselves have specific genetic qualities, which are what we call "allergies", and this kind of population is very sensitive, and the skin, eyes, and respiratory tract are prone to reactions. After repeated exposure to pollen, the body's immune system will produce an antibody specifically against these pollen, that is, specific IgE antibodies, and cause a series of clinical symptoms such as itching, redness, tearing, sneezing, runny nose, nasal congestion, cough, and even asthma.
In today's world, the incidence of hay fever is high. According to statistics, the incidence of hay fever in China and the United States can reach 11.3% and 14% respectively, and even as high as 26.5% in Japan. So, in this case, is it not possible to raise flowers at home? Don't be in a hurry to throw away the flowers and plants that have been carefully raised, let's first understand what are the common allergenic pollen that causes symptoms?
First of all, we must know that the vast majority of causes of hay fever are wind-borne flowers, like many trees and wildflowers, most of them are not ornamental, the flowers are small, the flower color is not bright, and it is not fragrant, and sometimes there is even a special smell. However, when the season comes, they are pollinated in large quantities, which can cause obvious symptoms in patients who are allergic to them. It's spring, and cypresses, birches, sycamores, ash, willows, etc., will gradually begin to spread pollen.
How do we treat hay fever? It is mainly divided into three aspects: isolation of allergens, symptomatic treatment with drugs, and immunotherapy.
Isolate allergens
Since the symptoms are caused by allergenic pollen, we need to minimize exposure to these pollen through various environmental control and physical protection methods.
(1) Wear goggles and masks. In the early stage, due to the epidemic, everyone generally wore masks when going out, which will effectively help us isolate the flower pollen, but those with severe symptoms in the past should also consider wearing goggles or goggles to reduce direct contact with the conjunctiva of the eye.
(2) Try using a pollen blocker, similar to using an invisible anti-pollen mask.
(3) Reduce outdoor activities. In particular, go out at noon and in the afternoon, when air convection is often stronger and pollen concentrations may be higher.
(4) During the period when the pollen concentration is too high, pay attention to closing the windows, and cooperate with indoor air purification and humidification.
(5) Nasal irrigation, moistening.
(6) If conditions permit, they can live in areas with relatively low air pollen concentrations during the pollen season, such as the southern coastal areas.
Symptomatic treatment with drugs
For patients with obvious symptoms of the five senses and affecting their lives, they need to receive symptomatic treatment with a regular course of drugs. The most important drugs include oral second-generation antihistamines (such as loratadine, cetirizine, ebastine, etc.), and the use of nasal glucocorticoids (such as budesonide nasal spray, fluticasone propionate nasal spray, mometasone furoate nasal spray, etc.).
If eye symptoms are significant, artificial tear rinsing, antihistamine eye drops, NSAIDs, and even hormonal eye drops may be added. If cough or even wheezing is significant, an oral leukotriene receptor antagonist (eg, montelukast sodium), inhaled sex corticosteroids, and bronchodilators may be added. It should be emphasized that because allergic disease is a chronic disease, it will recur and the disease will gradually progress, so the patient must take the medication regularly according to the doctor's requirements, and use enough course of treatment, regular review, and continuous adjustment, so as to achieve the best control effect.
Immunotherapy
In addition to symptomatic treatment with regular drugs, desensitization therapy should be considered in patients who can identify the allergen. This treatment has a history of more than 100 years and has been widely used in the treatment of allergic rhinitis and asthma, and has achieved very good results. This is currently the only treatment that has been shown to be effective in altering the entire course of allergic disease. However, due to the long course of immunotherapy, generally at least 3 years, patients need to undergo a very detailed examination at the allergy specialist and whether the immunotherapy formula needs to be adjusted before starting treatment. After starting treatment, regular re-examinations should be carried out, and a comprehensive re-examination should be conducted once every 1-2 years to evaluate the clinical treatment effect and whether the immunotherapy formula needs to be adjusted.
In addition to the above treatment options, many people may ask, "Doctor, is it because my immunity is too low that I have allergies?" The symptoms of hay fever are indeed very similar to those of a "cold", in the early stage of the disease, many patients think that they are repeatedly "cold", so they feel that their "resistance" has decreased, but in fact, allergy itself is a manifestation of the body's immune system overreaction, if some drugs can really improve "resistance", then we should be vigilant not to aggravate allergic symptoms. Therefore, once again, everyone should go to the allergy specialist to make a treatment plan suitable for them.
May everyone enjoy this sweet spring breeze!
(The picture comes from the Internet)