Every year during the transition from spring to autumn, hospital ENT departments always see a unique group of patients—those who frequently rub their itchy noses, pile up tissues, and toss and turn at night due to nasal congestion. Behind these symptoms lies allergic rhinitis, a disease that afflicts over one billion people worldwide. This article will systematically analyze the effectiveness of nasal irrigation therapy, strategies for managing acute attacks, characteristics of high-risk groups, and preventive measures based on scientific principles, providing patients with practical health management solutions.
Nasal Irrigation: An Underestimated "Physical Barrier"
Saline nasal irrigation is proven effective for allergic rhinitis, and its mechanism of action is based on three core principles:
- Mechanical Removal of Allergens: The irrigation action of 0.9% isotonic saline can remove over 90% of allergens such as pollen and dust mites from the nasal cavity, reducing persistent stimulation of the immune system. Clinical data shows that patients who regularly rinse their noses twice daily experience a 68% reduction in nasal itching and sneezing symptoms.
- Improve the mucosal microenvironment: Saline irrigation can dilute inflammatory mediators (such as histamine and leukotrienes), reduce the osmotic pressure of the nasal mucosa, and alleviate edema. Studies have shown that nasal ventilation can increase by 30%-50% after nasal irrigation.
- Promote ciliary motility: Cilia on the nasal mucosa beat at a frequency of 1,000 beats per minute. Saline irrigation can enhance their clearance function and form a protective mucus layer.
Key points: Use medical-grade nasal wash solution, maintain a water temperature of 37-40°C, and use a head-down forward position. Rinse 1-2 times daily, using 200-300ml of saline each time.
Acute Attack: Graded Response Strategy
When persistent runny nose and nasal congestion occur, the following step-by-step approach can be adopted:
- Mild Attack (<5 sneezes per day, clear nasal discharge): Immediately rinse the nasal cavity with normal saline, combined with a nasal antihistamine (such as azelastine). Symptoms should be relieved within 15 minutes.
- Moderate attacks (5-10 sneezes, thick nasal discharge): In addition to nasal irrigation, add a nasal corticosteroid (such as mometasone furoate) once daily for no more than 7 consecutive days.
- Severe attacks (>10 sneezes, accompanied by itchy eyes and wheezing): Combined use of an oral antihistamine (such as loratadine) and a leukotriene receptor antagonist (such as montelukast) is necessary, and seek medical attention for comorbidities.
Special reminder: Avoid the misuse of vasoconstrictor nasal drops (such as oxymetazoline), as long-term use may lead to drug-induced rhinitis.
High-risk groups: Five groups of people should be vigilant
- Genetically susceptible individuals: If one parent has a history of allergies, the risk increases by 3 times; if both parents have a history of allergies, the risk jumps to 7 times.
- People with allergies: Those who test positive for common allergens such as dust mites, pollen, and animal dander have an incidence rate 5-8 times that of the general population.
- Immune Imbalance: Those with dysbiosis, vitamin D deficiency, or abnormally elevated IgE levels are more susceptible to an exaggerated immune response.
- Environmental Exposure: People with long-term exposure to vehicle exhaust, industrial dust, and tobacco smoke have a 40% increased risk of impaired nasal mucosal barrier function.
- Lifestyle Defects: Those who lack exercise, sleep, and consume a diet high in sugar and fat have a weakened immune system and are significantly more likely to develop allergies than healthy individuals.
Building a Prevention System: Blocking the Allergy Chain at the Source
Three Principles of Environmental Control:
Avoidance: Close doors and windows during pollen season and use an air purifier (CADR > 300 m³/h).
Replacement: Replace standard fabrics with mite-resistant bedding and wash bedding weekly at 55°C.
Cleaning: Wipe furniture surfaces daily with a damp cloth to reduce dust accumulation.
Immune Modulation:
Probiotic Intervention: Specific strains (such as Lactobacillus rhamnosus GG) can regulate the Th1/Th2 balance and reduce the risk of allergies.
Vitamin D Supplementation: Maintain serum 25(OH)D levels. >30ng/ml, enhancing mucosal barrier function.
Exercise prescription: 150 minutes of moderate-intensity aerobic exercise (such as brisk walking or swimming) per week can improve immune tolerance.
Early intervention strategies:
Pre-seasonal prevention: Start nasal corticosteroids 2-4 weeks before pollen season.
Desensitization therapy: For those sensitive to a single allergen (such as dust mites), sublingual immunotherapy can be considered, with an efficacy rate of 70%-80%.
Managing allergic rhinitis is a long-term battle, requiring patients to develop a comprehensive health strategy encompassing prevention, treatment, and recovery. From daily nasal irrigation to precise environmental control, from scientific immune regulation to timely medical intervention, every step is crucial to effective symptom control. With advances in allergen-specific immunotherapy and biologics, patients will have more treatment options in the future.
