[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"$f65-g5LTUgHIk8dGZIHhGe2pKpxnfW0g-O4HGxk3yxcs":3,"$fvbtMf32qOPYbFs5gbdVPUEVZclTkGryXXoWNiTgIWlA":8,"$fbF7ePTmzmWs7fc6_q3ZaIm1UvTJ2CfjnqpHO9SzDU7g":59,"$fnUZ56HGTjZIq6_yXCZIgS8aKJTJh3R9zY0l5h_gTBOg":60,"$fkep-7iepy2lWZ9diCqIQf2OvnNssGuIfK0KrHzugekE":64},{"code":4,"msg":5,"message":6,"data":6,"success":7},401,"认证失败，无法访问系统资源",null,false,{"code":9,"msg":10,"message":6,"data":11,"success":58},200,"操作成功",{"id":12,"specialistId":13,"specialistAssistants":14,"profilePhoto":15,"specialistName":16,"roleType":17,"adept":18,"hospital":19,"department":20,"postsTitle":21,"materialTotal":17,"videoTotal":22,"isConcern":7,"title":23,"coverVertical":24,"coverAcross":25,"directionMarker":26,"description":27,"vid":28,"time":29,"mediaType":26,"views":30,"likes":17,"isThumbsUp":7,"isCollection":7,"collections":17,"createTime":31,"seoTitle":32,"seoKeywords":33,"seoDescription":34,"shelvesTime":35,"menus":36,"menuId":38,"type":54,"quality":55,"commentCount":17,"isComment":26,"deviceType":56,"url":57},9714,871755,[],"https://cdn.haohuanjiao.com/learnMaterial/ystApp//G7dSnV6vewIjIOE3hUEqwoMyyvWCcgB7.png","蔺林",0,"擅长鼻炎、鼻窦炎、鼻息肉、腺样体肥大、鼻出血、鼻囊肿、鼻腔鼻窦良恶性肿瘤等多种鼻科疾病以及脑脊液鼻漏和鼻眼相关疾病。","复旦大学附属华山医院","耳鼻咽喉科","主任医师",3,"变应性鼻炎 - 症状、原因及治疗方法全解析","","https://cdn.yishi-tong.com/console/3/PXm0S5vZOrUDkvM0o7pKX41DqP7C9Gw_.png",1,"WEBVTT\n\n00:02.114 --> 00:03.813\n尊敬的各位同道，\n\n00:03.964 --> 00:04.714\n下午好。\n\n00:07.302 --> 00:07.626\n今天呢，\n\n00:07.626 --> 00:14.326\n我们给大家讲一下我们关于过敏性鼻炎的一些科普知识啊，\n\n00:14.326 --> 00:17.201\n还有一些包括各方面的，\n\n00:17.201 --> 00:18.326\n包括诊断，\n\n00:18.326 --> 00:19.052\n治疗啊，\n\n00:19.052 --> 00:21.201\n预防这一方面的知识。\n\n00:23.898 --> 00:27.347\n我们呢从下面这几个部分来给大家做介绍，\n\n00:27.398 --> 00:31.398\n一个是关于过敏性鼻炎的基本概念和发病原因，\n\n00:31.597 --> 00:32.373\n另外一个呢，\n\n00:32.373 --> 00:35.748\n讲一下过敏性鼻炎的诊断方法和评估指标。\n\n00:35.998 --> 00:36.597\n最后呢，\n\n00:36.597 --> 00:40.397\n讲一下过敏性鼻炎的治疗方案及预防措施。\n\n00:40.897 --> 00:41.548\n第一部分，\n\n00:41.548 --> 00:46.198\n我们先讲一下过敏性鼻炎的基本概念和发病原因，\n\n00:46.448 --> 00:47.048\n那么。\n\n00:47.984 --> 00:49.159\n变应性鼻炎啊，\n\n00:49.159 --> 00:51.683\n刚才我们一直谈到的是过敏性鼻炎，\n\n00:51.683 --> 00:55.284\n那么变应性鼻炎和过敏性鼻炎有什么区别呢？\n\n00:56.133 --> 00:57.234\n其实是这样的啊，\n\n00:57.383 --> 00:58.758\n变应性鼻炎呢，\n\n00:58.758 --> 01:00.433\n我们又叫过敏性鼻炎，\n\n01:00.534 --> 01:01.347\n我们呢，\n\n01:01.347 --> 01:02.484\n只开始呢，\n\n01:02.484 --> 01:05.933\n给大家只开始就直接讲的是过敏性鼻炎，\n\n01:05.933 --> 01:12.234\n是因为过敏性鼻炎更贴切我们老百姓的印象中的这么疾病的类型。\n\n01:12.683 --> 01:13.484\n以前呢，\n\n01:13.583 --> 01:16.033\n我们叫变应性鼻炎，\n\n01:16.083 --> 01:17.533\n变应性鼻炎的英文呢，\n\n01:17.533 --> 01:19.033\n是allergic rhinitis，\n\n01:19.234 --> 01:21.308\n而过敏性鼻炎的英文呢，\n\n01:21.308 --> 01:22.884\n是hyper sensitive rhinitis，\n\n01:23.083 --> 01:23.759\n以前呢，\n\n01:23.759 --> 01:24.634\n我们认为呢，\n\n01:24.833 --> 01:26.234\n过敏性鼻炎是。\n\n01:26.391 --> 01:27.791\n包括变异性鼻炎的，\n\n01:27.791 --> 01:32.092\n但现在后来认为这两个鼻炎的类型啊，\n\n01:32.092 --> 01:33.717\n我们在翻译的过程中啊，\n\n01:33.717 --> 01:35.092\n出现了一些纰漏，\n\n01:35.291 --> 01:35.817\n所以呢，\n\n01:35.817 --> 01:39.942\n我们现在统一的把变异性鼻炎称为过敏性鼻炎。\n\n01:39.991 --> 01:40.692\n我们呢，\n\n01:40.791 --> 01:46.141\n今天呢就全程把这个变异性鼻炎按过敏性鼻炎来讲。\n\n01:47.015 --> 01:48.765\n那什么是过敏性鼻炎呢？\n\n01:49.216 --> 01:50.365\n过敏性鼻炎呢，\n\n01:50.365 --> 01:54.166\n是特应性的个体接触致敏原以后啊，\n\n01:54.166 --> 02:00.115\n由免疫球蛋白E也就是IGE介导的介质的释放，\n\n02:00.216 --> 02:04.216\n并有多种免疫活性细胞和细胞因子等，\n\n02:04.416 --> 02:10.166\n参与的鼻粘膜的慢性炎症性反应性的疾病，\n\n02:10.466 --> 02:12.766\n是一种非感染性的疾病。\n\n02:12.966 --> 02:15.916\n其主要的临床表现是什么呢？\n\n02:15.916 --> 02:17.115\n包括是。\n\n02:17.292 --> 02:21.516\n鼻痒、打喷嚏、鼻分泌亢进、鼻粘膜肿胀等等，\n\n02:21.516 --> 02:22.792\n以此为特点。\n\n02:22.891 --> 02:23.641\n其实呢，\n\n02:23.641 --> 02:26.617\n说白了就是说四大症状呢，\n\n02:26.617 --> 02:32.042\n包括鼻痒、打喷嚏、流清鼻涕、鼻塞这些主要的症状。\n\n02:33.445 --> 02:33.895\n那么，\n\n02:33.895 --> 02:35.246\n有一部分患者呀，\n\n02:35.246 --> 02:39.395\n会有这个眼痒啊、眼红啊、流泪这些眼部的症状。\n\n02:39.395 --> 02:40.520\n那么这个症状呢，\n\n02:40.520 --> 02:46.246\n其实就是和过敏性鼻炎合并一起发作的过敏性的结膜炎。\n\n02:46.296 --> 02:47.070\n当然呢，\n\n02:47.070 --> 02:48.595\n还有一部分患者呢，\n\n02:48.595 --> 02:50.121\n具有哮喘的症状，\n\n02:50.121 --> 02:52.546\n比如说咳嗽胸闷。\n\n02:55.054 --> 02:55.503\n喘息。\n\n02:57.561 --> 02:58.037\n等等啊，\n\n02:58.037 --> 03:02.787\n这些症状那么过敏性鼻炎发病的原因是什么啊？\n\n03:02.787 --> 03:04.511\n我们过敏性鼻炎呢，\n\n03:04.662 --> 03:06.912\n就是遗传和环境啊，\n\n03:06.912 --> 03:08.412\n相互作用啊，\n\n03:08.462 --> 03:10.861\n相互作用所导致的。\n\n03:10.912 --> 03:12.261\n那么多数的患者呢，\n\n03:12.261 --> 03:14.662\n其实是具有特应性的体质，\n\n03:14.761 --> 03:16.561\n对多种的过敏原呢，\n\n03:16.561 --> 03:17.962\n都是敏感的。\n\n03:18.712 --> 03:19.186\n那么，\n\n03:19.186 --> 03:20.761\n其发病机制啊，\n\n03:20.761 --> 03:23.061\n我们认为过敏性鼻炎呢，\n\n03:23.061 --> 03:26.912\n它就是一个一型的变态反应性炎症性疾病，\n\n03:27.011 --> 03:27.712\n那么在。\n\n03:27.815 --> 03:29.315\n过敏源的刺激下，\n\n03:29.365 --> 03:32.766\n我们的机体会产生特异性的IGE抗体，\n\n03:32.815 --> 03:35.416\n并通过与肥大细胞，\n\n03:35.565 --> 03:40.865\n包括肥大细胞和嗜碱性粒细胞表面的一些高亲和力受体，\n\n03:40.865 --> 03:43.916\n也就是说IGE受体相结合。\n\n03:44.166 --> 03:44.916\n随后呢，\n\n03:44.916 --> 03:47.365\n发生了一系列的化学反应，\n\n03:47.416 --> 03:50.466\n然后导致鼻粘膜血管的扩张，\n\n03:50.516 --> 03:51.716\n通透性增加，\n\n03:51.865 --> 03:53.490\n腺体分泌增多啊，\n\n03:53.490 --> 03:55.516\n这一系列的病理的变化。\n\n03:56.542 --> 03:57.091\n那么，\n\n03:57.091 --> 04:00.917\n易感人群和危险的因素包括哪一些呢？\n\n04:00.917 --> 04:01.492\n首先，\n\n04:01.641 --> 04:03.891\n具有特应性个体的人群呢，\n\n04:03.891 --> 04:07.992\n它更容易患变异性鼻炎或者叫过敏性鼻炎，\n\n04:07.992 --> 04:08.891\n尤其是啊，\n\n04:08.891 --> 04:12.391\n是有过敏性疾病家族史的这一类人群。\n\n04:12.992 --> 04:13.442\n那么，\n\n04:13.442 --> 04:15.042\n有哪些危险因素呢？\n\n04:15.292 --> 04:20.541\n接触的过敏原是过敏性鼻炎发病的主要的危险因素。\n\n04:20.592 --> 04:21.541\n过敏原呢，\n\n04:21.541 --> 04:22.541\n非常的多，\n\n04:22.691 --> 04:26.541\n我们常见的有尘螨、花粉、宠物的皮屑。\n\n04:27.126 --> 04:27.651\n还有呢，\n\n04:27.651 --> 04:28.501\n蟑螂啊，\n\n04:28.501 --> 04:29.376\n霉菌呐，\n\n04:29.626 --> 04:30.901\n乌尘呐等等啊，\n\n04:30.901 --> 04:32.376\n这类过敏源啊，\n\n04:32.575 --> 04:35.501\n某些食物过敏源同时啊，\n\n04:35.501 --> 04:37.776\n可能会一起导致疾病。\n\n04:38.276 --> 04:39.026\n另外呢，\n\n04:39.026 --> 04:40.376\n像空气污染，\n\n04:40.526 --> 04:41.675\n吸烟啊，\n\n04:41.675 --> 04:46.575\n这些环境的因素也可能会增加过敏性鼻炎的发病的风险。\n\n04:47.682 --> 04:52.481\n那过敏性鼻炎的诊断方法和评估指标包括哪些呢？\n\n04:52.881 --> 04:53.881\n过敏性鼻炎啊，\n\n04:53.881 --> 04:56.532\n我们典型的症状的识别啊，\n\n04:56.532 --> 05:00.381\n刚才我们已经提到了过敏性鼻炎的四大症状啊，\n\n05:00.381 --> 05:06.332\n就是我们刚才提到的鼻痒、喷嚏、清水样鼻涕、鼻塞这些症状呢，\n\n05:06.332 --> 05:08.457\n可能跟季节相关，\n\n05:08.457 --> 05:10.557\n也可能是全年发作啊。\n\n05:10.557 --> 05:12.481\n刚才我们讲到了症状啊，\n\n05:12.481 --> 05:16.307\n这些症状四大症状是有它的特色的，\n\n05:16.307 --> 05:17.506\n比如说鼻痒啊，\n\n05:17.506 --> 05:17.881\n鼻子。\n\n05:17.924 --> 05:19.074\n里边奇痒难忍，\n\n05:19.223 --> 05:21.398\n喷嚏也是阵发性的喷嚏，\n\n05:21.398 --> 05:22.873\n而不是一个两个喷嚏。\n\n05:22.973 --> 05:23.498\n另外呢，\n\n05:23.498 --> 05:24.098\n鼻涕呢，\n\n05:24.098 --> 05:25.699\n不是说黄脓鼻涕啊，\n\n05:25.699 --> 05:26.924\n或者粘稠的鼻涕，\n\n05:27.023 --> 05:28.773\n主要是清水一样的鼻涕。\n\n05:28.924 --> 05:29.424\n还有呢，\n\n05:29.424 --> 05:30.324\n就是鼻塞。\n\n05:30.424 --> 05:31.598\n很多患者呀，\n\n05:31.598 --> 05:34.873\n其实是以鼻塞为主要的临床症状的。\n\n05:35.273 --> 05:37.523\n那么伴随症状有哪一些呢？\n\n05:37.523 --> 05:38.199\n刚才呢，\n\n05:38.199 --> 05:40.223\n其实我们也已经提到了，\n\n05:40.223 --> 05:43.674\n就是关于眼痒眼红流泪，\n\n05:43.723 --> 05:45.924\n有的时候会有眼部的灼热感。\n\n05:45.924 --> 05:47.674\n这些过敏性结膜炎的症状。\n\n05:47.911 --> 05:52.087\n刚才我们也提到了关于哮喘的相关的症状，\n\n05:52.087 --> 05:53.511\n比如说胸闷，\n\n05:53.511 --> 05:54.462\n咳嗽啊。\n\n05:56.360 --> 05:56.885\n还有呢，\n\n05:56.885 --> 05:58.936\n典型的喘息发作等等啊，\n\n05:58.936 --> 06:00.210\n这些呼吸道的症状，\n\n06:00.360 --> 06:06.460\n那么症状持续的时间是有助于我们判断它到底是过敏性鼻炎呢，\n\n06:06.460 --> 06:07.135\n还是呢，\n\n06:07.135 --> 06:09.161\n他的病情的严重程度啊，\n\n06:09.161 --> 06:12.661\n这些都和症状持续时间是相关的。\n\n06:13.411 --> 06:13.835\n那么，\n\n06:13.835 --> 06:19.860\n我们对于实验室的检查和辅助的诊断手段有哪一些呢？\n\n06:20.311 --> 06:23.985\n实验室检查和辅助诊断手段主要包括下面这几种，\n\n06:23.985 --> 06:24.786\n首先呢，\n\n06:24.786 --> 06:26.161\n是过敏原的检测。\n\n06:26.260 --> 06:26.710\n我们。\n\n06:26.776 --> 06:28.075\n过敏原的检测呢，\n\n06:28.075 --> 06:29.526\n有三种方法。\n\n06:29.526 --> 06:30.300\n首先呢，\n\n06:30.300 --> 06:32.126\n是皮肤点刺试验。\n\n06:32.226 --> 06:33.276\n皮肤点刺试验呢，\n\n06:33.276 --> 06:39.026\n就是在我们的这个前臂内侧做皮肤做皮内试验。\n\n06:39.075 --> 06:39.575\n还有呢，\n\n06:39.575 --> 06:41.626\n就是血清特异性IGE的检测。\n\n06:41.626 --> 06:42.126\n这个呢，\n\n06:42.126 --> 06:43.800\n是一个体外的检测，\n\n06:43.800 --> 06:45.675\n就是我们抽了患者的血，\n\n06:45.776 --> 06:48.575\n然后进行特异性IGE的检测。\n\n06:48.626 --> 06:49.526\n还有一种方法呢，\n\n06:49.526 --> 06:51.175\n叫鼻粘膜激发实验，\n\n06:51.226 --> 06:52.651\n因为这个激发实验呢，\n\n06:52.651 --> 06:54.425\n比较繁琐啊，\n\n06:54.425 --> 06:54.876\n所以呢，\n\n06:54.876 --> 06:56.726\n没有在这个很多的医院。\n\n06:56.880 --> 06:57.779\n推广开来，\n\n06:57.779 --> 07:01.079\n但是皮肤检测试验和血清特性IG的检测呢，\n\n07:01.079 --> 07:03.005\n是已经在很多的，\n\n07:03.005 --> 07:06.880\n甚至县级预算医院以上都会有这种检测的方法。\n\n07:07.804 --> 07:12.954\n这个检测的方法主要是确定患者对哪些过敏源是有过敏情况的，\n\n07:13.054 --> 07:15.804\n也有助于我们避免接触和针对性的治疗。\n\n07:16.005 --> 07:16.704\n另外呢，\n\n07:16.704 --> 07:18.779\n就是检查我们检查的话呢，\n\n07:18.779 --> 07:21.355\n我们主要是用前鼻镜检查，\n\n07:21.454 --> 07:23.204\n我们可以看到哪些体征呢，\n\n07:23.204 --> 07:25.105\n鼻腔黏膜的色泽呀，\n\n07:25.105 --> 07:26.029\n形态呀，\n\n07:26.029 --> 07:27.454\n分泌物啊，\n\n07:27.454 --> 07:30.154\n从而评估这个鼻腔的炎性的程度。\n\n07:30.204 --> 07:32.704\n比如说他鼻腔肿胀的情况，\n\n07:32.704 --> 07:34.630\n我们可以分为它多少分啊，\n\n07:34.630 --> 07:37.204\n来评估它的这个严重程度，\n\n07:37.255 --> 07:37.904\n另外就是。\n\n07:37.959 --> 07:38.859\n影像学检查，\n\n07:38.910 --> 07:40.359\n比如说鼻窦CT，\n\n07:40.410 --> 07:43.084\n我们看鼻窦CT的目的是什么？\n\n07:43.084 --> 07:44.709\n就是辅助诊断，\n\n07:44.809 --> 07:47.234\n看一看是不是有其他的合并症，\n\n07:47.234 --> 07:48.760\n比如说鼻窦炎，\n\n07:48.760 --> 07:50.510\n鼻息肉这些情况。\n\n07:51.662 --> 07:52.062\n那么，\n\n07:52.062 --> 07:53.613\n病情的严重程度的评估，\n\n07:53.912 --> 07:59.812\n我们呢把过敏性鼻炎分为轻度和中重度的过敏性鼻炎。\n\n07:59.812 --> 08:00.838\n那么轻度呢，\n\n08:00.838 --> 08:02.912\n指的是症状轻微啊。\n\n08:02.912 --> 08:08.963\n我们当然症状再轻微也至少包括四大症状里面的至少两个症状。\n\n08:10.165 --> 08:12.591\n对日常的生活影响并不大，\n\n08:12.591 --> 08:14.140\n比如说对工作呀，\n\n08:14.140 --> 08:15.466\n学习呀，\n\n08:15.466 --> 08:16.740\n日常的活动啊，\n\n08:16.740 --> 08:17.740\n甚至睡眠啊，\n\n08:17.740 --> 08:18.415\n情绪啊，\n\n08:18.415 --> 08:19.441\n影响并不大。\n\n08:19.441 --> 08:21.015\n我们称其为轻度的，\n\n08:21.015 --> 08:22.216\n那么中度的话呢，\n\n08:22.216 --> 08:24.566\n症状就较为的明显，\n\n08:24.716 --> 08:27.115\n对日常活动有一定的影响了。\n\n08:27.165 --> 08:28.640\n那么重度的话呢，\n\n08:28.640 --> 08:29.365\n指的是呢，\n\n08:29.365 --> 08:30.240\n症状啊，\n\n08:30.240 --> 08:33.565\n严重严重的影响到我们正常的生活。\n\n08:33.716 --> 08:34.341\n其实呢，\n\n08:34.341 --> 08:36.015\n按照I的分类呢，\n\n08:36.015 --> 08:37.466\n就是这个严重程度呢，\n\n08:37.466 --> 08:39.916\n对我们刚才说到的就是这些。\n\n08:40.440 --> 08:40.940\n生活呀，\n\n08:40.989 --> 08:41.765\n工作呀，\n\n08:41.765 --> 08:42.489\n学习呀，\n\n08:42.489 --> 08:43.590\n日常的活动啊，\n\n08:43.590 --> 08:46.614\n甚至睡眠情绪这些没有任何影响的，\n\n08:46.614 --> 08:47.890\n我们称其为轻度。\n\n08:47.989 --> 08:50.590\n但是有任何一项有影响呢，\n\n08:50.590 --> 08:52.289\n我们称其为中重度。\n\n08:52.640 --> 08:53.239\n另外呢，\n\n08:53.239 --> 08:54.789\n我们根据发作的频率呢，\n\n08:54.789 --> 08:56.739\n分为间歇性和持续性。\n\n08:56.840 --> 08:57.590\n间歇性呢，\n\n08:57.590 --> 08:58.140\n指的是呢，\n\n08:58.140 --> 09:01.039\n症状发作的时间少于四周，\n\n09:01.640 --> 09:05.789\n而且连续发作的时间是不超过十天的啊，\n\n09:05.789 --> 09:07.690\n就是一周里边不超过10天的，\n\n09:07.890 --> 09:08.340\n还有呢，\n\n09:08.340 --> 09:09.015\n持续性的，\n\n09:09.015 --> 09:10.340\n持续性的指的是症。\n\n09:10.416 --> 09:12.765\n症状发作的时间超过了四周，\n\n09:12.916 --> 09:15.065\n而且连连，\n\n09:15.065 --> 09:19.491\n而且一周里边持续发作的时间是超过10天的。\n\n09:19.491 --> 09:21.916\n我们称其为持续性的过敏性鼻炎。\n\n09:23.010 --> 09:23.609\n那么，\n\n09:23.609 --> 09:25.559\n病情严重程度的评估啊，\n\n09:25.559 --> 09:29.159\n刚才我们已经都提到了轻度和中重度。\n\n09:29.260 --> 09:31.760\n那么对生活质量具体的影响，\n\n09:31.760 --> 09:33.984\n刚才我们其实也已经提到了。\n\n09:33.984 --> 09:35.934\n首先是睡眠的障碍。\n\n09:35.934 --> 09:38.059\n那么是什么原因导致睡眠障碍呢？\n\n09:38.059 --> 09:40.059\n就是鼻塞流鼻涕。\n\n09:40.109 --> 09:41.184\n鼻塞流鼻涕呢，\n\n09:41.184 --> 09:44.434\n会导致患者睡间夜间睡眠的时候啊，\n\n09:44.434 --> 09:45.760\n它的质量会下降，\n\n09:45.909 --> 09:47.460\n还有日常活动的受限。\n\n09:47.559 --> 09:48.385\n因为患者呀，\n\n09:48.385 --> 09:49.784\n症状的频繁的发作啊，\n\n09:49.784 --> 09:52.609\n患者要不同的擦鼻涕、擤鼻涕。\n\n09:53.171 --> 09:54.046\n要揉鼻子啊，\n\n09:54.046 --> 09:54.997\n因为鼻子比较痒，\n\n09:54.997 --> 09:58.421\n有的时候会有眼痒、眼红、流泪、揉眼睛啊。\n\n09:58.421 --> 09:58.947\n这些呢，\n\n09:58.947 --> 10:02.921\n严重的干扰了日常的正常的活动和工作。\n\n10:04.330 --> 10:06.929\n那么治疗方案和预防措施啊，\n\n10:06.929 --> 10:07.880\n包括哪一些呢？\n\n10:07.979 --> 10:10.280\n我们过敏性鼻炎的治疗呢，\n\n10:10.280 --> 10:11.479\n主要的啊，\n\n10:11.479 --> 10:13.729\n目前还是药物的治疗。\n\n10:13.880 --> 10:14.354\n那么，\n\n10:14.354 --> 10:17.705\n我们有哪些药物治疗和哪些注意事项呢？\n\n10:17.705 --> 10:19.630\n我们给大家来简单的介绍一下。\n\n10:19.630 --> 10:20.479\n首先呢，\n\n10:20.479 --> 10:21.729\n有抗组胺药。\n\n10:21.830 --> 10:23.005\n抗组胺药的话呢，\n\n10:23.005 --> 10:24.205\n我们有鼻喷的啊，\n\n10:24.205 --> 10:30.580\n就是局部用的也有口服的抗组胺药可以有效的缓解鼻痒啊，\n\n10:30.630 --> 10:31.455\n喷嚏啊，\n\n10:31.455 --> 10:32.255\n流涕啊，\n\n10:32.255 --> 10:33.979\n等等这些症状，\n\n10:34.030 --> 10:34.479\n但是。\n\n10:34.531 --> 10:34.831\n但是呢，\n\n10:34.831 --> 10:35.981\n我们需要它的注意，\n\n10:35.981 --> 10:37.156\n它的不良反应，\n\n10:37.156 --> 10:39.031\n尤其是一代的抗组胺药，\n\n10:39.031 --> 10:40.456\n它会导致嗜睡呀，\n\n10:40.456 --> 10:41.231\n口干，\n\n10:41.231 --> 10:42.581\n那么二代的话呢，\n\n10:42.581 --> 10:44.481\n像西替利嗪，\n\n10:44.581 --> 10:45.632\n氯雷他定啊，\n\n10:45.632 --> 10:46.956\n这一方面的不良反应啊，\n\n10:46.956 --> 10:47.882\n就比较少了。\n\n10:48.132 --> 10:48.706\n还有呢，\n\n10:48.706 --> 10:50.206\n鼻用糖皮质激素，\n\n10:50.206 --> 10:56.682\n鼻用糖皮质激素的主要的作用是减轻鼻腔粘膜的水肿和缓解啊，\n\n10:56.682 --> 10:57.581\n鼻腔的炎症，\n\n10:57.682 --> 10:58.331\n但是呢，\n\n10:58.331 --> 11:00.731\n需要遵循医嘱使用，\n\n11:00.731 --> 11:02.581\n避免长期大量使用，\n\n11:02.581 --> 11:03.106\n当然啊，\n\n11:03.106 --> 11:04.481\n我们这里长期大量使用的。\n\n11:04.536 --> 11:06.635\n指的是一个时间的限制，\n\n11:06.685 --> 11:08.810\n比如说我们常规用药三个月啊，\n\n11:08.810 --> 11:10.260\n对鼻腔黏膜的刺激啊，\n\n11:10.260 --> 11:11.486\n其实是并不大的。\n\n11:12.422 --> 11:14.372\n还有的口服皮质类固醇，\n\n11:14.523 --> 11:17.497\n那么这个口服的糖皮质激素呢，\n\n11:17.497 --> 11:18.098\n大家知道啊，\n\n11:18.098 --> 11:20.122\n这个对全身影响是比较大的，\n\n11:20.172 --> 11:21.922\n不良反应是比较多的。\n\n11:21.922 --> 11:22.572\n幸好呢，\n\n11:22.572 --> 11:23.547\n我们是短期使用，\n\n11:23.547 --> 11:24.372\n我们一般呢，\n\n11:24.523 --> 11:26.122\n一般不会超过6天。\n\n11:26.273 --> 11:26.773\n这个呢，\n\n11:26.773 --> 11:31.898\n主要是用于严重的症状和我们用局部用的皮质类固醇激素啊，\n\n11:31.898 --> 11:32.973\n效果不佳。\n\n11:33.372 --> 11:34.023\n但是呢，\n\n11:34.023 --> 11:36.197\n刚才我说了注意它的副作用啊，\n\n11:36.197 --> 11:37.773\n比如说肥胖啊，\n\n11:37.773 --> 11:39.773\n这个满月脸，\n\n11:39.773 --> 11:41.023\n向心性肥胖啊，\n\n11:41.023 --> 11:41.947\n水牛背啊，\n\n11:41.947 --> 11:42.572\n骨质疏。\n\n11:42.616 --> 11:42.966\n疏松啊，\n\n11:42.966 --> 11:44.216\n这都是它的不良反应。\n\n11:44.315 --> 11:45.015\n还有呢，\n\n11:45.015 --> 11:47.966\n就是过敏性鼻炎的脱敏治疗的方法。\n\n11:48.416 --> 11:49.591\n脱敏治疗呢，\n\n11:49.591 --> 11:50.815\n它的机理是什么呢？\n\n11:50.815 --> 11:51.591\n其实就是啊，\n\n11:51.591 --> 11:56.315\n我们通过逐渐增加这个过敏原的暴露量，\n\n11:56.315 --> 11:56.890\n然后呢，\n\n11:56.890 --> 12:00.466\n提高患者对过敏原的耐受度。\n\n12:00.466 --> 12:01.140\n但是呢，\n\n12:01.140 --> 12:02.366\n需要长期治疗。\n\n12:02.616 --> 12:03.716\n免疫治疗的话呢，\n\n12:03.716 --> 12:05.065\n主要包括两种方法，\n\n12:05.065 --> 12:05.616\n一种呢，\n\n12:05.616 --> 12:06.940\n是皮下注射的，\n\n12:06.940 --> 12:08.815\n还有一种是舌下含服的，\n\n12:08.815 --> 12:11.315\n但是不管是哪一种方法呢，\n\n12:11.315 --> 12:12.416\n我们都需要。\n\n12:12.619 --> 12:14.070\n至少三年的时间。\n\n12:15.226 --> 12:15.627\n那么，\n\n12:15.627 --> 12:17.577\n非药物治疗的方法包括哪些？\n\n12:17.776 --> 12:18.377\n首先，\n\n12:18.726 --> 12:23.577\n鼻腔冲洗我们用生理盐水或者高渗盐水做鼻腔冲洗呢，\n\n12:23.577 --> 12:29.726\n可以有助于鼻腔过敏源过敏原的清理以及鼻腔分泌物的清除。\n\n12:29.927 --> 12:33.302\n鼻腔冲洗的真正的原因真正的机制是什么？\n\n12:33.302 --> 12:35.577\n我们目前目前不是特别清楚，\n\n12:35.577 --> 12:38.601\n但是我们至少知道我们通过冲洗呢，\n\n12:38.601 --> 12:40.677\n可以清除鼻腔里面的过敏原，\n\n12:40.776 --> 12:43.226\n可以减少鼻腔的分泌物，\n\n12:43.577 --> 12:44.226\n并且呢，\n\n12:44.226 --> 12:45.327\n还可以减轻。\n\n12:45.400 --> 12:47.349\n鼻塞这个主要是用高渗盐水，\n\n12:47.349 --> 12:48.049\n或者呢，\n\n12:48.049 --> 12:50.200\n我们可以通过冲洗呢，\n\n12:50.200 --> 12:52.375\n减少局部炎症的介质浓度。\n\n12:52.375 --> 12:53.150\n这样的话呢，\n\n12:53.150 --> 12:55.599\n会缓解患者的鼻腔的症状。\n\n12:56.463 --> 12:56.838\n还有呢，\n\n12:56.838 --> 12:57.713\n就是激光的治疗。\n\n12:57.914 --> 13:01.114\n我们用激光照射鼻腔粘膜，\n\n13:01.263 --> 13:04.864\n主要是在鼻腔粘膜上面形成伤痕，\n\n13:04.963 --> 13:05.463\n然后呢，\n\n13:05.463 --> 13:08.463\n造成这个再次接触过敏源的时候啊，\n\n13:08.463 --> 13:10.189\n这个敏感性降低啊，\n\n13:10.189 --> 13:10.963\n这个目的。\n\n13:10.963 --> 13:12.338\n但是疗效啊，\n\n13:12.338 --> 13:14.489\n就是是每个人和每个人啊，\n\n13:14.489 --> 13:15.414\n他是不一样的。\n\n13:15.713 --> 13:17.914\n微波治疗微波治疗的和激光治疗呢，\n\n13:17.914 --> 13:19.013\n其实是类似的，\n\n13:19.013 --> 13:19.638\n也是呢，\n\n13:19.638 --> 13:20.588\n通过鼻啊，\n\n13:20.588 --> 13:22.614\n鼻腔粘膜局部的这么一个加热，\n\n13:22.713 --> 13:24.564\n导致鼻腔粘膜啊，\n\n13:24.614 --> 13:26.664\n粘膜和粘膜下蛋白的凝固。\n\n13:27.033 --> 13:27.934\n等等，\n\n13:27.934 --> 13:28.484\n从而呢，\n\n13:28.484 --> 13:29.958\n减轻鼻粘膜呢，\n\n13:29.958 --> 13:31.508\n对过敏原的敏感性啊，\n\n13:31.508 --> 13:32.908\n它的基本的机理啊，\n\n13:32.908 --> 13:33.633\n就是这样的，\n\n13:33.684 --> 13:34.684\n那么手术治疗，\n\n13:34.783 --> 13:36.934\n那么对于药物治疗无效啊，\n\n13:36.934 --> 13:38.934\n对于脱敏治疗效果也不佳的，\n\n13:38.984 --> 13:42.283\n或者伴有其他的鼻腔结构的异常，\n\n13:42.283 --> 13:43.633\n比如说鼻中隔偏曲的，\n\n13:43.833 --> 13:44.684\n或者说呢。\n\n13:45.448 --> 13:47.624\n有鼻窦炎的或者有鼻息肉的，\n\n13:47.624 --> 13:48.698\n那么我们这个呢，\n\n13:48.698 --> 13:50.198\n一般是考虑手术治疗。\n\n13:50.249 --> 13:50.598\n那么，\n\n13:50.598 --> 13:51.999\n如果没有鼻中隔偏曲，\n\n13:52.049 --> 13:53.273\n又没有鼻窦炎，\n\n13:53.273 --> 13:54.448\n又没有鼻息肉，\n\n13:54.448 --> 13:55.499\n那么我们一般呢，\n\n13:55.499 --> 13:58.499\n选做一些选择性的神经切断手术。\n\n13:58.549 --> 13:59.174\n但是呢，\n\n13:59.174 --> 14:00.598\n神经切断手术的话呢，\n\n14:00.648 --> 14:02.374\n会有一定的并发症，\n\n14:02.374 --> 14:04.223\n比如说鼻子干，\n\n14:04.223 --> 14:06.198\n眼睛干这些不良反应。\n\n14:06.198 --> 14:06.723\n但是呢，\n\n14:06.723 --> 14:09.073\n因为现在的手术比较先进啊，\n\n14:09.073 --> 14:10.848\n就是比较高选择，\n\n14:10.898 --> 14:13.049\n也就是说比较精准，\n\n14:13.098 --> 14:13.723\n因此呢，\n\n14:13.723 --> 14:15.198\n不良反应会越来越少。\n\n14:15.916 --> 14:16.366\n那么，\n\n14:16.366 --> 14:19.216\n如何预防第一，\n\n14:19.565 --> 14:20.541\n首先啊，\n\n14:20.541 --> 14:23.166\n我们就要尽量的避免接触过敏源。\n\n14:23.166 --> 14:25.291\n我们首先要知道是什么过敏源，\n\n14:25.291 --> 14:26.616\n比如说是花粉呢，\n\n14:26.616 --> 14:27.565\n还是尘螨呢？\n\n14:27.616 --> 14:30.265\n我们根据花粉或者尘螨采取一定的措施。\n\n14:30.265 --> 14:30.841\n比如说，\n\n14:30.841 --> 14:32.091\n如果对花粉过敏，\n\n14:32.091 --> 14:34.315\n那么我们在花粉播散季节呢，\n\n14:34.315 --> 14:35.515\n尽量减少外出。\n\n14:35.616 --> 14:36.890\n如果要外出的话呢，\n\n14:36.890 --> 14:38.841\n我们一定要带上防护口罩啊，\n\n14:38.841 --> 14:39.966\n防护眼罩啊，\n\n14:40.015 --> 14:40.666\n或者呢，\n\n14:40.666 --> 14:42.216\n带一些鼻腔过滤器啊，\n\n14:42.216 --> 14:43.916\n来减少过敏原的接触，\n\n14:44.166 --> 14:45.666\n那么对于尘螨过敏的话呢。\n\n14:45.762 --> 14:46.387\n方法呀，\n\n14:46.387 --> 14:47.137\n就更多了，\n\n14:47.137 --> 14:52.062\n比如说我们可以用这种这个防螨的一些纺织品，\n\n14:52.062 --> 14:53.961\n或者说用一些除螨的吸尘器啊，\n\n14:53.961 --> 14:57.111\n或者用一些物理或化学的方法杀螨等等啊，\n\n14:57.111 --> 14:57.711\n这些方法。\n\n14:57.762 --> 14:58.387\n另外呢，\n\n14:58.387 --> 15:01.262\n我们要保持室内的空气的清新啊，\n\n15:01.312 --> 15:03.461\n比如说有些患者对污尘过敏，\n\n15:03.461 --> 15:05.262\n那么我们就要开窗通风，\n\n15:05.262 --> 15:06.911\n保持室内空气的流通，\n\n15:06.961 --> 15:08.361\n降低过敏原的浓度，\n\n15:08.361 --> 15:08.986\n而且呢，\n\n15:08.986 --> 15:11.361\n尽量保持房间里边一定的湿度，\n\n15:11.661 --> 15:12.161\n还有呢，\n\n15:12.161 --> 15:13.611\n就是规律的作息和饮食，\n\n15:13.711 --> 15:15.161\n保持充足的睡眠，\n\n15:15.161 --> 15:15.661\n合理。\n\n15:15.739 --> 15:17.840\n饮食增强机体的免疫力，\n\n15:17.940 --> 15:22.940\n那么就会减少因为过敏性鼻炎并发的鼻窦炎的啊，\n\n15:22.940 --> 15:24.140\n这些发病率。\n\n15:24.239 --> 15:24.739\n还有呢，\n\n15:24.739 --> 15:25.539\n就是加强锻炼，\n\n15:25.640 --> 15:27.289\n适当的进行加强锻炼呢，\n\n15:27.289 --> 15:28.565\n提高我们身体素质，\n\n15:28.565 --> 15:29.940\n提高我们的抗病能力，\n\n15:29.940 --> 15:30.789\n也就是说，\n\n15:30.840 --> 15:34.190\n提高我们抵抗病毒和细菌感染的能力。\n\n15:34.190 --> 15:34.989\n这样子的话呢，\n\n15:34.989 --> 15:40.140\n也会减少因为过敏性鼻炎合并的慢性的鼻窦炎。\n\n15:41.398 --> 15:41.797\n好，\n\n15:41.997 --> 15:45.922\n今天我们的关于过敏性鼻炎的一些科普的一些知识啊，\n\n15:45.922 --> 15:47.098\n包括诊疗啊，\n\n15:47.098 --> 15:48.422\n包括如何预防啊，\n\n15:48.422 --> 15:49.997\n就给大家介绍到这里，\n\n15:49.997 --> 15:51.098\n谢谢大家的聆听。\n\n","v0347cg10004d60m1g2ljht1l5php6qg",957,670,"2026-01-24 19:30:34"," 变应性鼻炎 - 症状、原因及治疗方法全解析 | 专业指南  "," 变应性鼻炎,过敏性鼻炎症状,鼻炎原因,鼻炎治疗方法,花粉症,鼻塞流涕,抗组胺药,免疫疗法  "," 本文全面解析变应性鼻炎（过敏性鼻炎）的典型症状、常见诱因及最新治疗方法，涵盖药物控制、免疫疗法和日常预防措施，帮助您科学应对季节性过敏困扰。","2026-02-04 14:30:00",[37],{"menuId":38,"menuName":39,"parentId":17,"orderNum":22,"path":40,"component":41,"isFrame":42,"isCache":43,"menuType":44,"visible":26,"status":17,"createDept":6,"remark":24,"createTime":45,"children":46,"columnImage":47,"columnLogo":48,"uncheckedLogo":6,"checkedLogo":6,"isHot":17,"isHome":17,"forceLogin":17,"color":6,"seoTitle":49,"seoKeywords":50,"seoDescription":51,"contentNum":6,"promotionalPoster":52,"menuFrame":7,"innerLink":7,"parentView":7,"routeName":53,"routerPath":40,"componentInfo":41},"1986622624134549505","科普视频","video","/video.html","1","0","T","2025-11-07 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