药物性鼻炎的研究进展  

Research progress on rhinitis medicamentosa

作　　者：王雨农[1] 栾兆磊 王洪田[1] 

机构地区：[1]解放军总医院耳鼻咽喉头颈外科,北京100853

出　　处：《中华耳鼻咽喉头颈外科杂志》2017年第11期872-875,共4页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：国家自然科学基金面上项目（81371074、81670901）;海南省重大课题（ZDKJ2016008）

摘　　要：药物性鼻炎是指长期、过量应用鼻部减充血剂导致的鼻黏膜非变应性炎性反应，常发生于伴有鼻塞症状的鼻炎患者。在长期使用鼻减充血剂的基础上出现鼻塞症状为该病的主要特征，不包含流涕、喷嚏等。体征为鼻黏膜红肿、增厚、失去弹性、对减充血剂不再敏感。组织病理学变化主要包括鼻黏膜纤毛缺失、鳞状上皮化生、上皮水肿、上皮细胞裸露、杯状细胞增生以及炎性细胞浸润等，目前尚缺乏统一的诊断标准。治疗上主要为停用鼻部减充血剂及使用鼻喷糖皮质激素。Rhinitis medicamentosa （RM） refers to nonallergic inflammation in the nasal mucosa which is caused by the abuse of nasal decongestant and it often occurs in patients with allergic/nonallergic rhinitis along with nasal congestion. RM is characterized by nasal congestion based on long-term use of nasal decongestant, without rhinorrhoea or sneezing. The signs of RM include nasal swelling, thickening, loss of elasticity, and loss of sensitivity to the decongestant. The histological changes of RM are loss of nasal mucosa cilia, squamous epithelium metaplasia, edema of epithelium cell, hyperplasia of goblet cell, increased expression of epidermal growth factor receptor and infiltration of inflammatory cells, etc. There is no precise diagnosis standard for RM, making it even harder for its objective diagnosis. Patients with RM should immediately stop using nasal decongestant, in stead of using nasal glucocorticoid spray for the recovery of the nasal mueosa＇s function.

关 键 词：药物性鼻炎 鼻充血减轻剂 鼻塞 糖皮质激素类 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]