Rhinitis - the most common disease of the upper respiratory tract.
The main factor predisposing to the development of rhinitis can be considered as hypothermia, which contributes to a violation protective mechanisms of the organism and activate conditional pathogenic microflora in the nasal cavity, the nasopharynx and the oral cavity. Another factor is the reduction of organism resistance due transferred acute or chronic diseases.
Warming, moistening and filtering the air you breathe, the nasal cavity is protective. Nasal cavity and bronchial anatomically interconnected, covered with ciliated epithelium and are equipped with an arsenal of innate and acquired defense mechanisms. Therefore, the state, causing a runny nose can be a triggering factor for the development of lower respiratory tract disease.
Rhinitis may be the first sign of acute respiratory viral infections (SARS) And the start of an allergic reaction. The following types of rhinitis:
- allergic,
- infectious,
- non-allergic, non-infectious rhinitis.
Allocate seasonal and perennial allergic rhinitis, as well as intermittent and persistent during each of these forms.
Under non-allergic, non-infectious rhinitis persistent understand heterogeneous group of disorders nasal breathing, including professional rhinitis rhinitis drug, hormonal rhinitis, rhinitis and idiopathic elderly vasomotor rhinitis.
Infectious rhinitis occurs in about half of the adult population. Children, especially young children, the incidence of infectious rhinitis is significantly higher. May be non-specific (start respiratory infection) and specifically, for example caused by infectious agents - diphtheria, measles, scarlet feverTuberculosis.
In addition, isolated traumatic and acute rhinitis, mucosal injury caused by a nasal cavity (foreign body, cautery, surgical interventions, as well as environmental conditions - dust, smoke, inhalation of chemicals substances).
manifestations of rhinitis
Classic symptoms of rhinitis - nasal congestion, runny nose, sneezing. Rhinitis begins quickly with a general deterioration of the patient: increased body temperature, there is headacheDeteriorates nasal breathing, decreased sense of smell, which is caused by the spread of inflammation in the olfactory region. The patient noted a burning sensation, tickling and scratching in the nasal cavity. Then a discharge due to a liquid exuded from the vessels, and enhancing the function of the mucous glands. This discharge is irritating, especially in children, the skin of the vestibule of the nose and upper lip, which manifests itself in the form of redness and painful cracks. Nasal breathing is disturbed due to edema of the nasal turbinates.
Characteristically lachrymation due to irritation of sensitive reflex zones of nasal mucous membrane, sneezing. Swelling of the nasal mucous membrane leads to disruption of the drainage of the sinuses and middle ear, that It creates favorable conditions for the activation of conditionally pathogenic flora and promotes the development of bacterial complications. Later changes detachable nature of the nasal cavity, it becomes cloudy, and then the yellowish green. This is due to the presence of pus in it.
The patient's condition improves: headache decreases, the amount of discharge disappear unpleasant sensation in the nose (sneezing, lacrimation), improving nasal breathing. The total duration of acute rhinitis is 8-14 days, it can vary in one way or another for various reasons. Acute rhinitis may end in 2-3 days, if the general and local immunity of the child are not violated. In frail children (often ill SARS) in the presence of chronic foci of infection acute rhinitis may be protracted - up to 3-4 weeks.
Coryza in infants It has its own characteristics. It usually occurs as nasopharyngitis; often inflammatory process extends to the nasopharynx (adenoids), the middle ear, larynx, trachea, bronchi, and lungs. The child has violated the act of sucking, which leads to weight loss, sleep disturbances, Increased excitability. Especially severe acute rhinitis occurs in premature, weakened children, with sharply reduced ability to fight.
Chronic catarrhal rhinitis characterized by a number of common manifestations: chief complaint is impaired nasal breathing with alternately laying the one or the other half of the nose. Depending on the contents of certain elements exudate, nasal discharge can be serous, mucous or mucopurulent. Chronic hypertrophic rhinitis is characterized by long-term course. Nasal congestion is more permanent than when catarrhal rhinitis form, and does not pass after instillation of vasoconstrictor. Apart from the complicated nasal breathing, patients suffer from headaches, poor sleep. Nasal mucosa usually pale pink, reddish or bluish tint. Abundant thick discharge fill the nasal passages and drain into the nasal passages, but in rare cases, discharge may not be.
at chronic atrophic rhinitis patients complain of a feeling of dryness in the nose, crusting, feeling of pressure and headaches. Nasal secretions thick, yellow-green; places zasyhaya forms crusts. Increased permeability of the nasal passages, purulent secretions in large amounts may cause the spread of a chronic inflammatory process in the mucosa of the pharynx and larynx.
vasomotor rhinitis - a disease caused by increased sensitivity of the organism (allergic form) or neurovegetative disorders (neurovegetative form). These two forms are manifestations of the disease are similar: sneezing, nasal congestion, heavy liquid separation.
Constant feature for allergic rhinitis sneezing is accompanied by abundant clear watery nasal discharge and obstruction of nasal breathing. Allocation is preceded by itching of the nose.
Diagnosis of acute rhinitis put on the basis of patient complaints, subjective and objective symptoms front rinoskopii. Sometimes clinical observation is not enough for the diagnosis. In these cases, resorting to laboratory studies: general blood test, study the cytological picture of a print from the mucosa of the nasal cavities, virological tests.
rhinitis treatment
When symptoms of rhinitis with normal body temperature is prescribed
- home (not bed) mode,
- plenty of warm drinks,
- thermal procedures (hot foot bath and warm compresses on the back surface of the hands).
How to blow your nose
The main thing - the right to blow his nose, so that, firstly, to clear the nasal cavity, and secondly, to discharge from the nose does not fall into the paranasal sinuses and the middle ear cavity. For this purpose it is necessary to blow your nose without effort, with his mouth open and release each half of the nose, alternately pressing the nose wing to the wall. If nasyhaniya crusts in front of the nose is necessary to soften them with oil (olive, sunflower) and then gently remove with a cotton wick. And only then can otsmarkivat mucus from the nose.
In rhinitis is recommended to drink plenty of warm (tea with lemon and raspberry, milk and honey). In cases of high temperature (above 38) can be used antipyretics. Although it should be borne in mind that antipyretics, increasing perspiration, may predispose to various kinds of complications and worsen the disease, reducing the resistance to infectious aggression.
During exacerbation of chronic rhinitis use the same medication as that in acute rhinitis (Vasoconstrictive drops, drops and ointments with drugs possessing anti-inflammatory, antimicrobial effect). Use cementing formulations: 2-5% solution protargola (kolargola) in the form of nose drops (5 drops into each nostril 3 times a day).
Treatment of chronic atrophic rhinitis and subatrophic is based on the specific program: topically administered drugs that improve the condition of the nasal mucosa and stimulating function of mucous glands. Applied in the form of droplets alkaline solutions, pulverization, lubrication with a light massage, ointment furatsilinovoy rate of 1: 5000. Conduct courses strengthening therapy (autohemotherapy, proteotherapy, vaccinotherapy injections aloe extract, cocarboxylase, vitreous FIBS), vitamin therapy, for prozerinoterapii conventional schemes.
Treatment of chronic hypertrophic rhinitis It requires more drastic measures: moxibustion (manufactured chemicals - trichloroacetic acid, lapis, chromic acid, etc.), galvanokaustiki, diathermocoagulation, ultrasonic disintegration, cryotherapy, impact beam laser.
In acute rhinitis of physiotherapeutic methods used
- UV radiation locally to the area of the soles (6-8 biodozy);
- UHF (nose region of 5-8 minutes, the first 3 days daily, then every other day);
- microwave effects on the nose;
- effective inhalation (heat-alkaline, alkaline-oil, oil-adrenalin, fitontsidami, honey etc.).
In chronic catarrhal rhinitis often prescribed currents UHF solljuks, irradiation with ultraviolet rays, if there are no contraindications to him, microwave therapy, aerosols and negatively charged elektroaerozoli with antibiotics.
low-energy laser radiation is increasingly used from the various forms of chronic rhinitis in patients with catarrhal chronic rhinitis and rhinitis subatrophic and autonomic form of vasomotor rhinitis. The total exposure time of each half nose 3-4 minutes. The course of treatment of 10-12 daily procedures.
In the treatment of rhinosinusitis also used the following methods and quantum haemotherapy: vnutrivenoznoe blood irradiation helium-neon laser in conjunction with irradiation of the skin in the area of the projection vessels infrared laser.
Treatment of vasomotor Rinishe should be comprehensive and focused. All kinds of proposed therapeutic effects on the body can be divided into specific and nonspecific. specific desensitization success depends on early detection of the allergen, as over time in patients developing poliallergiya. Spend procaine blockade, exposure to cold, infrared coagulation, ultrasonic disintegration, vasotomy, hypobarotherapy in conjunction with desensitization, ultraviolet irradiation, gymnastics, air and sun baths, and many other methods of physiotherapy impact in view of the indications and contraindications. The beneficial effect of laser at vasomotor rhinitis associated with improved exchange capillary in the mucosa of the nasal cavity, resulting in elimination of edema and swelling.
In the absence of effect of conservative therapy, the presence of irreversible changes in the mucous membranes of the nasal cavity recommended sparing surgery. Also produce various embodiments of submucosal operations performed on the nasal turbinates: galvanokaustika, electrocautery, osteokonhotomiya, submucosal vaccine microsurgery, mukozotomiya, turbinotomy et al. methods.
The most effective method treatment of allergic rhinitis patient is to discontinue contact with an allergen. Drug therapy involves two main aspects of impacts: specific immunotherapy significant allergen and the use of antihistamine drugs (Tavegilum, terfenadine, loratadine, tsetirezin). First generation antihistamine drugs have several side effects (significant hypnotic effect). Therefore, use of these drugs must be administered with caution (certain group of people - drivers, etc... should discard them).
Treatment of allergic rhinitis is also made complex and stepwise. The first step is uschtranenie secretion due to irrigation of the nasal mucosa using a mineral water decoction of black tea, a massage of the nasal mucosa, acupressure wings of the nose and neck area; enterosorption (removing metabolic products, toxins, immune complexes, using for this purpose sorbents - Polyphepanum, ultrasorb, sums et al.). The second step is drug therapy. The third step is carried out specific and nonspecific immunotherapy, increases the content of immunoglobulin A. As an immunostimulant of bacterial origin used ribomunil, bronhovakson, bronhomunal. Specific immunotherapy is carried causative allergen.
