過敏性鼻炎的緩解
楊惟婷
據台北市衛生局統計，1985 年孩童過敏性鼻炎的比例為 7.84%，2007年竟增加至 50%，20年之間人數飆漲7倍。奇美醫學中心統計也發現，在 PM2.5濃度達到紫爆的期間，因鼻子過敏而就診的人數會增加 3∼4 成。
有過敏性鼻炎時，如何透過食療、改變生活習慣來改善？
一、過敏性鼻炎症狀
簡單的說，過敏(allergy)乃是我們體內免疫系統將一些原本是無害的物質，誤認為對我們有潛在威脅而產生不正確的過度反應。能導致過敏反應的物質通稱為過敏原(allergens)，常見的過敏原包括了塵蹣、黴菌、花粉、貓狗等動物皮屑、帶殼海鮮、大豆、花生等高致敏食物、蟑螂、空氣污染、化學品及其衍生物等。
鼻子是人體呼吸道的入口，具備呼吸、感覺及免疫器官的功能。
當我們吸入的過敏原與體內的特異性抗體結合，就可能會引發身體的免疫反應，屬於身體免疫細胞之一的肥大細胞釋放出組織胺等炎症物質，導致鼻黏膜發炎的狀態，就稱為過敏性鼻炎。所以，過敏性鼻炎是免疫系統受到刺激引發的發炎反應。
如何診斷過敏性鼻炎？
過敏性鼻炎有四大典型症狀。
1、鼻子癢
2、打噴嚏
3、流鼻水
4、鼻塞
診斷主要根據臨床症狀。
◎開始先鼻子癢、打噴嚏，嚴重時眼睛也會癢。鼻子過敏的打噴嚏很劇烈，連續十幾聲，和一般感冒的一兩聲不同，另外感冒也不容易鼻子癢、眼睛癢。
◎接著會流大量清澈的鼻水，有時一早醒來就要用掉半包衛生紙，到後來還會出現鼻塞。
◎若病患本身有其他過敏疾病，或父母、兄弟姐妹有過敏病史，或理學檢查發現有黑眼圈及鼻黏膜蒼白腫脹，就可以更加確定診斷。
◎另外可檢驗過敏抗體.IgE、過敏原皮膚試驗、鼻黏膜抹片檢查等來輔助診斷。
二、過敏性鼻炎的食療
避免菸酒與少攝取帶殼海鮮、堅果、人工添加物、油炸與辛辣食物。
中醫認為冰品冷飲與西瓜、竹筍等寒性食物會刺激副交感神經，增加發作頻率，也應盡量避免食用。
過敏性鼻炎的食療可多用以下食物﹕
1、薑
薑的辛味成分薑辣素和薑烯酚能提高身體免疫力與新陳代謝、治鼻塞，可以期待緩和過敏性鼻炎症狀的效果。
2、蓮藕
蓮藕含有豐富的黏液素，能避免鼻黏膜太過乾燥，1 天吃 30∼40 公克的蓮藕粉，連續 2 周就可期待改善過敏性鼻炎的效果。
3、洋蔥
洋蔥含有豐富的槲皮素，槲皮素是一種類似抗組織胺特性的物質，具有抑制過敏、抗發炎的作用。
4、黑豆
黑豆含有能強化鼻黏膜的維生素 B12、鋅、鐵、大豆皂苷，能提高免疫力的卵磷脂、木酚素等成分，有助於預防過敏。
5、益生菌
益生菌可以調節免疫系統，降低過敏反應。從優格、優酪乳、味噌、泡菜等食物中也能攝取到益生菌。
6、魚油
沙丁魚、鰹魚、鯖魚、秋刀魚等青背魚含有豐富的 EPA 和 DHA，可以讓免疫系統正常運作，有抗發炎、抗過敏的效果。
7、紫蘇
紫蘇有很高的殺菌效果，富含維生素K、木犀草素、α-亞麻酸等，可以恢復免疫機能、減少發炎反應，緩和過敏性鼻炎的症狀。
8、薄荷
薄荷的類黃酮能抑制肥大細胞釋放出過敏物質，對一般的過敏性鼻炎也有效。
三、過敏性鼻炎的環境改善
1、徹底清潔室內及寢具
勤於打掃，冷氣機、除濕機、空氣清淨機等要定期清洗與更換濾網。
枕頭套每周洗一次，寢具2周洗一次，以 55∼65 度的熱水清洗後日曬，用吸塵器吸除塵蟎與蟑螂屍骸、糞便，也可選用防蟎寢具。
2、少放地毯與絨毛玩具
布製品容易堆積灰塵、孳生黴菌、藏匿塵蟎，應盡量少用，或是選擇短毛地毯，絨毛玩具不放床邊，不用太厚重的窗簾布，時常清潔。
3、保持環境通風
現代住宅密閉性高，濕氣容易留在室內，利於塵蟎、黴菌繁殖。多通風換氣，使用除濕機讓室內濕度不超過 65%，使用空氣清淨機也能減少空氣中的過敏原。
另避免使用家中的冷氣機，尤其過敏兒最好少吹冷氣。因為，濕冷的環境也會讓支氣管變得更敏感，大部分的氣喘或鼻子過敏症狀，會在接觸冷風和冰水後變得更嚴重。
4、室內避免豢養寵物
寵物容易掉落毛髮，產生灰塵等過敏原，毛髮與皮屑都是塵蟎喜愛的食物，應該盡量讓寵物待在室外，常幫牠洗澡。
5、生活作息規律
過勞、壓力大、熬夜、情緒起伏大都會影響免疫系統，保持睡眠充足、紓解壓力，可以調節自律神經，降低鼻過敏發作。
6、適度運動能增強免疫力
多多運動，尤其是游泳，多曬太陽，增加抵抗力，也比較容易改善過敏體質。
日本耳鼻喉科學會表示，游泳能減少鼻子對過敏原的敏感度，但泳池的餘氯量要在 0.3∼0.7ppm之間，以免刺激鼻黏膜。
7、避免出現在溫差變化大的場所，如夏季在大太陽下突然喝冰水或吹冷氣。
很多人以為注意保暖只能預防感冒，但對於長期受呼吸系統過敏困擾的民眾而言，保持身體暖和更是一項不可忽視的工作。
身體最容易著涼的部位，分別是頭頂、後腦、喉嚨、前胸、上背、腰、腳踝，以及大腿前側與手指、腳趾。無論什麼季節，都要注意這幾個地方的溫度，尤其到了炎熱夏天，只想躲進冷氣房裡，更要小心別讓自己的頭部、肩頸直接吹到風。女生穿短褲短裙，坐下來時也建議在腿上蓋一件薄外套，避免腿部受寒。
《哈佛醫師養生法》一書指出，不論是哪一種過敏，切忌冰冷，因為人是恆溫的動物，只要冰品一下肚，人體便需要耗費能量來平衡下降的體溫。
所以，除了從外部加強保暖，日常生活中也可以用食物提升體內的溫度。容易受寒的人可以在食物中添加熱性佐料，例如老薑、大蒜，胡椒粉、肉桂這些吃了會讓身體暖呼呼，微微冒汗的食物，都能活化血液循環、促進代謝。
8、多喝熱水，因為口腔的熱度會提升鼻腔的溫度，減少鼻黏膜腫大的機會。
9、騎乘機車或可能吸入不舒服的冷空氣時，戴上口罩或用圍巾掩口鼻。
四、過敏性鼻炎的緩解過敏症狀
由於引起過敏性鼻炎的根本原因是監控環境的自律神經太過敏感、失調，而導致對過敏原反應過度，所以也沒有藥物可以從過敏的源頭發揮根本治療的效果。
吃藥治療只能緩解過敏性鼻炎症狀，無法治療造成症狀的源頭—-「鼻子的自律神經失調」。所以，只能緩解過敏的症狀，是無法斷根。
很多家屬在門診常問：鼻子過敏能不能斷根？答案是不能。
但治療後可以減緩症狀，改善生活品質。
◎治療方法有下列幾種：目前緩解過敏的症狀，仍是以藥物、鼻劑為主。
1、藥物包括四類，抗組織胺、抗鼻充血劑、類固醇及敏鼻速樂(cromoglycate)。
抗組織胺Anti-histamine是治療鼻過敏的首選藥物，可以緩解打噴嚏、流鼻水、鼻子搔癢症狀及減少因鼻水倒流引起的咳嗽，但對鼻塞效果有限。
以往第一代抗組織胺為短效，常用於孕婦及兒童（因為藥物比較老，上市時間長，可確定沒有畸形兒或其他影響兒童發育的後遺症），缺點是常有嗜睡的壞處，影響日常作息。
不過，現在已經有長效的第二、三代抗組織胺，服藥改為每天1∼2次，而且不會嗜睡，不會影響白天工作，非常方便。
2、抗鼻充血劑常和抗組織胺並用，可加速解決流鼻水的惱人症狀。
解鼻充血劑Nasal decongestant
- 促進鼻腔內血管收縮，可以緩解鼻塞症狀
- 缺點是可能造成興奮或心悸，奧運選手常因服用感冒藥被查出含有麻黃素等興奮劑，就是此類藥物惹的事。
- 不適合長期使用，可能會有鼻黏膜萎縮的副作用
3、手術治療的選擇。當內科療法無法改善時，可考慮用手術治療，主要有各式雷射手術、冷凍治療、電燒、下鼻甲手術等等，可供選擇來改善過敏所導致的鼻塞、流鼻涕、打噴嚏症狀。但要注意的是，手術治療的確會改善鼻塞症狀，但長時間後過敏症狀可能會再復發，因為過敏是屬於全身發炎反應，不易因手術而完全治癒。
◎藥物治療主要使用方式﹕
1、若症狀輕微，不影響活動、上學、情緒，且間歇性發作，以口服抗組織胺為主。
2、若症狀較嚴重或持續性發作，可直接使用類固醇鼻噴劑，初期併用口服抗組織胺。
3、新一代的鼻噴劑中類固醇含量不到口服類固醇的百分之一，而且絕大部分只作用於鼻黏膜，被身體吸收的很少，是目前治療過敏性鼻炎中最有效且沒有全身性類固醇之副作用。
4、目前最新的類固醇鼻噴劑也製造成每天一噴的長效簡單型，可以說是越來越方便了。敏鼻速樂是一種作用在黏膜內肥大細胞的外用藥，常見於鼻噴劑及眼藥水，少有副作用，也可以嘗試一下。
五、對抗花粉症的食療
對抗花粉症（hay fever）不見得完全要靠吃藥，以下五種食物就能助你對抗花粉症。
1、優格：
田納西州的泛德堡大學（Vanderbilt University）醫學院發現，吃優格可影響白血球，提升你的免疫系統，進而緩解一些花粉症的症狀。研究員針對涉及1900人的23項研究進行分析，其中17項顯示，優格所含的益生菌（probiotics）可緩解花粉症。益生菌可能改變患者過敏的嚴重度、症狀和生活品質。.
2、蜂蜜：
地方出產的蜂蜜因為含有造成花粉症的當地花粉，可減少花粉症的症狀，而你的花粉症是對所住地區的花粉產生的反應，所以吃了所住地產的蜂蜜，有助你的免疫系統對抗過敏原。不過這不會馬上見效，必須吃一整年才能受益。
3、檸檬：
花粉症患者體內往往缺乏生物黃酮（bioflavonoids），這種抗氧化劑保持你的眼睛健康。生物黃酮通常在含有大量維他命C的食物可找到，例如檸檬和覆盆子（raspberries）。
4、薑黃（turmeric）：
薑黃含有薑黃素（curcumin），這種化學合成物具有強大的抗發炎效用，也有抗過敏的功用，能制止組織胺在身體釋出。咖哩內富含薑黃素，不妨多吃。
5、鳳梨：
鳳梨不但含有生物黃酮，也有豐富的鳳梨酵素（bromelain），有助分解積聚的黏液，使鼻子暢通。
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Güvenilir bir medyum için bizi tercih ediniz, medyum haluk hocamız sizler için elinden geleni yapıyor.
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Güvenilir bir medyum için bizi tercih ediniz, medyum haluk hocamız sizler için elinden geleni yapıyor.
Öd ağacı tütsüsü gerçekten başarılı bir tütsüdür, insanın güveni ve özgürlüğü ile bilinir ve başarı verir.
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