耳鼻喉科普 · Allergic Rhinitis
过敏性鼻炎：识别、分层治疗与共病管理
过敏性鼻炎是IgE 介导的鼻黏膜炎症，表现为喷嚏、清水样鼻涕、鼻痒与鼻塞，常合并结膜炎与哮喘。治疗按国际与中国指南分层：鼻用糖皮质激素是中重度患者的一线，鼻内或口服第二代抗组胺药用于轻中度，白三烯受体拮抗剂作为联合选项，免疫治疗是目前唯一可能改变疾病进程的手段；鼻腔冲洗有辅助作用，但 Cochrane 评价提示证据质量低。
十二句速查 · 过敏性鼻炎
先看结论，再看机制与证据。带编号处可点击跳转到文献。
四大典型症状喷嚏、清水样鼻涕、鼻痒与鼻塞，常伴眼痒与流泪
与感冒的关键区别症状持续超过两周、无发热且与季节或环境相关
按严重度分层治疗间歇/持续与轻度/中重度决定用药强度
鼻用激素是一线中重度患者的首选，规范使用全身吸收很低
抗组胺药分鼻内与口服第二代口服药嗜睡少，鼻内起效更快
白三烯受体拮抗剂可联合与抗组胺药联合优于单药，注意情绪相关不良反应
免疫治疗可能改变病程舌下或皮下，疗程常需三年，需专科评估
鼻腔冲洗是辅助可减轻症状，但证据质量低，不能替代药物
避免过敏原要讲方法尘螨、花粉与宠物管理需针对性措施，不必极端回避
共病要一起管合并哮喘、鼻窦炎与腺样体肥大会影响疗效
儿童诊断用药有差异儿童剂量与剂型按中国儿童指南执行
偏方与保健品不靠谱缺乏高质量证据，不能替代规范治疗
速查卡为结论摘要，具体检查、用药与剂量请遵循耳鼻喉科/变态反应科医生意见。
先看懂四件事：鼻炎是什么、有哪些表型、为什么和哮喘相关、能控制到什么程度What Allergic Rhinitis Is
过敏性鼻炎不是「小毛病」：它影响睡眠、学习与工作，还与哮喘、鼻窦炎相互加重；分型与分级是选择治疗方案的前提。
发病机理：IgE 致敏、鼻黏膜炎症与共病机制Pathogenesis
过敏原与特异性 IgE 结合后触发肥大细胞脱颗粒，组胺等介质引起速发症状，随后嗜酸性粒细胞等炎症细胞浸润造成持续性鼻塞——这也解释了为什么抗组胺药缓解喷嚏快、而鼻用激素改善鼻塞更有效。
过敏原暴露（尘螨、花粉、宠物皮屑等） → 与肥大细胞表面特异性 IgE 结合 → 脱颗粒释放组胺与白三烯等介质 → 速发相：喷嚏、鼻痒、清水样涕 → 炎症细胞浸润（嗜酸性粒细胞等）与黏膜水肿 → 迟发相：持续性鼻塞与嗅觉下降 → 鼻-支气管反射与全身炎症 → 哮喘、鼻窦炎与睡眠障碍等共病
哪些因素与过敏性鼻炎相关
| 类别 | 具体因素 | 机制要点 | 证据强度 |
|---|---|---|---|
| 遗传 | 家族过敏性疾病史（鼻炎、哮喘、湿疹） | 特应性体质 | 强 |
| 过敏原 | 尘螨、花粉、宠物皮屑与霉菌 | IgE 致敏与暴露 | 强 |
| 空气污染 | PM2.5、二氧化氮与二手烟 | 黏膜屏障与炎症加重 | 较强 |
| 共病 | 哮喘、鼻窦炎、腺样体肥大 | 同一气道与相互加重 | 强 |
| 年龄 | 儿童与青少年高发 | 免疫发育与暴露 | 较强 |
| 职业暴露 | 粉尘、化学物与面粉等 | 职业性鼻炎 | 中等 |
| 气候与季节 | 花粉季节与温差变化 | 暴露与黏膜反应性 | 中等 |
| 生活习惯 | 通风不足、地毯与毛绒玩具积聚尘螨 | 室内过敏原负荷 | 中等 |
两个容易被忽略的问题
怎么识别与分级：病史、检测与严重度Assessment
| 项目 | 方法与要点 | 判读说明 | 证据强度 |
|---|---|---|---|
| 症状与病史 | 症状性质、时间规律、诱因与家族史 | 初步判断过敏性与季节规律 | 强 |
| 鼻腔检查 | 黏膜颜色、分泌物与鼻甲情况 | 支持诊断并排除其他病因 | 强 |
| 皮肤点刺试验 | 常用过敏原检测方法 | 快速、成本低，需专业判读 | 强 |
| 血清特异性 IgE | 适合不能停药或皮肤条件差者 | 与病史结合判断致敏 | 较强 |
| 鼻激发试验 | 科研与疑难病例使用 | 不作为常规检查 | 中等 |
| 严重度与生活质量评估 | 按症状对睡眠、学习与工作的影响分级 | 决定治疗强度 | 强 |
| 共病筛查 | 哮喘、鼻窦炎与睡眠呼吸问题 | 共病影响整体疗效 | 较强 |
| 儿童评估 | 腺样体、扁桃体与张口呼吸 | 儿童需评估结构与发育问题 | 较强 |
需要专科就诊的情形
- 规范用药后症状仍控制不佳
- 出现哮喘症状（喘息、胸闷、夜间咳嗽）
- 长期单侧鼻塞、鼻出血或嗅觉丧失
- 儿童张口呼吸、打鼾或听力下降
- 计划开始免疫治疗或需要明确过敏原
怎么治疗：鼻用激素、抗组胺与免疫治疗Treatment
治疗方式一览
| 方式 | 适用人群 | 关键要点 | 证据强度 |
|---|---|---|---|
| 鼻用糖皮质激素 | 中重度患者首选 | 规律使用，注意正确喷鼻姿势 | 强 |
| 鼻内抗组胺药 | 轻中度或按需 | 起效快，可与鼻用激素联合 | 强 |
| 口服第二代抗组胺药 | 轻中度、伴眼部症状 | 嗜睡少，注意驾驶与个体反应 | 强 |
| 白三烯受体拮抗剂 | 合并哮喘或联合治疗 | 注意情绪相关不良反应 | 较强 |
| 舌下免疫治疗 | 尘螨或花粉致敏的持续患者 | 疗程 3 年，需专科管理 | 强 |
| 皮下免疫治疗 | 需快速起效或多种致敏 | 需在医疗场所注射并观察 | 强 |
| 鼻腔冲洗 | 各年龄辅助使用 | 证据质量低，不能替代药物 | 中等 |
| 生物制剂 | 重度难治性患者 | 费用高，需专科评估 | 中等 |
需要说明的边界
- 鼻用糖皮质激素需要规律使用 1–2 周才达到最佳效果，按需「喷一下」效果有限。
- 免疫治疗是目前唯一可能改变疾病进程的治疗，但必须由专科评估适应证并长期随访。
- 鼻腔冲洗只能作为辅助，Cochrane 评价认为其证据质量低，不能替代药物。
- 任何宣称根治鼻炎的偏方与保健品都缺乏高质量证据，不建议停用规范治疗去尝试。
日常管理：环境控制与随访Daily Management
| 管理点 | 具体做法 | 预期作用 | 证据强度 |
|---|---|---|---|
| 尘螨控制 | 勤洗晒床品、使用防螨床罩、降低室内湿度 | 减少常年性过敏原暴露 | 较强 |
| 花粉季节防护 | 外出戴口罩与眼镜，回家后洗脸洗鼻 | 减少花粉暴露 | 中等 |
| 宠物管理 | 避免宠物进入卧室并定期清洁 | 降低皮屑暴露 | 中等 |
| 室内通风与净化 | 定期通风、必要时使用空气净化设备 | 降低颗粒物与过敏原 | 中等 |
| 规范用药 | 按医嘱规律使用鼻用激素，不随意停药 | 稳定控制症状 | 强 |
| 共病监测 | 关注哮喘症状与睡眠质量 | 改善整体控制 | 较强 |
| 鼻腔护理 | 按需使用生理盐水冲洗 | 减轻症状与药物负担 | 中等 |
| 定期随访 | 按严重度每 1–6 个月复诊评估调整 | 减少复发与用药不足 | 较强 |
本页立场
过敏性鼻炎的管理逻辑是「分级用药 + 共病同治 + 长期随访」：鼻用激素打基础，抗组胺药与白三烯拮抗剂按需联合，免疫治疗用于希望改变病程的患者；把鼻炎控制好，哮喘与睡眠问题往往也会跟着改善。
十个常见误区Ten Common Misconceptions
| 编号 | 常见说法 | 更准确的理解（含出处） |
|---|---|---|
| 误区 1 | 「鼻炎是小事，不用治」 | 未控制的鼻炎影响睡眠、学习与工作，并与哮喘控制变差相关。20 |
| 误区 2 | 「鼻用激素会「上瘾」或伤身」 | 规范使用的全身吸收很低，安全性综述未显示明显全身风险；擅自停药才会反复。11 |
| 误区 3 | 「症状好了就可以停药」 | 鼻用激素需要规律使用维持，突然停药常导致症状快速复发。9 |
| 误区 4 | 「抗生素能治鼻炎」 | 过敏性鼻炎不是细菌感染，抗生素无效且增加耐药风险。6 |
| 误区 5 | 「只靠避开过敏原就够了」 | 环境控制有帮助，但中重度患者通常仍需要药物治疗。1 |
| 误区 6 | 「儿童不能用鼻用激素」 | 儿童可按中国儿童指南与年龄剂量规范使用，不应因担心而延误治疗。7 |
| 误区 7 | 「白三烯拮抗剂可以随便长期吃」 | 需注意情绪与睡眠相关不良反应，应定期评估是否继续使用。15 |
| 误区 8 | 「免疫治疗没有用」 | 舌下与皮下免疫治疗均有系统评价支持，能减轻症状并减少用药。1617 |
| 误区 9 | 「盐水冲洗可以替代药物」 | Cochrane 评价提示其证据质量低或极低，只能作为辅助措施。19 |
| 误区 10 | 「偏方、维生素或益生菌能治好鼻炎」 | 目前缺乏高质量证据支持，不应停用规范治疗去尝试。82 |
参考文献与证据来源References & Evidence
本页共 24 条文献，来自国际共识与指南、随机对照试验、荟萃分析与机制研究，链接指向 PubMed。每条结论后的编号对应下方文献；证据不足或结论不一致之处已在正文标注。
- ARIA 2016 修订版指南Brożek JL, Bousquet J, Agache I, Agarwal A, Bachert C, Bosnic-Anticevich S, Brignardello-Petersen R, Canonica GW, Casale T, Chavannes NH, Correia de Sousa J, Cruz AA, Cuello-Garcia CA, Demoly P, Dykewicz M, Etxeandia-Ikobaltzeta I, Florez ID, Fokkens W, Fonseca J, Hellings PW, Klimek L, Kowalski S, Kuna P, Laisaar KT, Larenas-Linnemann DE, Lødrup Carlsen KC, Manning PJ, Meltzer E, Mullol J, Muraro A, O'Hehir R, Ohta K, Panzner P, Papadopoulos N, Park HS, Passalacqua G, Pawankar R, Price D, Riva JJ, Roldán Y, Ryan D, Sadeghirad B, Samolinski B, Schmid-Grendelmeier P, Sheikh A, Togias A, Valero A, Valiulis A, Valovirta E, Ventresca M, Wallace D, Waserman S, Wickman M, Wiercioch W, Yepes-Nuñez JJ, Zhang L, Zhang Y, Zidarn M, Zuberbier T, Schünemann HJ. Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines-2016 revision J Allergy Clin Immunol. 2017;140(4):950-958. pubmed.ncbi.nlm.nih.gov/28602936
- ARIA 2024 诊疗路径Bousquet J, Schünemann HJ, Sousa-Pinto B, Zuberbier T, Togias A, Samolinski B, Bedbrook A, Czarlewski W, Hofmann-Apitius M, Litynska J, Vieira RJ, Anto JM, Fonseca JA, Brozek J, Bognanni A, Brussino L, Canonica GW, Cherrez-Ojeda I, Cruz AA, Vecillas LL, Dykewicz M, Gemicioglu B, Giovannini M, Haahtela T, Jacobs M, Jacomelli C, Klimek L, Kvedariene V, Larenas-Linnemann DE, Louis G, Lourenço O, Leemann L, Morais-Almeida M, Neves AL, Nadeau KC, Nowak A, Nowak A, Palamarchuk Y, Palkonen S, Papadopoulos NG, Parmelli E, Pereira AM, Pfaar O, Regateiro FS, Savouré M, Taborda-Barata L, Toppila-Salmi SK, Torres MJ, Valiulis A, Ventura MT, Williams S, Yepes-Nuñez JJ, Yorgancioglu A, Zhang L, Zuberbier J, Abdul Latiff AH, Abdullah B, Agache I, Al-Ahmad M, Al-Nesf MA, Al Shaikh NA, Amaral R, Ansotegui IJ, Asllani J, Balotro-Torres MC, Bergmann KC, Bernstein JA, Bindslev-Jensen C, Blaiss MS, Bonaglia C, Bonini M, Bossé I, Braido F, Caballero-Fonseca F, Camargos P, Carreiro-Martins P, Casale T, Castillo-Vizuete JA, Cecchi L, Teixeira MDC, Chang YS, Loureiro CC, Christoff G, Ciprandi G, Cirule I, Correia-de-Sousa J, Costa EM, Cvetkovski B, de Vries G, Del Giacco S, Devillier P, Dokic D, Douagui H, Durham SR, Enecilla ML, Fiocchi A, Fokkens WJ, Fontaine JF, Gawlik R, Gereda JE, Gil-Mata S, Giuliano AFM, Gotua M, Gradauskiene B, Guzman MA, Hossny E, Hrubiško M, Iinuma T, Irani C, Ispayeva Z, Ivancevich JC, Jartti T, Jeseňák M, Julge K, Jutel M, Kaidashev I, Bennoor KS, Khaltaev N, Kirenga B, Kraxner H, Kull I, Kulus M, Kuna P, Kupczyk M, Kurchenko A, La Grutta S, Lane S, Miculinic N, Lee SM, Le Thi Tuyet L, Lkhagvaa B, Louis R, Mahboub B, Makela M, Makris M, Maurer M, Melén E, Milenkovic B, Mohammad Y, Moniuszko M, Montefort S, Moreira A, Moreno P, Mullol J, Nadif R, Nakonechna A, Navarro-Locsin CG, Neffen HE, Nekam K, Niedoszytko M, Nunes E, Nyembue D, O'Hehir R, Ollert M, Ohta K, Okamoto Y, Okubo K, Olze H, Padukudru MA, Palomares O, Pali-Schöll I, Panzner P, Palosuo K, Park HS, Passalacqua G, Patella V, Pawankar R, Pétré B, Pitsios C, Plavec D, Popov TA, Puggioni F, Quirce S, Raciborski F, Ramonaité A, Recto M, Repka-Ramirez S, Roberts G, Robles-Velasco K, Roche N, Rodriguez-Gonzalez M, Romualdez JA, Rottem M, Rouadi PW, Salapatas M, Sastre J, Serpa FS, Sayah Z, Scichilone N, Senna G, Sisul JC, Solé D, Soto-Martinez ME, Sova M, Sozinova O, Stevanovic K, Ulrik CS, Szylling A, Tan FM, Tantilipikorn P, Todo-Bom A, Tomic-Spiric V, Tsaryk V, Tsiligianni I, Urrutia-Pereira M, Rostan MV, Sofiev M, Valovirta E, Van Eerd M, Van Ganse E, Vasankari T, Vichyanond P, Viegi G, Wallace D, Wang Y, Waserman S, Wong G, Worm M, Yusuf OM, Zaitoun F, Zidarn M. Concepts for the Development of Person-Centered, Digitally Enabled, Artificial Intelligence-Assisted ARIA Care Pathways (ARIA 2024) J Allergy Clin Immunol Pract. 2024;12(10):2648-2668.e2. pubmed.ncbi.nlm.nih.gov/38971567
- ARIA-EAACI 口服与眼部用药推荐Vieira RJ, Sousa-Pinto B, Bousquet J, Schünemann HJ, Zuberbier T, Bognanni A, Togias A, Samolinski B, Valiulis A, Williams S, Bedbrook A, Czarlewski W, Torres MJ, Shamji MH, Morais-Almeida M, Canonica GW, Vecillas LL, Dykewicz MS, Jacomelli C, Klimek L, Leemann L, Lourenço O, Papadopoulos NG, Pereira AM, Savouré M, Toppila-Salmi SK, Ventura MT, Yepes-Nuñez JJ, Cruz AA, Ciprandi G, Gemicioglu B, Giovannini M, Gradauskiene B, Jartti T, Jeseňák M, Kuna P, Kvedariene V, Larenas-Linnemann DE, Latiff AHA, Mohammad Y, Ohta K, Mahesh PA, Pali-Schöll I, Pfaar O, Regateiro FS, Roche N, Taborda-Barata L, Ulrik CS, Viegi G, Zhang L, Haahtela T, Cherrez-Ojeda I, Ivancevich JC, Khaltaev N, Yorgancioglu A, Abdullah B, Al-Ahmad M, Al-Nesf MA, Amaral R, Asllani J, Bergmann KC, Bernstein JA, Blaiss MS, Toskala E, Carreiro-Martins P, Casale T, Cecchi L, Fiocchi A, Giuliano AFM, Christoff G, Cirule I, de Sousa JC, Costa EM, Devillier P, Hossny E, Iinuma T, Ispayeva Z, Julge K, Kaidashev I, Bennoor KS, Kraxner H, Kull I, Kulus M, Kupczyk M, Kurchenko A, La Grutta S, Miculinic N, Tuyet LLT, Lee SM, Montefort S, Moreira A, Mullol J, Nadif R, Nakonechna A, Neffen HE, Niedoszytko M, O'Hehir RE, Ogulur I, Okamoto Y, Olze H, Palomares O, Panzner P, Patella V, Pitsios C, Puggioni F, Quirce S, Ramonaité A, Repka-Ramirez MS, Roberts G, Robles-Velasco K, Rottem M, Salapatas M, Sastre J, Scichilone N, Sisul JC, Solé D, Soto-Martinez ME, Sova M, Tantilipikorn P, Todo-Bom A, Tsaryk V, Tsiligianni I, Urrutia-Pereira M, Valovirta E, Vasankari T, Wallace D, Wang Y, Worm M, Yusuf OM, Gil-Mata S, Marques-Cruz M, Mahboub B, Romano A, Aberer W, Artesani MC, Azzolini E, Barreto B, Bartra J, Becker S, Beghe B, Boner A, Borowiack E, Bouchard J, Brussino L, Buhl R, Catamerò F, Charpin D, Chavannes NH, Chełmińska M, Cheng L, Chkhartishvili E, Cho SH, Chong-Neto HJ, Chu DK, Cingi C, Compalati E, Costa RA, Cvetkovski B, Cardona V, D'Amato G, Davies JM, Di Bona D, Gonzalez Diaz SN, Dimou MV, Doulaptsi M, Ferreira-da-Silva R, Gawlik R, Calvo-Gil M, Gómez MR, Gotua M, Grigoreas C, Guzman MA, House R, Hyland M, Ierodiakonou D, Karavelia A, Keith P, Kisiel M, Kosak TS, Kosnik M, Koyuncu IV, Kritikos V, Litynska J, Lombardi C, Louis G, Luo X, Martini M, Meço C, Mesonjesi E, Mihaltan F, Moniuszko M, Naclerio RN, Neisinger S, Ollert M, Ordak M, Paoletti G, Parmelli E, Perdomo-Flores EA, Pereira H, Pérez JMF, Pham-Thi N, Prokopakis E, Ribeiro-Vaz I, Rolla G, Romantowski J, Rombaux P, Rouadi PW, Ryan D, Sadowska E, Sakurai D, Salameh L, Serrano E, Da Silva J, Soyka MB, Specjalski K, Tomic-Spiric V, Stevanovic K, Subramaniam A, Thomander T, Tong W, Vachova M, van Hage M, Wagenmann M, Ko FWS, Werminghaus P, Xepapadaki PV, Xiang YK, Yang Q, Zhang H, Zuberbier J, Fonseca JA. Allergic Rhinitis and Its Impact on Asthma (ARIA)-EAACI Guidelines-2024-2025 Revision: Part II-Guidelines on Oral and Ocular Treatments Allergy. 2026;81(6):1947-1970. pubmed.ncbi.nlm.nih.gov/41877472
- ARIA 鼻内治疗推荐（中文解读）Li JN. [Interpretation of Allergic Rhinitis and Its Impact on Asthma (ARIA) Guidelines 2024-2025 Revision: guidelines on intranasal treatments] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2026;61(6):696-701. pubmed.ncbi.nlm.nih.gov/42420039
- ARIA 免疫治疗路径Bousquet J, Pfaar O, Togias A, Schünemann HJ, Ansotegui I, Papadopoulos NG, Tsiligianni I, Agache I, Anto JM, Bachert C, Bedbrook A, Bergmann KC, Bosnic-Anticevich S, Bosse I, Brozek J, Calderon MA, Canonica GW, Caraballo L, Cardona V, Casale T, Cecchi L, Chu D, Costa E, Cruz AA, Czarlewski W, Durham SR, Du Toit G, Dykewicz M, Ebisawa M, Fauquert JL, Fernandez-Rivas M, Fokkens WJ, Fonseca J, Fontaine JF, Gerth van Wijk R, Haahtela T, Halken S, Hellings PW, Ierodiakonou D, Iinuma T, Ivancevich JC, Jacobsen L, Jutel M, Kaidashev I, Khaitov M, Kalayci O, Kleine Tebbe J, Klimek L, Kowalski ML, Kuna P, Kvedariene V, La Grutta S, Larenas-Linemann D, Lau S, Laune D, Le L, Lodrup Carlsen K, Lourenço O, Malling HJ, Marien G, Menditto E, Mercier G, Mullol J, Muraro A, O'Hehir R, Okamoto Y, Pajno GB, Park HS, Panzner P, Passalacqua G, Pham-Thi N, Roberts G, Pawankar R, Rolland C, Rosario N, Ryan D, Samolinski B, Sanchez-Borges M, Scadding G, Shamji MH, Sheikh A, Sturm GJ, Todo Bom A, Toppila-Salmi S, Valentin-Rostan M, Valiulis A, Valovirta E, Ventura MT, Wahn U, Walker S, Wallace D, Waserman S, Yorgancioglu A, Zuberbier T, ARIA Working Group. 2019 ARIA Care pathways for allergen immunotherapy Allergy. 2019;74(11):2087-2102. pubmed.ncbi.nlm.nih.gov/30955224
- 中国过敏性鼻炎诊疗指南（2022）Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Group of Rhinology, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. [Chinese guideline for diagnosis and treatment of allergic rhinitis (2022, revision)] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022;57(2):106-129. pubmed.ncbi.nlm.nih.gov/35078291
- 中国儿童过敏性鼻炎诊疗指南（2022）Subspecialty Group of Rhinology, Editorial Board of Chinese Journal of Otorhinolaryngology Head and Neck Surgery, Subspecialty Groups of Rhinology and Pediatrics, Society of Otorhinolaryngology Head and Neck Surgery, Chinese Medical Association. [Guideline for diagnosis and treatment of pediatric allergic rhinitis (2022, revision)] Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2022;57(4):392-404. pubmed.ncbi.nlm.nih.gov/35359078
- 网状荟萃分析（中重度治疗方案比较）Zhang Z, Fang D, Wang C, Zhang Y, Zhang L. Efficacy and Safety of Biologics, Allergen Immunotherapy, and Pharmacotherapies for Moderate-to-Severe Allergic Rhinitis: A Network Meta-Analysis Int Forum Allergy Rhinol. 2026;16(6):582-594. pubmed.ncbi.nlm.nih.gov/41587102
- 网状荟萃分析（鼻内用药）Sousa-Pinto B, Vieira RJ, Bognanni A, Gil-Mata S, Ferreira-da-Silva R, Ferreira A, Cardoso-Fernandes A, Ferreira-Cardoso H, Marques-Cruz M, Duarte VH, Castro-Teles J, Campos-Lopes M, Teixeira-Ferreira A, Lourenço-Silva N, Chérrez-Ojeda I, Bedbrook A, Klimek L, Nuñez JJY, Zuberbier T, Fonseca JA, Schünemann HJ, Bousquet J, ARIA 2024 guideline panel. Efficacy and safety of intranasal medications for allergic rhinitis: Network meta-analysis Allergy. 2025;80(1):94-105. pubmed.ncbi.nlm.nih.gov/39548801
- 系统评价（鼻内抗组胺联合鼻用激素）Kim M, Ryu G, Kang SY, Kim MA, Yang SI, Lee IH, Choi GS, Kim HJ, Lee SM, Kim DK, Choi JH, Yang HJ, Kim SW, Work Group for Rhinitis, the Korean Academy of Asthma, Allergy and Clinical Immunology. Intranasal antihistamine and corticosteroid to treat allergic rhinitis: A systematic review and meta-analysis Allergy. 2022;77(11):3436-3440. pubmed.ncbi.nlm.nih.gov/35716356
- 综述（鼻用糖皮质激素安全性）Maglica M, Batinović F, Gudelj M, Bošković B, Mizdrak I, Radić S, Knežević M, Paladin I. Safety Profile of Intranasal Corticosteroids in Allergic Rhinitis: A Comprehensive Review Biomedicines. 2026;14(7):1536. pubmed.ncbi.nlm.nih.gov/42512009
- 网状荟萃分析（口服抗组胺药）Hong D, Weng J, Ye M, Liu Y. Efficacy of different oral H1 antihistamine treatments on allergic rhinitis: a systematic review and network meta-analysis of randomized controlled trials Braz J Otorhinolaryngol. 2023;89(4):101272. pubmed.ncbi.nlm.nih.gov/37271114
- 随机试验（第二代抗组胺药与睡眠）Sato T, Tareishi Y, Suzuki T, Ansai N, Asaka C, Ohta N. Effect of second-generation antihistamines on nighttime sleep and daytime sleepiness in patients with allergic rhinitis Sleep Breath. 2023;27(6):2389-2395. pubmed.ncbi.nlm.nih.gov/37382850
- 系统评价（白三烯受体拮抗剂联合治疗）Seresirikachorn K, Chitsuthipakorn W, Kanjanawasee D, Khattiyawittayakun L, Snidvongs K. Leukotriene Receptor Antagonist Addition to H1-Antihistamine Is Effective for Treating Allergic Rhinitis: A Systematic Review and Meta-analysis Am J Rhinol Allergy. 2019;33(5):591-600. pubmed.ncbi.nlm.nih.gov/31007040
- 系统评价（孟鲁司特联合抗组胺药）Kim JS, Stybayeva G, Hwang SH. Efficacy of Montelukast-Antihistamine Combination Therapy Versus Antihistamine Monotherapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis Clin Exp Otorhinolaryngol. 2026;19(2):164-176. pubmed.ncbi.nlm.nih.gov/40961985
- 网状荟萃分析（舌下免疫治疗）Ji Z, Jiang F. Efficacy and safety of sublingual immunotherapy for allergic rhinitis: A network meta-analysis Front Immunol. 2023;14():1144816. pubmed.ncbi.nlm.nih.gov/37063866
- 系统评价（皮下与舌下免疫治疗比较）Samajdar SS, Moitra S, Sarkar S, Tripathi SK. Efficacy and Safety of Subcutaneous vs. Sublingual Immunotherapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis Clin Exp Allergy. 2025;55(2):199-201. pubmed.ncbi.nlm.nih.gov/39343422
- 系统评价（儿童盐水冲洗）Esmaeel SE, Alanazi RIS, Albladi OOA, Alharbi RFH, Alwasil TAS, Alanazi DSA, Almazyad MHB, F Almutairi AB, Alanazi DSK, Alsel BA, Fawzy MS, Fahmy EK, Nabil Y. Efficacy and safety of nasal saline irrigation for allergic rhinitis in children and adolescents: A systematic review and meta-analysis with GRADE assessment Int J Pediatr Otorhinolaryngol. 2026;208():112973. pubmed.ncbi.nlm.nih.gov/42579992
- Cochrane 评价（盐水冲洗）Head K, Snidvongs K, Glew S, Scadding G, Schilder AG, Philpott C, Hopkins C. Saline irrigation for allergic rhinitis Cochrane Database Syst Rev. 2018;6():CD012597. pubmed.ncbi.nlm.nih.gov/29932206
- 综述（同一气道同一疾病）Compalati E, Ridolo E, Passalacqua G, Braido F, Villa E, Canonica GW. The link between allergic rhinitis and asthma: the united airways disease Expert Rev Clin Immunol. 2010;6(3):413-423. pubmed.ncbi.nlm.nih.gov/20441427
- 荟萃分析（中国鼻炎与哮喘共病）Shen Y, Zeng JH, Hong SL, Kang HY. Prevalence of allergic rhinitis comorbidity with asthma and asthma with allergic rhinitis in China: A meta-analysis Asian Pac J Allergy Immunol. 2019;37(4):220-225. pubmed.ncbi.nlm.nih.gov/30525742
- 系统评价（中国患病率与危险因素）Pang K, Li G, Li M, Zhang L, Fu Q, Liu K, Zheng W, Wang Z, Zhong J, Lu L, Li P, Zhou Y, Zhang W, Zhang Q. Prevalence and Risk Factors for Allergic Rhinitis in China: A Systematic Review and Meta-Analysis Evid Based Complement Alternat Med. 2022;2022():7165627. pubmed.ncbi.nlm.nih.gov/36193147
- 全国调查（患病率趋势）Pu X, Zheng M, Ge S, Sima Y, Yu X, Wang Z, Wang X, Zhang L. Prevalence of Allergic Rhinitis in China Continues to Increase Without Reaching a Plateau: An Analysis of Three Waves of National Surveys From 2005 to 2019 Allergy. 2026;81(5):1874-1878. pubmed.ncbi.nlm.nih.gov/41527961
- 共识（鼻炎表型与内型）Papadopoulos NG, Bernstein JA, Demoly P, Dykewicz M, Fokkens W, Hellings PW, Peters AT, Rondon C, Togias A, Cox LS. Phenotypes and endotypes of rhinitis and their impact on management: a PRACTALL report Allergy. 2015;70(5):474-494. pubmed.ncbi.nlm.nih.gov/25620381