妊娠期鼻炎患者临床治疗及用药方案的研究进展

doi:10.6040/j.issn.1673-3770.0.2022.349

Abstract

Abstract: Although various treatment options are available for rhinitis, research on the treatment and medication regimen for patients suffering from pregnancy rhinitis is relatively scant. In pregnant patients, the pharmacokinetics and pharmacodynamics of drugs differ significantly from those in non-pregnant patients. Some drugs may cross the placental barrier and cause adverse effects on the embryo, fetus, and even in the newborn. Therefore, the choice of medical regimen for patients with pregnancy rhinitis needs careful consideration. Corticosteroids, decongestants, antihistamines, chromones, and anticholinergics are commonly used for treating rhinitis, and it is important to study their efficacy and safety in patients with pregnancy rhinitis. In this article, we present research update on pregnancy rhinitis, with a focus on evaluating the current clinical treatment and medication regimen for patients with this condition.

Key words: Pregnancy rhinitis, Diagnosis, Medication during pregnancy, Treatment plan

CLC Number:

R765.21

ZHANG Kunyi, XIAO Xuping. Research progress in the clinical treatment and drug regimen for patients with pregnancy rhinitis[J].Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(5): 175-183.

References

[1] Namazy JA, Schatz M. Diagnosing rhinitis during pregnancy[J]. Curr Allergy Asthma Rep, 2014, 14(9): 458. doi:10.1007/s11882-014-0458-0
[2] Baudoin T, Šimunjak T, Bacan N, et al. Redefining pregnancy-induced rhinitis[J]. Am J Rhinol Allergy, 2021, 35(3): 315-322. doi:10.1177/1945892420957490
[3] Bourjeily G, Danilack VA, Bublitz MH, et al. Obstructive sleep apnea in pregnancy is associated with adverse maternal outcomes: a national cohort[J]. Sleep Med, 2017, 38: 50-57. doi:10.1016/j.sleep.2017.06.035
[4] Franklin KA, Holmgren PA, Jönsson F, et al. Snoring, pregnancy-induced hypertension, and growth retardation of the fetus[J]. Chest, 2000, 117(1): 137-141. doi:10.1378/chest.117.1.137
[5] Ellegård EK. The etiology and management of pregnancy rhinitis[J]. Treat Respir Med, 2003, 2(6): 469-475. doi:10.1007/BF03256674
[6] Karata??塂 M, Çam OH, Tekin M. Assessment of nasal airway patency during pregnancy and postpartum period: correlation between subjective and objective techniques[J]. Kulak Burun Bogaz Ihtis Derg, 2016, 26(2): 92-100. doi:10.5606/kbbihtisas.2016.34545
[7] Indirani B, Raman R, Omar SZ. Hormonal changes causing rhinitis in pregnancy among Malaysian women[J]. J Laryngol Otol, 2013, 127(9): 876-881. doi:10.1017/S0022215113001692
[8] Ellegård E, Karlsson G. Nasal congestion during pregnancy[J]. Clin Otolaryngol Allied Sci, 1999, 24(4): 307-311. doi:10.1046/j.1365-2273.1999.00264.x
[9] Orban N, Maughan E, Bleach N. Pregnancy-induced rhinitis[J]. Rhinology, 2013, 51(2): 111-119. doi:10.4193/Rhino12.045
[10] Hoffmann TK, Wagenmann M, Kojda G, et al. Symptoms and therapy for pregnancy rhinitis[J]. Z Geburtshilfe Neonatol, 2004, 208(4): 126-132. doi:10.1055/s-2004-827218
[11] Ulkumen B, Ulkumen BA, Pala HG, et al. Pregnancy rhinitis in Turkish women: do gestational week, BMI and parity affect nasal congestion?[J]. Pak J Med Sci, 2016, 32(4): 950-954. doi:10.12669/pjms.324.10164
[12] Caparroz FA, Gregorio LL, Bongiovanni G, et al. Rhinitis and pregnancy: literature review[J]. Braz J Otorhinolaryngol, 2016, 82(1): 105-111. doi:10.1016/j.bjorl.2015.04.011
[13] Demir UL, Demir BC, Oztosun E, et al. The effects of pregnancy on nasal physiology[J]. Int Forum Allergy Rhinol, 2015, 5(2): 162-166. doi:10.1002/alr.21438
[14] 武琼, 李琳, 沙骥超, 等. 妊娠期鼻炎的研究进展[J]. 临床耳鼻咽喉头颈外科杂志, 2017, 31(22): 1778-1782. doi:10.13201/j.issn.1001-1781.2017.22.020 WU Qiong, LI Lin, SHA Jichao, et al. Research advances of pregnancy rhinitis[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2017, 31(22): 1778-1782. doi:10.13201/j.issn.1001-1781.2017.22.020
[15] Ellegard EK. Pregnancy rhinitis[J]. Immunol Allergy Clin North Am, 2006, 26(1): 119-135, vii. doi:10.1016/j.iac.2005.10.007
[16] Aït-Khaled N, Pearce N, Anderson HR, et al. Global map of the prevalence of symptoms of rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood(ISAAC)Phase Three[J]. Allergy, 2009, 64(1): 123-148. doi:10.1111/j.1398-9995.2008.01884.x
[17] 程雷. 变应性鼻炎的诊断和治疗[J]. 山东大学耳鼻喉眼学报, 2013, 27(2): 1-4. doi:10.6040/j.issn.1673-3770.1.2012.016 CHENG Lei. Diagnosis and treatment of allergic rhinitis[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2013, 27(2): 1-4. doi:10.6040/j.issn.1673-3770.1.2012.016
[18] Tongtako W, Klaewsongkram J, Mickleborough TD, et al. Effects of aerobic exercise and vitamin C supplementation on rhinitis symptoms in allergic rhinitis patients[J]. Asian Pac J Allergy Immunol, 2018, 36(4): 222-231. doi:10.12932/AP-040417-0066
[19] Richerson HB, Seebohm PM. Nasal airway response to exercise[J]. J Allergy, 1968, 41(5): 269-284. doi:10.1016/0021-8707(68)90032-4
[20] Forsyth RD, Cole P, Shephard RJ. Exercise and nasal patency[J]. J Appl Physiol Respir Environ Exerc Physiol, 1983, 55(3): 860-865. doi:10.1152/jappl.1983.55.3.860
[21] Syabbalo NC, Bundgaard A, Widdicombe JG. Effects of exercise on nasal airflow resistance in healthy subjects and in patients with asthma and rhinitis[J]. Bull Eur Physiopathol Respir, 1985, 21(6): 507-513.
[22] Rundcrantz H. Postural variations of nasal patency[J]. Acta Otolaryngol, 1969, 68(5): 435-443. doi:10.3109/00016486909121582
[23] Stroud RH, Wright ST, Calhoun KH. Nocturnal nasal congestion and nasal resistance[J]. Laryngoscope, 1999, 109(9): 1450-1453. doi:10.1097/00005537-199909000-00018
[24] Kawamoto Y, Ueno Y, Nakahashi E, et al. Prevention of allergic rhinitis by ginger and the molecular basis of immunosuppression by 6-gingerol through T cell inactivation[J]. J Nutr Biochem, 2016, 27: 112-122. doi:10.1016/j.jnutbio.2015.08.025
[25] Seo JH, Kwon SO, Lee SY, et al. Association of antioxidants with allergic rhinitis in children from Seoul[J]. Allergy Asthma Immunol Res, 2013, 5(2): 81-87. doi:10.4168/aair.2013.5.2.81
[26] Adams S, Lopata AL, Smuts CM, et al. Relationship between serum Omega-3 fatty acid and asthma endpoints[J]. Int J Environ Res Public Health, 2018, 16(1): 43. doi:10.3390/ijerph16010043
[27] Hoff S, Seiler H, Heinrich J, et al. Allergic sensitisation and allergic rhinitis are associated with n-3 polyunsaturated fatty acids in the diet and in red blood cell membranes[J]. Eur J Clin Nutr, 2005, 59(9): 1071-1080. doi:10.1038/sj.ejcn.1602213
[28] Li HB, Shi JB, Cao F, et al. Hypertonic saline solution stimulated CLC-3 production in primary cultured human nasal epithelial cells[J]. Auris Nasus Larynx, 2008, 35(1): 47-51. doi:10.1016/j.anl.2007.04.015
[29] 李越, 宫庆. 3%高渗盐水鼻腔盥注保留法对改善妊娠期鼻炎鼻塞症状的临床观察[J]. 中国医学文摘(耳鼻咽喉科学), 2021, 36(1): 59-60, 71. doi:10.19617/j.issn1001-1307.2021.01.59 LI Yue, GONG Qing. Clinical observation of 3% hypertonic saline nasal lavage retention Method in improving the symptoms of rhinitis and nasal obstruction during pregnancy[J]. Chinese Medical Digest(Otorhinolaryngology), 2021, 36(1): 59-60, 71. doi:10.19617/j.issn1001-1307.2021.01.59
[30] Timmis A, Roobottom CA. National institute for health and care excellence updates the stable chest pain guideline with radical changes to the diagnostic paradigm[J]. Heart, 2017,103(13):982-986. doi: 10.1136/heartjnl-2015-308341
[31] Scadding GK, Kariyawasam HH, Scadding G, et al. BSACI guideline for the diagnosis and management of allergic and non-allergic rhinitis(Revised Edition 2017; First edition 2007)[J]. Clin Exp Allergy, 2017, 47(7): 856-889. doi:10.1111/cea.12953
[32] Horton LR. Food and drug administration[J]. BMJ, 2007,334(7584):55-56. doi: 10.1136/bmj.39049.545880.BE
[33] Hillson R. Joint formulary committee british national formulary(online)[M]. London: BMJ Group and Pharmaceutical Press, 2022
[34] Dykewicz MS, Wallace DV, Amrol DJ, et al. Rhinitis 2020: a practice parameter update[J]. J Allergy Clin Immunol, 2020, 146(4): 721-767. doi:10.1016/j.jaci.2020.07.007
[35] Norjavaara E, de Verdier MG. Normal pregnancy outcomes in a population-based study including 2, 968 pregnant women exposed to budesonide[J]. J Allergy Clin Immunol, 2003, 111(4): 736-742. doi:10.1067/mai.2003.1340
[36] Lal D, Jategaonkar AA, Borish L, et al. Management of rhinosinusitis during pregnancy: systematic review and expert panel recommendations[J]. Rhinology, 2016, 54(2): 99-104. doi:10.4193/Rhino15.228
[37] Ellegård EK, Hellgren M, Karlsson NG. Fluticasone propionate aqueous nasal spray in pregnancy rhinitis[J]. Clin Otolaryngol Allied Sci, 2001, 26(5): 394-400. doi:10.1046/j.1365-2273.2001.00491.x
[38] Park-Wyllie L, Mazzotta P, Pastuszak A, et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies[J]. Teratology, 2000, 62(6): 385-392. doi:10.1002/1096-9926(200012)62: 6<385: AID-TERA5>3.0.CO;2-Z
[39] Bandoli G, Palmsten K, Forbess Smith CJ, et al. A review of systemic corticosteroid use in pregnancy and the risk of select pregnancy and birth outcomes[J]. Rheum Dis Clin North Am, 2017, 43(3): 489-502. doi:10.1016/j.rdc.2017.04.013
[40] Johnson DA, Hricik JG. The pharmacology of alpha-adrenergic decongestants[J]. Pharmacotherapy, 1993, 13(6 Pt 2): 110S-115S;discussion 143S-146S
[41] Black MJ, Remsen KA. Rhinitis medicamentosa[J]. Can Med Assoc J, 1980, 122(8): 881-884
[42] Yau WP, Mitchell AA, Lin KJ, et al. Use of decongestants during pregnancy and the risk of birth defects[J]. Am J Epidemiol, 2013, 178(2): 198-208. doi:10.1093/aje/kws427
[43] Hoffman JI, Kaplan S. The incidence of congenital heart disease[J]. J Am Coll Cardiol, 2002, 39(12): 1890-1900. doi:10.1016/s0735-1097(02)01886-7
[44] Yau WP, Mitchell AA, Lin KJ, et al. Use of decongestants during pregnancy and the risk of birth defects[J]. Am J Epidemiol, 2013, 178(2): 198-208. doi:10.1093/aje/kws427
[45] Ellegård EK. Special considerations in the treatment of pregnancy rhinitis[J]. Womens Health(Lond), 2005, 1(1): 105-114. doi:10.2217/17455057.1.1.105
[46] Gilboa SM, Strickland MJ, Olshan AF, et al. Use of antihistamine medications during early pregnancy and isolated major malformations[J]. Birth Defects Res A Clin Mol Teratol, 2009, 85(2): 137-150. doi:10.1002/bdra.20513
[47] Stephansson O, Granath F, Svensson T, et al. Drug use during pregnancy in Sweden - assessed by the Prescribed Drug Register and the Medical Birth Register[J]. Clin Epidemiol, 2011, 3: 43-50. doi:10.2147/CLEP.S16305
[48] Seto A, Einarson T, Koren G. Pregnancy outcome following first trimester exposure to antihistamines: meta-analysis[J]. Am J Perinatol, 1997, 14(3): 119-124. doi:10.1055/s-2007-994110
[49] Bousquet J, Van Cauwenberge P, Khaltaev N, et al. Allergic rhinitis and its impact on asthma[J]. J Allergy Clin Immunol, 2001, 108(5 Suppl): S147-S334. doi:10.1067/mai.2001.118891
[50] Einarson A, Bailey B, Jung G, et al. Prospective controlled study of hydroxyzine and cetirizine in pregnancy[J]. Ann Allergy Asthma Immunol, 1997, 78(2): 183-186. doi:10.1016/S1081-1206(10)63385-6
[51] Weber-Schoendorfer C, Schaefer C. The safety of cetirizine during pregnancy. A prospective observational cohort study[J]. Reprod Toxicol, 2008, 26(1): 19-23. doi:10.1016/j.reprotox.2008.05.053
[52] Källén B. Use of antihistamine drugs in early pregnancy and delivery outcome[J]. J Matern Fetal Neonatal Med, 2002, 11(3): 146-152. doi:10.1080/jmf.11.3.146.152
[53] Moretti ME, Caprara D, Coutinho CJ, et al. Fetal safety of loratadine use in the first trimester of pregnancy: a multicenter study[J]. J Allergy Clin Immunol, 2003, 111(3): 479-483. doi:10.1067/mai.2003.130
[54] Diav-Citrin O, Shechtman S, Aharonovich A, et al. Pregnancy outcome after gestational exposure to loratadine or antihistamines: a prospective controlled cohort study[J]. J Allergy Clin Immunol, 2003, 111(6): 1239-1243. doi:10.1067/mai.2003.1499
[55] National Asthma Education and Prevention Program. Expert panel report 3(EPR-3): guidelines for the diagnosis and management of asthma-summary report 2007[J]. J Allergy Clin Immunol, 2007, 120(5 Suppl): S94-S138. doi:10.1016/j.jaci.2007.09.043
[56] Zuberbier T, Aberer W, Asero R, et al. The EAACI/GA(2)LEN/EDF/WAO Guideline for the definition, classification, diagnosis, and management of urticaria: the 2013 revision and update[J]. Allergy, 2014, 69(7): 868-887. doi:10.1111/all.12313
[57] Einarson A, Levichek Z, Einarson TR, et al. The antiemetic effect of cetirizine during pregnancy[J]. Ann Pharmacother, 2000, 34(12): 1486-1487. doi:10.1345/aph.10072
[58] Norris AA. Pharmacology of sodium cromoglycate[J]. Clin Exp Allergy, 1996, 26(Suppl 4): 5-7. doi:10.1111/j.1365-2222.1996.tb00661.x
[59] Wilson J. Disodium cromoglicate use during pregnancy[J]. Acta Therapeutica, 1982, 8(2):45-51
[60] Schatz M, Zeiger RS, Harden K, et al. The safety of asthma and allergy medications during pregnancy[J]. J Allergy Clin Immunol, 1997, 100(3): 301-306. doi:10.1016/s0091-6749(97)70241-0
[61] Demoly P, Piette V, Daures JP. Treatment of allergic rhinitis during pregnancy[J]. Drugs, 2003, 63(17): 1813-1820. doi:10.2165/00003495-200363170-00004
[62] Gonzalez-Estrada A, Geraci SA. Allergy medications during pregnancy[J]. Am J Med Sci, 2016, 352(3): 326-331. doi:10.1016/j.amjms.2016.05.030
[63] 蔡岱吟, 陈伟东, 蔡冰瑶. 鼻腔超声雾化治疗妊娠期鼻炎的效果观察[J]. 中国临床护理, 2016, 8(2): 153-154. doi:10.3969/j.issn.1674-3768.2016.02.023 CAI Daiyin, CHEN Weidong, CAI Bingyao. The effect of the ultrasonic atomizing inhalation on rhinitis in pregnancy[J]. Chinese Clinical Nursing, 2016, 8(2): 153-154. doi:10.3969/j.issn.1674-3768.2016.02.023
[64] 汪兰玲. 维生素C雾化吸入联合洗鼻疗法用于妊娠期变应性鼻炎患者的疗效分析[J]. 中国医学文摘(耳鼻咽喉科学), 2021, 36(4): 116-118. doi:10.19617/j.issn1001-1307.2021.04.116 WANG Lanling. Efficacy analysis of vitamin C aerosol inhalation combined with nasal washing therapy in pregnancy women with allergic rhinitis[J]. Chinese Medical Digest(Otorhinolaryngology), 2021, 36(4): 116-118. doi:10.19617/j.issn1001-1307.2021.04.116
[65] 周永梅. 中药雾化结合3%高渗盐水鼻腔冲洗治疗妊娠期鼻炎的疗效观察[J]. 中国医学文摘(耳鼻咽喉科学), 2021, 36(2): 133-134. doi:10.19617/j.issn1001-1307.2021.02.133 ZHOU Yongmei. Observation on the curative effect of traditional Chinese medicine atomization combined with 3% hypertonic saline nasal cavity flushing in the treatment of rhinitis during pregnancy[J]. Chinese Medical Digest(Otorhinolaryngology), 2021, 36(2): 133-134. doi:10.19617/j.issn1001-1307.2021.02.133
[66] 石静. 经鼻持续正压通气治疗妊娠合并中重度阻塞性睡眠呼吸暂停低通气综合征[J]. 世界睡眠医学杂志, 2021, 8(3): 539-540. doi:10.3969/j.issn.2095-7130.2021.03.069 SHI Jing. Clinical study of nasal continuous positive pressure ventilation in the treatment of pregnant women with moderate to severe obstructive sleep apnea hypopnea syndrome[J]. World Journal of Sleep Medicine, 2021, 8(3): 539-540. doi:10.3969/j.issn.2095-7130.2021.03.069
[67] Daly A, Robertson A, Bobek G, et al. Sleep disordered breathing controlled by CPAP and sFlt-1 in a pregnant patient with chronic hypertension: case report and literature review[J]. Obstet Med, 2018, 11(1): 32-34. doi:10.1177/1753495X17708949
[68] Zhang XQ, Zhao X, Hong PW, et al. Change in quality of life of OSAHS patients with minimally invasive surgery or CPAP therapy: a 2-year retrospective, single-center parallel-group study[J]. Curr Mol Med, 2020, 20(3): 231-239. doi:10.2174/1566524019666191009150734
[69] 谷亮, 吴波. 持续气道正压通气治疗依从性对妊娠合并阻塞性睡眠呼吸暂停低通气综合征患者妊娠结局的影响[J]. 临床内科杂志, 2021, 38(8): 522-525. doi:10.3969/j.issn.1001-9057.2021.08.006 GU Liang, WU Bo. Influence of compliance of continuous positive airway pressure treatment on pregnancy outcome of pregnant patients with obstructive sleep apnea-hypopnea syndrome[J]. Journal of Clinical Internal Medicine, 2021, 38(8): 522-525. doi:10.3969/j.issn.1001-9057.2021.08.006

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