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為什麼過敏藥物沒有效？兩個字：非過敏性鼻炎

2022 年 2 月 18 日  |  Luke Lemons  |  ✓  由 Rebecca Rosenberger MMSc, PA-C 進行醫療審查  

Rebecca Rosenberger 除了在過敏和免疫學作為一名執業醫師助理擁有 20 年以上的經驗外，也在 Thermo Fisher Scientific 擔任免疫診斷臨床事務 & 教育副主任。

在嘗試多種抗組織胺成藥及不同劑量，甚至獲得醫療處方後，您仍可能會懷疑「為什麼我的抗組織胺沒有效？」

有許多關於春季過敏季的迷思，其中最常見的就是只有過敏會造成類似過敏的症狀。如果您的 流鼻涕和打噴嚏 在服用抗組織胺後沒有消失，那可能完全不是過敏導致的。那麼哪些因素可能導致春季過敏症狀？答案可能是非過敏性鼻炎。

什麼是非過敏性鼻炎？

為協助您瞭解非過敏性鼻炎，我們必須先瞭解過敏。

過敏表示您的免疫系統會對與多數人無害的物質產生反應(例如 花粉、 狗皮屑、 貓皮屑、 黴菌等)。若您的免疫系統辨識出過敏原並將其視為威脅，您的身體將會釋放一種稱為組織胺的化學物質，而該化學物質會引發過敏症狀。這就是抗組織胺能協助緩解症狀的原因，因為其能抑制您系統中的組織胺。

若您的免疫系統未對過敏原產生反應，則不會釋放組織胺。如果沒有組織胺，抗組織胺也無法緩解症狀。如果抗組織胺對您沒有作用，而且您有 類似過敏的症狀，那可能不是嚴重的過敏季節所導致，而是您正對某種非過敏物質產生反應。

非過敏性鼻炎症狀包括：1

  • 打噴嚏
  • 流鼻涕或鼻塞
  • 咳嗽

如您所見，這些症狀與過敏症狀非常相似。有時，某些醫療照護提供者會將非過敏性鼻炎誤診為過敏性鼻炎。事實上在一項研究中，因為過敏而獲得抗組織胺處方的人之中，百分之 65 其實是非過敏性的。2

什麼會造成非過敏性鼻炎？

簡單來說，不會造成過敏反應但仍會導致流鼻水或打噴嚏等症狀的物質，可能是非過敏性誘發因子。

以下是一些例子：3,5

  • 汙染
  • 香菸煙霧
  • 清潔劑化學物質 (漂白水、洗衣精等)
  • 香水/古龍水 
  • 病毒

您的身體接觸到香菸煙霧或香水後不會釋放組織胺。身體其實是因為煙霧而受刺激，造成類似過敏的症狀。

處理過敏性和非過敏性鼻炎時， 緩解症狀 的最佳做法之一就是找出造成您反應的肇因並避免之。

如何分辨非過敏性鼻炎和過敏性鼻炎之間的差異？

由於症狀相似，如果某些醫療照護提供者沒有執行診斷檢測，則瞭解患者是過敏性或非過敏性鼻炎可能很有挑戰性。4

幸好， 特異性 IgE 血液檢測 可協助醫療照護提供者進一步瞭解您的病症，並讓您獲得您需要的治療。特異性 IgE 血液檢測是一項簡單的血液檢測，可協助臨床醫師判斷您可能會對什麼過敏。如果您有類似過敏的症狀，也可以用其來協助 排除 過敏的可能性。

如果我的檢測結果為陰性，該怎麼辦？

如果您的過敏血液檢測並未指出您對經常接觸的過敏原產生致敏反應，這可能表示非過敏性刺激物是導致鼻炎的原因。試想您最近是否換了香水或古龍水？您是否曾在抽菸的人附近？您是否曾整天處在污染漫布的車流之中？

尋找導致您症狀的原因的第一步，就是與您的醫療照護提供者討論是否需要特異性 IgE 血液檢測。

進一步瞭解如何進行特異性 IgE 血液檢測，或完成我們的症狀追蹤工具，協助您找出隨後可與您醫療照護提供者分享的關鍵症狀之深入資訊。

Track Your Symptoms

如果您是健康照護提供者，請按一下下方，以進一步瞭解特異性 IgE 血液檢測如何協助診斷季節性過敏。

深入瞭解

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  2. Szeinbach SL, Williams B, Muntendam P, et al. Identification of allergic disease among users of antihistamines. J Manag Care Pharm. 2004;10(3):234-238.
  3. Tantilipikorn, Pongsakorn, et al. “Efficacy and Safety of Once Daily Fluticasone Furoate Nasal Spray for Treatment of Irritant (Non-Allergic) Rhinitis.” The Open Respiratory Medicine Journal, vol. 4, no. 1, 2010, pp. 92–99.
  4. Wheeler PW, et al. Am Fam Physician. 2005;72:1057-1062.
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