The do’s and don’ts of nasal spray usage 鼻塞不能亂 噴藥 收縮劑別連用逾
Mon, Mar 31, 2014 – Page 11
A 57-year-old woman surnamed Yang had been troubled by allergic rhinitis since childhood. After recently taking antihistamines, her nose was still congested, so she went to a pharmacy and bought a nasal spray that included vasoconstrictors. She says that although her stuffy nose initially got better, the congestion eventually returned and got worse after one or two weeks of using the nasal spray. When she finally went to see a doctor, Yang was already experiencing rebound nasal congestion. Doctors say that you should only use nasal sprays containing vasoconstrictors for up to 10 days and that most people are unaware of the restrictions regarding the use of such sprays, which can lead to more serious problems.
Taiwan Otolaryngological Society president and National Cheng Kung University Hospital Department of Otolaryngology professor Fang Sheen-yie says that allergic rhinitis is typically accompanied by annoying symptoms, such as sneezing, nasal congestions, runny nose and discomfort of the eyes. Other complications, including sinusitis, sleep disorders and asthma, can also occur. The current methods for treating allergic rhinitis include taking antihistamines, intranasal vasoconstrictors and steroid nasal sprays.
Tai Chih-jaan, director of China Medical University Hospital’s Department of Otolarngology, says that antihistamines taken orally work fast but the effect does not last long. Most of the nasal sprays sold over-the-counter at pharmacies are intranasal vasoconstrictors, Tai says. Although they temporarily alleviate nasal congestion, he says that using them for an extended period of time might create dependence and damage the hyperplasia of mucous membrane epithelium, further exacerbating one’s nasal congestion.
Doctors say that when treating allergic rhinitis it is best to start out taking antihistamines and eventually switch to steroid nasal sprays to allow your nasal allergies to remain stable. Steroid nasal sprays usually do not start having an effect for two to four weeks. Many people are suspicious about steroids, but the dose is actually quite small and only affects the nasal mucous membranes. It will not cause any full-body symptoms, doctors say.
(Liberty Times, Translated by Kyle Jeffcoat)
五十七歲的楊女士，自小就受過敏性鼻炎的困擾，日前她在吃抗組織胺治療後仍覺得鼻塞，於是
自行到藥房購買含血管收縮劑的鼻噴劑使用，她說，開始用的時候，鼻塞問題的確改善不少，於 是連續使用一兩週，發現鼻塞反而更加惡化，就醫時已有「反彈性鼻塞」的問題；醫師提醒，含血管收縮劑的鼻噴劑最多只能用十天，但多數⺠民眾不清楚使用限制，結果反而造成更嚴重的問題。
台灣鼻科醫學會理事長、成大醫院⽿耳鼻喉部教授方深毅表示，過敏性鼻炎常出現如打噴嚏、鼻
塞、流鼻水及眼睛不適等惱人症狀，還可能併發鼻竇炎、睡眠障礙及氣喘等問題，目前過敏性鼻 炎治療方式包含口服抗組織胺、鼻黏膜血管收縮劑及類固醇鼻噴劑等。
中國醫藥大學附設醫院耳鼻喉部主任戴志展表示，口服抗組織胺作用效果快，但治療效果並不持久，而坊間藥局鼻噴劑多屬於鼻黏膜血管收縮劑，雖可暫時緩解鼻塞，但長期使用下來，可能會產生依賴性及黏膜上皮破壞增生，鼻塞的情形將更加嚴重。
醫師指出，治療過敏性鼻炎，一開始服用口服抗組織胺，之後最好使⽤用含類固醇的鼻噴劑，讓鼻子過敏的狀況維持穩定，由於含類固醇的鼻噴劑在使用二至四週後效果才會顯現出來，加上不少民眾對類固醇有疑慮，事實上，其劑量很小且僅作用在鼻黏膜，並不會引起全身症狀。
（自由時報記者魏怡嘉）
中國醫藥大學附設醫院耳鼻喉部教授級主治醫師兼鼻科主任姓名 戴志展