ANALYSIS OF CURRENT THERAPEUTIC APPROACHES TO CHRONIC RHINITIS ACCORDING TO THE POLYCLINIC DATA OF AMBULATORY SERVICE OF MOSCOW

Abstract

The term «rhinitis» comprises a large heterogeneous group of diseases with different etiology and pathophysiological mechanisms. The latest consensual documents recommend that all rhinitis be classified into 3 main types: infectious, allergic (AR) and non-infectious and non-allergic with subsequent subdivision of each type into separate subtypes. In the Russian Federation, standards and clinical guidelines have been developed only for allergic rhinitis. The therapeutic agement of 779 patients with chronic rhinitis in outpatient settings have been analysed. When formulating the diagnosis, codes J31.0 and J30.0 and the terms «Hypertrophic rhinitis» and «Vasomotor rhinitis» were used for non-allergic rhinitis, while code J30.4 and the terms «Allergic rhinitis» or «Vasomotor-allergic rhinitis» were used for allergic genesis. The diagnosis «Intermittent AR» was indicated once, and severity was mentioned only in 2 patients. In AR group (216 people), a comprehensive study was performed in 6.5% of cases, the diagnosis was established empirically in 52.7% of cases. Antihistamines were prescribed in 27.3% of cases, intranasal corticosteroids in 77.8%, montelukast in 9.7%, allergen-specific immunotherapy was performed in 1.9%. In non-allergic rhinitis (563 patients), 77.4% intranasal received corticosteroids, 7.5% received antihistamines, 3.7% – montelukast, 4.8% underwent surgical treatment. In both groups, original methods of therapy in the form of local antibiotics, homeopathic drugs, bacterial lysates were reported. In the AR group, a violation of the step-by-step therapy regimen was identified.

Keywords

• rhinitis
• allergy
• classification
• quality of life
• treatment
• antihistamines
• topical corticosteroids
• allergen-specific immunotherapy