Chronic nonallergic rhinitis

Perennial non-allergic rhinitis is a group of nasal inflammatory diseases, including vasomotor rhinitis and non-allergic rhinitis with eosinophilia syndrome. Under the effect of non-allergic factors, the patients develop symptoms such as sneezing, rhinorrhea, nasal congestion and postnasal drip. Vasomotor rhinitis occurs in middle-aged people aged 35 to 45 years old. Women are more common, the cause is unknown, and environmental factors can trigger nasal symptoms. Non-allergic rhinitis with eosinophilia syndrome is more common in women, nasal symptoms are often more severe than vasomotor rhinitis and allergic rhinitis, olfactory damage is common 1.
The specific cause is still unclear, and some causes such as immunity, infection, drugs, structure, hormones, vasculitis, metabolism or atrophic causes need to be excluded. Vasomotor rhinitis may be caused by excessive release of parasympathetic neurotransmitters due to mental stress, anxiety, changes in environmental temperature, endocrine dysfunction, etc, causing non-specific release of histamine, vasodilation, increased glandular secretion, resulting in corresponding clinical symptom. The pathogenesis of non-allergic rhinitis with eosinophilia syndrome is unknown, and the significance of eosinophils and their associated inflammatory response markers is valued 1.
chronic presence of one or more of the four following cardinal symptoms of rhinitis, in the absence of a specific etiology (such as an immunologic, infectious, pharmacologic, structural, hormonal, vasculitic, metabolic, or atrophic cause:
●Nasal congestion
●Postnasal drainage
Vasomotor rhinitis: First of all, avoid exposure to environmental stimuli. The overall efficacy of medication for vasomotor rhinitis is less than that for AR. When patients have symptoms of nasal congestion and salivation at the same time, nasal antihistamines may be preferred, and nasal corticosteroids may be used in combination when poor efficacy. When medical treatment is not effective for 6-9 months, surgery can be considered.
Non-allergic rhinitis with eosinophilia syndrome: Avoidance of irritants contact and nasal irrigation can be used as routine control. Nasal glucocorticoid is the main drug for treatment, and it has a significant effect on relieving nasal symptoms, but it has no obvious effect on the improvement of olfactory 1.

1.  Luo Zhang, Demin Han. A brief introduction to non-allergic rhinitis[J]. Chinese Journal of Otorhinolaryngology head and neck surgery, 2010,45(12):976-981. DOI:10.3760/cma.j.issn1673-0860.2010.12.003.