Questionnaire Analysis Of Combined Allergic Rhinitis And Asthma Syndrome In Chongqing

Objective： To study the ratio of BA patients with upper airwaysymptoms and the ratio of AR patients with lower airway symptoms. Toinvestigate the current state of the diagnosis and treatment of CARAS inChongqing, as well as to summarize the questions of diagnosis andtreatment of the disease, so as to improve the clinician’s understanding ofthe CARAS and the level of diagnosis and treatment.Methods：256cases aging from18to70years old with bronchialasthma and/or allergic rhinitis were collected in the outpatient departmentof respiratory medicine and otolaryngology in the First Affiliated Hospitalof Chongqing Medical University from Oct.2011to Sept.2012. We usequestionnaire to study the patient’s demographic characteristics, medicalhistory, the ratio of BA patients with upper airway symptoms, the ratio ofAR patients with lower airway symptoms, as well as the current state of thediagnosis and treatment of the CARAS retrospectively. The256cases weredivided into three groups according to the diagnosis: only confirmed BAfor Ⅰ group, only confirmed AR for Ⅱ group, BA and AR were both diagnosed for Ⅲ group. And according to patients’ medication compliance,each group was divided into two subgroups: regular medication subgroupand irregular medication subgroup, comparing the difference of the clinicalcontrol rate between the subgroups respectively.Results:72.3%(112/155) of the BA patients had AR relatedsymptoms and35.6%(36/101) of the AR patients had BA related symptoms.The number of patients with combined diagnosis only accouted for25.0%(63/256). There were148cases with combined upper and lowerairway symptoms, but only13.5%(20/148) of the cases on correctcombination treatment. The main reasons for patients not taking combinedtreatment were as follows: The idea of doctors not informing theimportance accouted for51%, patient’s worries about the side effects of thedrug accouted for14%and the standpoint that there was no need to treatthe combined syndrome because of the little impact on life accouted for12%. Patients adhering to regular medication just accouted for36.72%(94/256). The BA control rates of RM and IRM subgoups inGroup Ⅰ were45.71%and4.41%, between which there was significantdifference(P<0.05). The AR control rates of RM and IRM subgoups inGroup Ⅱ were61.54%and21.47%, between which there was significantdifference(P<0.05). The general clinical control rates of RM and IRMsubgoups in Group Ⅲ were45.00%and4.65%, between which there wassignificant difference(P<0.05). And There were significant differences between the two subgroups of Group Ⅲ in BA control and AR controlrespectively(P<0.05).Conclusion：（1）Allergic rhinitis is present in the majority of patients with asthma,and a significant minority of patients with rhinitis have concomitant asthmain Chongqing.（2）Most of the patients have not got correct diagnosis and standardcombined treatment in Chongqing. The main reasons for not takingcombined treatment include the two following aspects:①doctors did notfully inform the importance of combined treatment.②Patients worriedabout the side effects of the drug and was lack of understanding andattention of the disease.（3）The majority of the CARAS patients did not take regularmedication in Chongqing. Otherwise, regular medication plays animportant role in the treatment of CARAS. Insisting on regular medicationcan help control symptoms.BA and AR are different manifestations of a common pathogenicphenomenon. The mobidity of bronchial asthma combining with allergicrhinitis is high in Chongqing. Allergic rhinitis is present in the majority ofpatients with asthma, and a significant minority of patients with rhinitishave concomitant asthma. But most of the patients have not got combineddiagnosis and the treatment status is disappointed. （4）When accepting BA or AR patients, clinicians should examineand evaluate both upper and lower airway, and establish the collaborativediagnosis of CARAS to make individualized treatment programs forpatients and manage the whole respiratory system.（5）Attach great importance to the health education and follow-upmanagement of CARAS patients，so as to improve patient compliance andget better result. With the effort of patients and doctors, satisfyingtherapeutic effect can be achieved.（6）The investigation confirmed that BA and AR are differentmanifestation of a common pathogenic phenomenon. Only treated theinflammation of upper and lower airway collaboratively can CARASpatients get good clinical control and improve life quality.