双相障碍与过敏性鼻炎共病的现状、机制与治疗策略

Comorbidity of bipolar disorder and allergic rhinitis: current status, mechanisms, and treatment strategies

  • 摘要: 双相障碍是一种重性精神障碍,而过敏性鼻炎是常见过敏性疾病,两者均为严重影响患者生活质量的常见疾病。既往流行病学研究提示,两者具有较高的共病率,但关于两者之间的内在联系机制,目前尚未明确,两者可能共享一个由多因素相互作用构成的动态病理生理网络,潜在机制涉及免疫炎症、神经内分泌调节、睡眠障碍及环境因素等多方面。文章分别从流行病学、共病机制这2个方面深入探讨它们之间的联系,旨在加深临床医师对两者共病的理解。文章同时分析了双相障碍与过敏性鼻炎共病的整合治疗管理策略,认为需基于共享病理机制采取多维度、多学科整合策略,建立跨学科协作模式,对患者进行早期识别与整体评估,对该类患者的药物治疗应优先考虑兼具心境稳定和潜在抗炎作用的药物(如部分非典型抗精神病药),合理使用过敏性鼻炎的一线药物(如鼻用激素),关注药物不良反应,而心理干预、睡眠干预、生活方式干预在患者的长期管理中具有重要意义。

     

    Abstract: Bipolar disorder is a severe mental illness, while allergic rhinitis is a common allergic disease. Both are common diseases that significantly affect patients' quality of life. Previous epidemiological studies have suggested a high comorbidity rate between the two, but the underlying mechanism of their association remains unclear. They may share a dynamic pathophysiological network composed of multiple factors interacting with each other, with potential mechanisms involving immunoinflammation, neuroendocrine regulation, sleep disorders, and environmental factors. This article delves into the connection between them from two aspects: epidemiology and comorbidity mechanism, aiming to deepen clinicians' understanding of comorbidity between the two. The article also analyzes the integrated treatment management strategies for comorbidity of bipolar disorder and allergic rhinitis, suggesting the need for a multidimensional and multidisciplinary integrated strategy based on shared pathological mechanisms, establishing an interdisciplinary collaboration model for early identification and comprehensive assessment of patients. For pharmacological treatment of such patients, priority should be given to drugs with both mood stabilizing and potential anti-inflammatory effects (such as some atypical antipsychotics), and the rational use of first-line drugs for allergic rhinitis (such as nasal steroids) should be emphasized. Attention should also be paid to adverse drug reactions, while psychological intervention, sleep intervention, and lifestyle intervention are of great significance in the long-term management of patients.

     

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