免疫调节剂治疗鼻部炎症性疾病专家共识(2023，深圳)

Expert consensus on immunomodulatory drugs for nasal inflammatory diseases (2023，Shenzhen)

摘要:

鼻部炎症性疾病临床主要包括变应性鼻炎(AR)、非变应性鼻炎(NAR)和慢性鼻窦炎(CRS)，其发病机制尚未完全阐明，涉及遗传学、免疫调节、炎症介质、环境因素、微生物群状态等多方面，传统药物治疗后部分患者症状仍无法缓解或出现不必要的副作用，且容易反复发作或呈慢性持续状态，因其发病多与免疫失衡相关，免疫调节是一个有效的治疗方案。近年来，免疫调节剂的品种和应用越来越广泛，主要包括化学合成制剂、生物制剂、人和动物免疫系统的产物、中药及其制剂等。但免疫调节剂治疗鼻部炎症疾病缺乏高水平的循证医学证据，使用尚不规范，因此，我们特组织该领域有经验的中青年鼻科专家，基于临床经验和循证医学证据制定了免疫调节剂治疗鼻部炎症性疾病专家共识，本共识从鼻部炎症性疾病发病机制角度出发，系统总结了鼻炎及CRS常用免疫调节剂的免疫作用机制、临床研究证据、适应证、用法用量及注意事项等，以供临床医生在选择和应用免疫调节剂时参考。

Abstract:

The clinical entity of nasal inflammatory diseases mainly includes allergic rhinitis, non-allergic rhinitis and chronic rhinosinusitis. The pathogenesis has not been fully clarified, involving genetics, immune regulation, inflammatory mediators, environmental factors, microbial community status, and other aspects. Conventional drug treatment may fail to relieve symptoms or even cause side effect in some patients.And the patients are prone to recurrent the disease or be in chronic persistent state. Considering its pathogenesis mostly related to immune imbalance, immune regulation is an effective treatment plan. Recently, the variety and application of immunomodulatory drugs have become more and more extensive, including chemically synthesized molecules, biological agents, products of human and animal immune systems, and traditional Chinese medicine. However, the application of immunomodulatory drugs in the treatment of nasal inflammatory diseases is not standardized due to the lack of high-level evidence-based medical evidences. Therefore, we intentionally organized young and middle-aged nasal experts with experience in this field to develop an expert consensus on immunomodulatory drugs for the treatment of nasal inflammatory diseases based on clinical experience and evidence-based medical evidence. This consensus systematically summarizes the immune mechanisms,clinical research evidence， indications, usage and dosage, as well as precautions of immunomodulatory drugs for rhinitis and chronic rhinosinusitis, so as to provide a reference for clinical selection and application of immunomodulatory drugs.