Part 6 of 6 in the allergic rhinitis series. Part 1 is what allergic rhinitis is and what histamine does; part 2 is how TCM reads the nose; part 3 is the measures at home; part 4 is air-conditioning and haze; part 5 is when to see a doctor first.

With the theory, the yardstick and the measures all covered, the last thing is how "my kind of nose" is handled inside a consultation.

The short version

• A practitioner asks about five directions: the pattern, what it does, what sets it off, what comes with it, and the sprays and medicines you already use.
• What has already been ruled out is information too — whether you have seen a doctor, whether you have had allergy testing.
• Why the tongue: the World Health Organization's terminology standard defines tongue diagnosis as "A diagnostic method to inspect the patient's tongue body and tongue coating"; online it works from the photo you take.
• What cannot be done online, the practitioner will say. Looking inside the nose, listening with a stethoscope, allergy testing and nasal endoscopy are a doctor's.
• Three possible directions: acupuncture, Chinese herbs, lifestyle adjustments. Which, and whether, is decided after the consultation.
• The goal is to manage a recurring condition, not to "root it out" — there is no promise of a cure here.

First, the things that cannot wait

Difficulty breathing, wheezing, speaking in short phrases, or blue lips — call 999 now, or go to the nearest hospital emergency department.

A nosebleed lasting longer than 10 to 15 minutes, or bleeding that seems excessive — the NHS nosebleed page puts this one in A&E. Call 999 now, or go to the nearest hospital emergency department.

Persistent one-sided blockage, repeated nosebleeds, or blood-streaked discharge — have a doctor establish the cause first; do not treat it as allergic rhinitis yourself. The full list is in part 5.

⚠️ A safety note: TCM and Western medicine complement each other; it is not a choice between them. If you are under medical treatment, TCM care is a layer added on top — not a layer swapped in.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

I. What an online consultation does

① The five directions a practitioner asks about. The pattern — time of day, time of year, which places; what it does — sneezing, clear discharge, blockage, itching in the nose or eyes, and which troubles you most.

What sets it off — air-conditioning, dust, haze, pets; whether cough, skin problems or disturbed sleep come with it; and the sprays, medicines and supplements you already use.

Also: whether you have seen a doctor, whether you have had allergy testing, and which sprays you have used. What has already been ruled out is information too.

② Why the tongue. The World Health Organization's terminology standard defines tongue diagnosis (舌诊) as "A diagnostic method to inspect the patient's tongue body and tongue coating". An online consultation works from the tongue photo you take — see how to take a useful tongue photo.

③ What cannot be done online, the practitioner will say. Looking inside the nasal passages and listening with a stethoscope cannot be done online; investigations — allergy testing, nasal endoscopy — are a doctor's. If the practitioner thinks a Western medical check should come first, they say so.

④ Three possible directions: acupuncture, Chinese herbs, and lifestyle adjustments. The herbs may be concentrated granule powder; the lifestyle side means the kind of habits in parts 2 to 4.

The goal is to manage a recurring condition, not to "root it out" — there is no promise of a cure here. Which, and whether, is decided after the consultation, and the practitioner's written instructions take precedence.

⑤ Reminders by situation, not by constitution:

• On long-term medication: tell the practitioner everything you take; if you already take other medicines, the NHS says speak to a pharmacist or GP before taking antihistamines; a nosebleed while taking a medicine that helps prevent blood clots is on the NHS list of reasons to see a GP. Never stop your medication on your own.
• Pregnant, trying, or breastfeeding: for antihistamines in pregnancy or while breastfeeding, the NHS says speak to a pharmacist or GP first; the MOH states an N95 mask "is not suitable for pregnant women and children". Whether herbs or acupuncture suit you, ask the practitioner first.
• Under 12: the NHS states decongestants "should not be given to children under 6 years of age", and that "Children aged 6 to 11 should take them for no longer than 5 days", asking a pharmacist first; for an antihistamine for a young child, speak to a pharmacist or GP first; an N95 mask is not suitable for children. For a child's nose, see a paediatrician first.
• Older adults: the NHS says older people should speak to a pharmacist or GP before taking antihistamines; the MOH counts older people among the high-risk group in haze.
• Before surgery, or a chronic condition under regular review: tell your doctor the herbs, herbal teas and supplements you take, and let the doctor judge.

II. Keep two weeks of notes first

Keep two weeks of notes: which day, what time, where you were, what the API was. Two weeks of notes beats recall.

Write down the sprays and medicines you have bought too — what you bought and for how long you used it. Herbal-tea-shop teas and direct-sales supplements: mention those at the consultation as well, and the practitioner looks at them together.

What to prepare beforehand is in what to prepare before an online consultation.

The words in this part

• Tongue diagnosis (舌诊) — the World Health Organization's TCM terminology standard: "A diagnostic method to inspect the patient's tongue body and tongue coating." Online it works from a photo.
• Antihistamine (抗组织胺) — the NHS's definition: a medicine that blocks "the effects of a substance called histamine in your body". If you already take other medicines, or are pregnant, breastfeeding or buying for a young child, the NHS says speak to a pharmacist or GP first.
• Decongestant (减充血剂) — the NHS's definition: a type of medicine that gives short-term relief for a blocked or stuffy nose. The NHS states they should not be given to children under 6, and no longer than 5 days for children aged 6 to 11.
• A medicine that helps prevent blood clots — the NHS nosebleed page's wording; a nosebleed while taking one is on that page's list of reasons to see a GP.
• N95 respirator (N95 呼吸器) — the MOH states it may be used as protection during the haze, but that it "is not suitable for pregnant women and children".

Frequently asked

What does TCM look at for allergic rhinitis? The whole picture around the recurrence: when it happens, what it tracks with, how the rest of the body is, plus tongue diagnosis — "A diagnostic method to inspect the patient's tongue body and tongue coating", in the WHO standard's words, done online from your photo. The practitioner uses the theory's language — lung, wind-cold, nasal discharge — and does not make the Western diagnosis of "allergic rhinitis" or replace it. The goal is to manage the recurrence, not to "root it out"; whether acupuncture, herbs or lifestyle adjustments is decided after the consultation.

The other five parts

• Part 1: How allergic rhinitis happens, and what histamine does
• Part 2: How TCM reads the nose, and the "surface"
• Part 3: At home: bedding, dust, rinsing the nose
• Part 4: Air-conditioning, haze, masks and the pharmacy
• Part 5: When to see a doctor first

👉 If you are not sure where to even start describing a nose problem that keeps coming back, you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 can assess it with you; if anything in "First, the things that cannot wait" above or in part 5 applies, see a doctor first.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

Sources

• World Health Organization, WHO international standard terminologies on traditional Chinese medicine, 2022 — https://www.who.int/publications/i/item/9789240042322
• NHS, Antihistamines, page last reviewed 16 May 2023 — https://www.nhs.uk/medicines/antihistamines/
• NHS, Decongestants, page last reviewed 03 November 2022 — https://www.nhs.uk/medicines/decongestants/
• NHS, Nosebleed, page last reviewed 05 December 2023 — https://www.nhs.uk/conditions/nosebleed/
• Kementerian Kesihatan Malaysia, Usage Of Personal Protection During Haze, last updated 29 September 2025 — https://www.moh.gov.my/teras/info-kesihatan/jerebu/artikel-dan-panduan-pengguna-berkaitan-jerebu/usage-of-personal-protection-during-haze
• Kementerian Kesihatan Malaysia, Langkah-Langkah Pencegahan Semasa Jerebu, last updated 29 September 2025 — https://www.moh.gov.my/teras/info-kesihatan/jerebu/artikel-dan-panduan-pengguna-berkaitan-jerebu/langkah-langkah-pencegahan-semasa-jerebu

本文是「鼻敏感」系列的第 6 篇，共 6 篇。第 1 篇讲鼻敏感是什么、组织胺做什么，第 2 篇讲中医怎么看鼻子，第 3 篇讲家里的做法，第 4 篇讲冷气与烟霾天，第 5 篇讲什么时候要先看医生。

理论、尺和做法都讲完了，最后一件事是：「我这种鼻子」在问诊里是怎么被处理的。

一分钟看完

• 医师会问五个方向：发作的规律、具体的表现、诱发的情境、有没有伴随的症状、您已经在用的喷剂和药物。
• 已经排除过的可能性，同样是重要的资讯——看过西医没有、做过过敏原检测没有。
• 为什么看舌头：世界卫生组织的术语标准把舌诊定义为「观察病人舌体和舌苔的诊法」；线上看的是您拍的照片。
• 线上做不到的，医师会说。看鼻腔内部、听诊、过敏原检测和鼻内视镜，都是医生的事。
• 可能采用的方向有三个：针灸、中药、生活调整。用哪一种、要不要用，看诊后才决定。
• 目标是管理反覆发作的情况，不是「断根」——这里没有「治好」的承诺。

先说不能等的几件事

呼吸困难、喘鸣、说话时断句、嘴唇发紫——请立刻拨打 999，或前往最近的医院急诊部。

流鼻血超过 10 到 15 分钟，或出血量大——NHS 的流鼻血页把这一项放在急诊。请立刻拨打 999，或前往最近的医院急诊部。

单侧持续鼻塞、反覆流鼻血，或鼻涕带血——先让医生查明原因，不要当成鼻敏感自己处理。完整的清单，见第 5 篇。

⚠️ 安全提醒：中医与西医是互相补位的关系，不是二选一。若您正在西医治疗中，中医调理是加上去的一层，不是拿来替换的那一层。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

一、线上问诊会做什么

① 医师会问的五个方向。 发作的规律——一天里、一年里、在什么地方；具体的表现——喷嚏、清涕、鼻塞、鼻痒、眼睛痒，哪一项最困扰。

诱发的情境——冷气、灰尘、烟霾、宠物；有没有伴随咳嗽、皮肤问题、睡眠受影响；您已经在用的喷剂、药物、保健品。

还会问：看过西医没有、做过过敏原检测没有、用过什么喷剂。已经排除过的可能性，同样是重要的资讯。

② 为什么要看舌头。 世界卫生组织的术语标准把舌诊 tongue diagnosis 定义为「观察病人舌体和舌苔的诊法」。线上问诊看的是您拍的舌头照片，拍法见：舌头照片怎么拍。

③ 线上做不到的，医师会说。 需要看鼻腔内部、需要听诊的部分，线上做不到；需要检查的——过敏原检测、鼻内视镜——是医生的事。医师若认为应该先做西医检查，会直接说。

④ 可能采用的方向有三个：针灸、中药，以及生活调整。 中药可能是浓缩中药粉；生活调整指第 2 篇到第 4 篇那类习惯。

目标是管理反覆发作的情况，不是「断根」——这里没有「治好」的承诺。用哪一种、要不要用，看诊后才决定，以医师的书面指示为准。

⑤ 按情况的提醒——不是按体质：

• 正在长期服药：所有药都告诉医师；已经在服其他药的，NHS 建议用抗组织胺前先问药剂师或医生；正在服用帮助防止血液凝结的药而流鼻血，NHS 列为应看医生的情况。切勿自行停药。
• 孕期、备孕或哺乳：孕期或哺乳期用抗组织胺，NHS 建议先问药剂师或医生；卫生部写明 N95 口罩不适合孕妇。中药与针灸是否适合，先问医师。
• 12 岁以下：NHS 写明减充血剂 6 岁以下不宜使用，6 至 11 岁使用不超过 5 天，并要先问药剂师；给幼儿选抗组织胺，先问药剂师或医生；N95 口罩不适合儿童。孩子的鼻子，先看儿科医生。
• 乐龄人士：NHS 建议乐龄人士用抗组织胺前先问药剂师或医生；卫生部把乐龄人士列入烟霾高风险群体。
• 准备手术、慢性病定期复诊中：把您在吃的中药、凉茶、保健品告诉医生，由医生判断。

二、来之前先记两周

记录两周的发作情形：哪一天、什么时段、当时在哪里、当天的 API 是多少。两周的记录比回忆准确。

买过的喷剂和药，也一并写下来——买了什么、用了多久。凉茶铺的茶、直销的保健品，看诊时都说出来，医师会一并看。

问诊前的准备，见：线上问诊前该准备什么。

这篇出现的几个词

• 舌诊 tongue diagnosis——世界卫生组织中医术语标准的定义：观察病人舌体和舌苔的诊法。线上看的是照片。
• 抗组织胺 antihistamine——NHS 的定义：阻断体内一种叫组织胺的物质的作用的药。已经在服其他药、孕期、哺乳期或给幼儿用，NHS 都建议先问药剂师或医生。
• 减充血剂 decongestant——NHS 的定义：为鼻塞提供短期缓解的一类药。NHS 写明 6 岁以下不宜使用，6 至 11 岁不超过 5 天。
• 帮助防止血液凝结的药——NHS 流鼻血页的说法；正在服这一类药而流鼻血，该页列为应看医生的情况。
• N95 呼吸器 N95 respirator——卫生部写明它可以在烟霾期间使用，但不适合孕妇和儿童。

常见问题

中医看鼻敏感看什么？ 看的是反覆发作这件事的整体情况：什么时候发、和什么有关、身体其他方面如何，加上舌诊——世界卫生组织的标准把它定义为「观察病人舌体和舌苔的诊法」，线上看的是照片。医师用的是理论的语言——肺、风寒、涕——不做「过敏性鼻炎」这个西医诊断，也不取代它。目标是管理反覆发作，不是「断根」；针灸、中药还是生活调整，看诊后才决定。

这个系列的另外五篇

• 第 1 篇：鼻敏感是怎么发生的，组织胺做什么
• 第 2 篇：中医怎么看鼻子，和那一道「表」
• 第 3 篇：家里怎么处理：床单、灰尘、洗鼻子
• 第 4 篇：冷气、烟霾、口罩和药剂行
• 第 5 篇：什么时候要先看医生

👉 如果您不确定「我这种反覆发作的鼻子情况，该从哪里说起」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估；若有本文「先说不能等的几件事」或第 5 篇列出的情况，请先看医生。

无论身在何处，与持证中医师对坐。

汉方现代中医

资料来源

• 世界卫生组织，WHO international standard terminologies on traditional Chinese medicine，2022 — https://www.who.int/publications/i/item/9789240042322
• NHS，Antihistamines，页面最后审阅 2023 年 5 月 16 日 — https://www.nhs.uk/medicines/antihistamines/
• NHS，Decongestants，页面最后审阅 2022 年 11 月 3 日 — https://www.nhs.uk/medicines/decongestants/
• NHS，Nosebleed，页面最后审阅 2023 年 12 月 5 日 — https://www.nhs.uk/conditions/nosebleed/
• 马来西亚卫生部，Usage Of Personal Protection During Haze，最后更新 2025 年 9 月 29 日 — https://www.moh.gov.my/teras/info-kesihatan/jerebu/artikel-dan-panduan-pengguna-berkaitan-jerebu/usage-of-personal-protection-during-haze
• 马来西亚卫生部，Langkah-Langkah Pencegahan Semasa Jerebu，最后更新 2025 年 9 月 29 日 — https://www.moh.gov.my/teras/info-kesihatan/jerebu/artikel-dan-panduan-pengguna-berkaitan-jerebu/langkah-langkah-pencegahan-semasa-jerebu