Part 5 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 6 is what an online consultation does.

"When do I handle it myself, and when do I see a doctor first?" It is the most important question in the whole series.

This part sets out the situations that go to a doctor first — each with the reason its own NHS page gives, meaning what that sign can be a sign of.

The short version

• 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 is one the NHS puts in A&E.
• A persistent one-sided blockage or repeated nosebleeds are investigated by a Western doctor first. The NHS nasal polyps page and nosebleed page each give a reason.
• Facial pain may be the sinuses: the NHS states that sinusitis makes the lining of the sinuses swell, so mucus cannot drain properly.
• If your sense of smell has not returned in a few weeks, the NHS says see a doctor; the doctor checks for the obvious causes first.
• If a long-term breathing condition has already been diagnosed, follow your doctor's treatment and never stop an inhaler or controller medication on your own — see the first item below.

See a doctor first in these situations

• You have asthma, or have been diagnosed with it. Asthma needs medical diagnosis and treatment, with a clear medication and emergency plan. Follow your doctor's treatment, and never stop an inhaler or controller medication on your own. — Why this one matters: the NHS asthma page states that "the main symptoms of asthma are problems with breathing" — wheezing, coughing, shortness of breath, your chest feeling tight — and that "an asthma attack is when you have severe symptoms and it's difficult to breathe, which can be life-threatening". Allergic rhinitis with asthma getting worse too is on the NHS list of reasons to see a GP
• Difficulty breathing, wheezing, speaking in short phrases, or blue lips. Call 999 now, or go to the nearest hospital emergency department. — Wheezing and shortness of breath are among the main asthma symptoms the NHS asthma page lists, and an asthma attack can be life-threatening; for an attack where you "start to feel worse at any time", "do not feel better after taking the maximum dose using an asthma reliever inhaler", or "do not have an asthma inhaler", that page's own tier is 999. For speaking in short phrases and blue lips, none of the pages consulted here gives a reason, and this article does not supply one
• Persistent one-sided blockage, or repeated nosebleeds. These need medical investigation. — The NHS nosebleed page states that nosebleeds needing medical attention can come from deeper inside the nose, caused by an injury or broken nose, conditions that affect the blood vessels or how the blood clots, or certain medicines, "like warfarin" — which the same page describes as a medicine that helps prevent blood clots. On the one-sided blockage: the NHS nasal polyps page states that nasal polyps are "painless soft growths inside your nose" which "can keep growing and block your nose if not treated", and that "A GP should be able to tell if you have nasal polyps by looking inside your nose"; the NHS sinusitis page states that a GP may refer you to an ENT specialist if you only have symptoms on 1 side of your face
• Blood-streaked discharge, facial pain, a marked loss of smell, or persistent fever alongside it. See a doctor first. — On the facial pain, the NHS sinusitis page gives the reason: the sinuses are "small, empty spaces behind your cheekbones and forehead that connect to the inside of the nose", and sinusitis "causes the lining of the sinuses to swell up", which "stops mucus draining into your nose and throat properly, making you feel blocked up". That page puts being very unwell, painkillers not helping or symptoms getting worse, and a weakened immune system, at same-day care. On the smell, the NHS page states that changes in the sense of smell are most often caused by a cold, flu or COVID-19, sinusitis, an allergy, or growths in the nose (nasal polyps); if it does not go back to normal in a few weeks, see a doctor, and the GP "will check for any obvious causes, such as sinusitis or nasal polyps". A high temperature for more than 3 days is the NHS common cold page's line. For blood-streaked discharge, none of the pages consulted here gives a reason, and this item keeps its present form
• Recurrence that disrupts sleep, school or work. Worth a proper medical assessment rather than managing it yourself indefinitely. — The NHS lists symptoms affecting your sleep and everyday life as a reason to see a GP. That page does not say what it is a sign of, and this article does not supply one
• No firm diagnosis yet. Establish what it is first, then talk about TCM care. — Not being sure what is causing your symptoms is on the NHS list too. This is not a sign of one particular condition; it is why establishing the cause comes before managing it, since the same page states that you may be referred to a specialist for further tests and treatment if the cause is not clear or the symptoms are severe

"Seek care the same day" means a same-day visit to a Klinik Kesihatan or clinic; "see a doctor" means an ordinary appointment; the "call 999 now" situations do not wait for a clinic.

⚠️ 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 nosebleed lasting longer than 10 to 15 minutes or bleeding that seems excessive is one the NHS puts in A&E: call 999 now, or go to the nearest hospital emergency department.

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.

The words in this part

• Asthma (气喘) — the NHS asthma page states the main symptoms are problems with breathing: wheezing, coughing, shortness of breath, a tight chest; an asthma attack is severe symptoms with difficulty breathing, and can be life-threatening. It needs medical diagnosis and treatment.
• Nasal polyps (鼻息肉) — the NHS's definition: painless soft growths inside the nose, which can keep growing and block the nose if not treated, and which a GP should be able to see by looking inside the nose.
• Sinusitis (鼻窦炎) — the NHS states the sinuses are small empty spaces behind the cheekbones and forehead that connect to the nose; sinusitis makes their lining swell so mucus cannot drain.
• Warfarin (华法林) — the NHS nosebleed page lists it among the medicines that can cause a nosebleed needing medical attention, and describes it as a medicine that helps prevent blood clots. Say what you take, at a consultation and at a clinic, and never stop your medication on your own.
• ENT specialist (耳鼻喉专科) — ear, nose and throat; the NHS states a GP may refer you to this specialty if you only have symptoms on 1 side of your face.

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.

Frequently asked

Why does a one-sided blockage go to a doctor first? Because the one-sidedness is itself the thing a Western doctor looks into. The NHS nasal polyps page states that nasal polyps are painless soft growths inside the nose which can keep growing and block the nose if not treated, and that a GP should be able to tell by looking inside the nose; the NHS sinusitis page states that a GP may refer you to an ENT specialist if you only have symptoms on 1 side of your face. Have a doctor establish the cause first; do not treat it as allergic rhinitis yourself.

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 6: What an online consultation does

👉 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 above applies, see a doctor first.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

Sources

• NHS, Allergic rhinitis, page last reviewed 08 January 2026 — https://www.nhs.uk/conditions/allergic-rhinitis/
• NHS, Asthma, page last reviewed 07 April 2025 — https://www.nhs.uk/conditions/asthma/
• NHS, Nasal polyps, page last reviewed 29 June 2023 — https://www.nhs.uk/conditions/nasal-polyps/
• NHS, Nosebleed, page last reviewed 05 December 2023 — https://www.nhs.uk/conditions/nosebleed/
• NHS, Sinusitis (sinus infection), page last reviewed 31 January 2024 — https://www.nhs.uk/conditions/sinusitis-sinus-infection/
• NHS, Lost or changed sense of smell, page last reviewed 01 December 2023 — https://www.nhs.uk/symptoms/lost-or-changed-sense-smell/
• NHS, Common cold, page last reviewed 22 March 2024 — https://www.nhs.uk/conditions/common-cold/

本文是「鼻敏感」系列的第 5 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 6 篇讲线上问诊会做什么。

「什么时候该自己处理，什么时候该先看医生？」这是整个系列最要紧的一个问题。

这一篇把要先看医生的几项列出来——每一项都写上 NHS 对应页面给的理由，也就是这个征兆可能是什么的征兆。

一分钟看完

• 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 把这一项放在急诊。
• 单侧持续鼻塞或反覆流鼻血，要先由西医查明原因。NHS 的鼻息肉页和流鼻血页各给了理由。
• 脸部疼痛可能来自鼻窦：NHS 写明鼻窦炎使鼻窦的内膜肿起来，鼻涕于是无法正常流出。
• 嗅觉几周内没有恢复，NHS 说看医生；医生会先找明显的原因。
• 已经被诊断过呼吸方面的长期疾病的，请以西医的治疗为主，切勿自行停用喷剂或控制药物；详见下面第一项。

这些情况请先看西医

• 有气喘，或曾被诊断过气喘：气喘需要西医的诊断与治疗，并有明确的用药与急救安排。请以西医的治疗为主，切勿自行停用喷剂或控制药物。——为什么这一项要紧：NHS 的气喘页写明，气喘的主要症状是呼吸上的问题——喘鸣、咳嗽、气促、胸闷；而气喘发作指症状严重、呼吸困难，可能危及生命。鼻敏感加上气喘也在加重，NHS 的鼻敏感页列为应看医生
• 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。——喘鸣与气促是 NHS 气喘页列出的气喘主要症状，而气喘发作可能危及生命；对气喘发作中「情况随时变差」「用了气喘缓解喷雾的最大剂量仍没有好转」「手上没有气喘喷雾」这三种情形，该页给的就是 999。说话时断句和嘴唇发紫这两项，本文查过的页面都没有写原因，这里不替它补
• 单侧持续鼻塞，或反覆流鼻血：需要西医检查确认原因。——NHS 的流鼻血页写明，需要就医的鼻血可能来自鼻腔更深处，成因包括受伤或鼻骨骨折、影响血管或凝血功能的状况，以及某些药物，例如华法林 warfarin（NHS 在同一页把它描述为帮助防止血液凝结的药）。单侧鼻塞那一边：NHS 的鼻息肉页写明鼻息肉是鼻腔内无痛的软性增生，不处理可能会继续长大并塞住鼻子，而医生通常看一下鼻腔内部就能判断；NHS 的鼻窦炎页写明，症状只在脸的一侧时，医生可能转介耳鼻喉专科
• 鼻涕带血、脸部疼痛、嗅觉明显减退，或伴随持续发烧：请先就医。——脸部疼痛那一边，NHS 的鼻窦炎页给了原因：鼻窦是颊骨与前额后方的小空腔，与鼻腔相通；鼻窦炎使鼻窦的内膜肿起来，鼻涕于是无法正常流入鼻腔和咽喉，人就觉得塞。该页把「很不舒服」、「止痛药没有帮助或症状变差」，以及「免疫系统较弱」列为当天求医。嗅觉那一边，NHS 的嗅觉页写明，嗅觉改变最常见的原因是感冒、流感或 COVID-19、鼻窦炎、过敏，以及鼻腔内的增生（鼻息肉）；几周内没有恢复就看医生，医生会先找明显的原因，例如鼻窦炎或鼻息肉。高烧超过 3 天看医生，是 NHS 感冒页列的。鼻涕带血这一项，本文查过的页面都没有给原因，这一项照原样保留
• 反覆发作影响睡眠、上课或工作：值得让医生正式评估一次，而不是长期自行处理。——NHS 把症状影响睡眠和日常生活列为应看医生的情况。该页没有写这是什么的征兆，这里也不替它补
• 还没有明确诊断：先看西医确认是什么，再谈调理。——不确定是什么引起的，NHS 也列为应看医生的情况。这不是某一个病的征兆，而是为什么「先确认」比「先调理」重要：同一页写明，原因不清楚或症状严重时，可能被转介做进一步检查与治疗

「当天求医」指 Klinik Kesihatan 或诊所的当天门诊；「看医生」指一般门诊；「立刻拨打 999」的情况，不等门诊。

⚠️ 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。流鼻血超过 10 到 15 分钟或出血量大，NHS 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。

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。

这篇出现的几个词

• 气喘 asthma——NHS 的气喘页写明，气喘的主要症状是呼吸上的问题：喘鸣、咳嗽、气促、胸闷；气喘发作指症状严重、呼吸困难，可能危及生命。它需要西医的诊断与治疗。
• 鼻息肉 nasal polyps——NHS 的定义：鼻腔内无痛的软性增生；不处理可能会继续长大并塞住鼻子，而医生通常看一下鼻腔内部就能判断。
• 鼻窦炎 sinusitis——NHS 写明鼻窦是颊骨与前额后方与鼻腔相通的小空腔；鼻窦炎使鼻窦的内膜肿起来，鼻涕无法正常流出。
• 华法林 warfarin——NHS 的流鼻血页把它列为可能引起需就医鼻血的药物之一，并描述为帮助防止血液凝结的药。您在用什么药，看诊和就医时都如实说明；切勿自行停药。
• 耳鼻喉专科 ENT specialist——耳、鼻、喉的专科；NHS 写明症状只在脸的一侧时，医生可能转介这一科。

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。

常见问题

单侧鼻塞为什么要先看医生？ 因为「单侧」这件事本身，是西医会去查的线索。NHS 的鼻息肉页写明鼻息肉是鼻腔内无痛的软性增生，不处理可能会继续长大并塞住鼻子，而医生通常看一下鼻腔内部就能判断；NHS 的鼻窦炎页写明，症状只在脸的一侧时，医生可能转介耳鼻喉专科。先让医生查明原因，不要当成鼻敏感自己处理。

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 6 篇：线上问诊会做什么

👉 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

• NHS，Allergic rhinitis，页面最后审阅 2026 年 1 月 8 日 — https://www.nhs.uk/conditions/allergic-rhinitis/
• NHS，Asthma，页面最后审阅 2025 年 4 月 7 日 — https://www.nhs.uk/conditions/asthma/
• NHS，Nasal polyps，页面最后审阅 2023 年 6 月 29 日 — https://www.nhs.uk/conditions/nasal-polyps/
• NHS，Nosebleed，页面最后审阅 2023 年 12 月 5 日 — https://www.nhs.uk/conditions/nosebleed/
• NHS，Sinusitis (sinus infection)，页面最后审阅 2024 年 1 月 31 日 — https://www.nhs.uk/conditions/sinusitis-sinus-infection/
• NHS，Lost or changed sense of smell，页面最后审阅 2023 年 12 月 1 日 — https://www.nhs.uk/symptoms/lost-or-changed-sense-smell/
• NHS，Common cold，页面最后审阅 2024 年 3 月 22 日 — https://www.nhs.uk/conditions/common-cold/