An English-speaking GP meets with a Chinese-speaking patient during a consultation about persistent nasal and eye symptoms.
- GP · turn 1
Good morning. I'm Dr Wilson. Please come in and have a seat. What brings you in today?
早安。我是Wilson醫生。請進，坐吧。您今天為甚麼來看醫生？
- Patient · turn 2
醫生你好，我最近一個多月一直打噴嚏、流鼻水，鼻子又癢，眼睛也很癢，尤其是早上起床和下午出門的時候最嚴重。我原本以為只是感冒，可是一直都沒有好。
Hello, doctor. For more than a month, I’ve been sneezing and having a runny nose, and both my nose and eyes are very itchy. It is particularly severe when I wake up in the morning and go outside in the afternoon. I originally thought it was only a cold, but it hasn’t improved.
- GP · turn 3
I see. Have you had a fever, sore throat or body aches? Those symptoms would be more consistent with a viral infection than hay fever.
明白。您有發燒、喉嚨痛或全身疼痛嗎？這些症狀會比較符合病毒感染，而不是花粉症。
- Patient · turn 4
沒有，我沒有發燒，也沒有喉嚨痛，就是不停打噴嚏，鼻塞、流鼻水，眼睛還常常充血、流眼淚，有時候晚上睡覺都會被鼻塞弄醒。
No. I don’t have a fever or sore throat. I just keep sneezing and have a blocked, runny nose. My eyes are also frequently bloodshot and watery, and sometimes the nasal congestion even wakes me during the night.
- GP · turn 5
Have you noticed whether your symptoms get worse after you've been outdoors, mowing the lawn, gardening or visiting places with lots of flowers, such as Floriade in Canberra?
您有沒有注意到，在戶外活動、修剪草坪、園藝，或前往花卉很多的地方後，例如坎培拉花展，症狀會不會加劇？
- Patient · turn 6
有，我上星期剛去了坎培拉花展，回來之後症狀變得更嚴重。而且只要風一大，我就開始不停打噴嚏。
Yes. I went to Floriade in Canberra last week, and my symptoms became worse afterwards. Whenever the wind becomes strong, I also start sneezing continuously.
- GP · turn 7
That certainly sounds like hay fever, also known as allergic rhinitis. It's an allergic reaction rather than an infection. Common allergens include pollen, mould spores, dust mites and pet dander.
這聽起來確實像花粉症，也稱為過敏性鼻炎。這是一種過敏反應，而不是感染。常見的過敏原包括花粉、霉菌孢子、塵蟎和寵物皮屑。
- Patient · turn 8
原來是這樣。我家裡養了一隻貓，不過已經養了很多年了，所以我一直以為不是牠造成的。
I see. I have a cat at home, but I’ve had it for many years, so I always assumed it wasn’t the cause.
- GP · turn 9
You can develop allergies at any stage of life. Just because you've lived with your cat for years doesn't necessarily mean you can't become allergic to pet dander now.
過敏可以在人生任何階段出現。即使您已經和貓一起生活多年，也不代表現在不會對寵物皮屑產生過敏。
- Patient · turn 10
原來如此。我最近搬了新家，家附近有很多樹，而且最近天氣又比較乾燥，不知道會不會也有影響。
I understand. I recently moved to a new home with many trees nearby, and the weather has also been relatively dry. I wonder whether those factors could be having an effect.
- GP · turn 11
Yes, seasonal pollen levels and weather conditions can make symptoms worse. Have you recently been exposed to mould, dust or anything unusual at home or at work?
是的，季節性花粉水平和天氣狀況都可能令症狀惡化。您最近在家中或工作場所接觸過霉菌、灰塵或任何異常物質嗎？
- Patient · turn 12
我在一家家具工廠上班，最近倉庫裡有不少灰塵，而且前陣子下雨之後，角落還長了一些霉菌。我每天都會接觸到那些灰塵。
I work in a furniture factory. Recently, there has been a lot of dust in the warehouse, and some mould grew in the corners after it rained a while ago. I’m exposed to that dust every day.
- GP · turn 13
That may well be contributing to your symptoms. Allergens irritate the lining of your respiratory tract, causing inflammation. That's why your nose becomes congested and your eyes become itchy and bloodshot.
這很可能是導致症狀的其中一個因素。過敏原會刺激呼吸道內壁，引起炎症。這就是您的鼻子會堵塞，而眼睛會發癢和充血的原因。
- Patient · turn 14
難怪我每天都覺得鼻子很不舒服。我有時候還會一直咳嗽，晚上甚至覺得有點喘，不過休息一下就會好。
No wonder my nose feels so uncomfortable every day. Sometimes I also cough continuously and even feel slightly short of breath at night, although it improves after I rest for a while.
- GP · turn 15
Have you ever been diagnosed with asthma or eczema? People with hay fever are more likely to have those conditions as well.
您以前有被診斷患上哮喘或濕疹嗎？花粉症患者也比較容易患有這些疾病。
- Patient · turn 16
我小時候得過濕疹，不過很多年沒有發作了。至於哮喘，我從來沒有被診斷過。
I had eczema as a child, but it hasn’t flared up for many years. As for asthma, I’ve never been diagnosed with it.
- GP · turn 17
Thank you. I'll have a listen to your chest. *(After examination.)* Your lungs sound clear today, which is reassuring. However, if you continue to experience wheezing or shortness of breath, I'd like you to come back because we may need to investigate asthma.
謝謝。我來聽診一下您的胸部。 *（檢查後。）* 今天聽起來您的肺部很清晰，這令人放心。不過，如果您繼續出現喘鳴或呼吸困難，我希望您回來覆診，因為我們可能需要檢查是否患有哮喘。
- Patient · turn 18
好的，我會留意。不過我最困擾的還是鼻塞和眼睛癢，工作時很難集中精神。
All right. I’ll pay attention to that. However, the blocked nose and itchy eyes are still troubling me the most and make it difficult to concentrate at work.
- GP · turn 19
Have you tried any medication?
您有嘗試過任何藥物嗎？
- Patient · turn 20
上次醫生開給我的抗過敏藥，我覺得沒什麼作用，所以吃了幾天就停了。
The anti-allergy medication the doctor prescribed last time didn’t seem very effective, so I stopped taking it after a few days.
- GP · turn 21
Do you remember which medication it was?
您記得那是甚麼藥嗎？
- Patient · turn 22
名字我忘了，只記得一天吃一次，而且吃了之後有點想睡覺。
I’ve forgotten the name. I only remember taking it once a day and feeling a little drowsy afterwards.
- GP · turn 23
It may have been an older antihistamine. I'll prescribe a newer antihistamine that usually causes much less drowsiness. I'd also recommend using a corticosteroid nasal spray every day. The spray is actually the most effective treatment for persistent hay fever, but you need to use it regularly for it to work properly.
那可能是較舊式的抗組織胺藥。我會處方一種較新式、通常較少引起嗜睡的抗組織胺藥。我也建議您每天使用皮質類固醇鼻噴劑。這種噴劑其實是治療持續花粉症最有效的方法，但您需要定期使用，才能正常發揮作用。
- Patient · turn 24
原來如此。我之前以為鼻噴劑只是鼻塞的時候噴一下，所以都是想到才用。
I see. I previously thought the nasal spray was only meant to be used when my nose was blocked, so I used it only when I remembered.
- GP · turn 25
Many people think that, but the nasal spray works best when it's used consistently. I'll also show you the correct technique because using it the wrong way reduces its effectiveness.
很多人都這樣想，但持續使用鼻噴劑才能達到最佳效果。我也會向您示範正確的使用方法，因為錯誤使用會降低療效。
- Patient · turn 26
好的，麻煩你教我怎麼用。我以前都是隨便噴幾下。
All right. Please show me how to use it. Previously, I simply sprayed it a few times without paying much attention.
- GP · turn 27
I'd also recommend avoiding your triggers where possible. Keep your windows closed on high-pollen days, shower after spending time outdoors, wash your clothes, and consider wearing sunglasses to reduce pollen getting into your eyes.
我也建議您盡可能避開誘發因素。在花粉水平高的日子關上窗戶，外出後淋浴並清洗衣物，也可以考慮佩戴太陽眼鏡，以減少花粉進入眼睛。
- Patient · turn 28
好的，我會試試看。不過工作沒辦法避免接觸灰塵，有沒有什麼方法可以減少影響？
All right. I’ll try that. However, I can’t avoid dust at work. Is there any way to reduce its effects?
- GP · turn 29
You could wear a properly fitted P2 face mask when you're working in dusty environments, and speak with your employer about improving ventilation if possible.
在多塵環境工作時，您可以佩戴尺寸合適並正確貼合面部的P2口罩；如果可行，也可以與僱主商討改善通風。
- Patient · turn 30
明白。我會跟主管商量，也會開始戴口罩。
I understand. I’ll discuss it with my supervisor and start wearing a mask.
- GP · turn 31
I'd also like to arrange an allergy test if your symptoms don't improve after four to six weeks of treatment. That may help us identify exactly what you're allergic to.
如果接受四至六星期治療後症狀仍未改善，我也想為您安排過敏測試。這可能有助於我們確定您究竟對甚麼過敏。
- Patient · turn 32
好的，我願意做檢查。我也想知道到底是不是對花粉，還是對貓的皮屑過敏。
All right. I’m willing to undergo the test. I’d also like to know whether I’m allergic to pollen or cat dander.
- GP · turn 33
Finally, if you develop a high fever, severe facial pain, thick green nasal discharge or swelling around your eyes, you should seek medical attention promptly because those symptoms could suggest sinusitis or another complication rather than simple hay fever.
最後，如果您出現高燒、嚴重面部疼痛、濃稠綠色鼻涕或眼睛周圍腫脹，應該立即求醫，因為這些症狀可能表示患有鼻竇炎或其他併發症，而不只是普通花粉症。
- Patient · turn 34
好的，我明白了。如果只是一般的鼻敏感，我就按時吃藥和使用鼻噴劑；如果出現你剛才說的那些症狀，我會馬上去看醫生。
All right, I understand. If it is only ordinary nasal allergy, I’ll take the medication and use the nasal spray as directed. If I develop any of the symptoms you just mentioned, I’ll see a doctor immediately.
- GP · turn 35
Excellent. I'll print your prescription and give you an information sheet about managing allergic rhinitis. Please make another appointment in about six weeks so we can review how you're responding to treatment.
很好。我會列印您的處方，並給您一份有關管理過敏性鼻炎的資料。請預約大約六星期後再來覆診，讓我們檢視您對治療的反應。
- Patient · turn 36
謝謝醫生，希望這次真的可以改善。我會按照你的建議做，也會按時回來覆診。
Thank you, doctor. I hope it genuinely improves this time. I’ll follow your advice and return for my follow-up appointment as scheduled.
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