To systematically evaluate the effectiveness of acupuncture for treating or preventing allergic rhinitis (AR).
We retrieved data from 17 electronic databases, nonelectronic searches of conference proceedings, our own files of articles, and bibliographies of located articles.
All randomized clinical trials (RCTs) of acupuncture for AR were considered for inclusion if they included placebo controls or were controlled against a comparator intervention.
One hundred fifteen possibly relevant studies were identified and 12 RCTs met our inclusion criteria. The methodologic quality of the individual trials was variable. Our review includes 7 trials of high quality that met standards of methodologic rigor. All RCTs tested the effectiveness of acupuncture on AR symptoms and none on its curative value. Three RCTs failed to show superiority of acupuncture for treating or preventing symptoms for seasonal AR compared with placebo acupuncture. For perennial AR, 1 study reported favorable effects of acupuncture on a rhinitis symptoms score and 1 found positive results for a nasal symptoms score compared with placebo acupuncture (n = 152; standard mean difference, 0.45; 95% confidence interval, 0.13-0.78; P = .006; heterogeneity: chi2 = 0.45, P = .50, I2 = 0%). Two RCTs compared acupuncture with oral pharmacologic medications. Their results were in favor of acupuncture.
The evidence for the effectiveness of acupuncture for the symptomatic treatment or prevention of AR is mixed. The results for seasonal AR failed to show specific effects of acupuncture. For perennial AR, results provide suggestive evidence of the effectiveness of acupuncture.
"Over the past decade an increasing number of randomised controlled trials have been conducted to determine the efficacy or effectiveness of acupuncture in patients with allergic rhinitis. As shown by previous systematic reviews of acupuncture for the treatment of allergic rhinitis, the evidence on the specific effects of acupuncture is still inconclusive [1,2]. The trials included in those reviews have suffered from a variety of methodological limitations, such as small patient numbers or the lack of a sham-acupuncture control group. "
[Show abstract][Hide abstract] ABSTRACT: In a large randomised trial in patients with seasonal allergic rhinitis (SAR), acupuncture was superior compared to sham acupuncture and rescue medication. The aim of this paper is to describe the characteristics of the trial's participating physicians and to describe the trial intervention in accordance with the STRICTA (Standards for Reporting Interventions in Controlled Trials of Acupuncture) guidelines, to make details of the trial intervention more transparent to researchers and physicians.
ACUSAR (Acupuncture in Seasonal Allergic Rhinitis) was a three-armed, randomised, controlled multicentre trial. 422 SAR patients were randomised to semi-standardised acupuncture plus rescue medication (RM, cetirizine), sham acupuncture plus RM or RM alone. We sent a questionnaire to trial physicians in order to evaluate their characteristics regarding their education about and experience in providing acupuncture. During the trial, acupuncturists were asked to diagnose all of their patients according to Chinese Medicine (CM) as a basis for the semi-standardised, individualized intervention in the acupuncture group. Every acupuncture point used in this trial had to be documented after each session RESULTS: Acupuncture was administered in outpatient clinics by 46 (mean age 47 +/- 10 years; 24 female/ 22 male) conventionally-trained medical doctors (67% with postgraduate specialization such as internal or family medicine) with additional extensive acupuncture training (median 500 hours (1st quartile 350, 3rd quartile 1000 hours with 73% presenting a B-diploma in acupuncture training (350 hours)) and experience (mean 14 years in practice). The most reported traditional CM diagnosis was 'wind-cold invading the lung' (37%) and 'wind-heat invading the lung' (37%), followed by 'lung and spleen qi deficiency' (9%). The total number of needles used was higher in the acupuncture group compared to the sham acupuncture group (15.7 +/- 2.5 vs. 10.0 +/- 1.6).
The trial interventions were provided by well educated and experienced acupuncturists. The different number of needles in both intervention groups could be possibly a reason for the better clinical effect in SAR patients. For future trials it might be more appropriate to ensure that acupuncture and sham acupuncture groups should each be treated by a similar number of needles.Trial registration: ClinicalTrials.gov: NCT00610584.
BMC Complementary and Alternative Medicine 04/2014; 14(1):128. DOI:10.1186/1472-6882-14-128 · 2.02 Impact Factor
"Acupuncture has been used widely in East Asia and Europe for the treatment of various kinds of diseases, including rhinitis. In a systematic review that evaluated the clinical effectiveness of acupuncture for treating or preventing allergic rhinitis in 2009, acupuncture was found to be ineffective in the treatment of seasonal AR; however, acupuncture was shown to be effective for the treatment of perennial AR . Recently, acupuncture treatment was shown to be effective in improving the symptoms of patients with persistent allergic rhinitis complicated by rhinosinusitis and asthma . "
[Show abstract][Hide abstract] ABSTRACT: Non-allergic rhinopathy (NAR), formerly known as vasomotor rhinitis, is a non-allergic and non-infectious chronic disease that is accompanied by nasal hyperemia, rhinorrhea, and no increase in the number of eosinophils. Although the medications for NAR, including intranasal corticosteroids and intranasal antihistamine, have been used in clinical practice, given the relative paucity of effective therapy with available medications, alternative non-pharmacologic treatments could play an important role in treating NAR. Acupuncture treatment is representative potential alternative therapy for the treatment of various diseases, including rhinitis. Therefore, the objective of this study was to evaluate the efficacy of pricking blood at Neiyingxiang (ExHN 9) relative to acupuncture treatment at Waiyingxiang (LI 20) in patients with NAR.
A randomized, parallel-group, controlled, assessor single-blinded, trial will be conducted. Fifty participants with NAR will be randomized into one of two groups: either the control group with acpuncture treatment at LI 20 or the experimental group with pricking blood at ExHN 9. After randomization, a total of three sessions of treatment will be performed once a week in both groups. The total nasal symptom score (TNSS) and the Mini-Rhinoconjunctivitis Quality-of-Life Questionnaire (MiniRQLQ) at baseline and the end of the trial will be used to evaluate the efficacy of each treatment.
This study will be the first randomized trial to evaluate the efficacy of pricking blood for the treatment of NAR. The results of this study will help establish an alternative approach for treating patients with NAR that do not respond to Western medication.
"Although firm evidence has not been established, acupuncture has been used by patients with AR. The results of our systematic review of six randomised controlled trials (RCTs) on acupuncture for PER revealed that acupuncture had a favourable effect on AR symptom scores compared to placebo acupuncture (standardised mean difference: 0.45, 95% CI: 0.13 – 0.78) . However, the results of our review on the efficacy of acupuncture in the treatment of AR were inconclusive, consistent with other studies [10,11]. "
[Show abstract][Hide abstract] ABSTRACT: Allergic rhinitis is one of the most common health complaints worldwide. Complementary and alternative medical approaches have been employed to relieve allergic rhinitis symptoms and to avoid the side effects of conventional medication. Acupuncture has been widely used to treat patients with allergic rhinitis, but the available evidence of its effectiveness is insufficient. Our objective is to evaluate the effectiveness of acupuncture in patients in Korea and China with persistent allergic rhinitis compared to sham acupuncture treatment or waitlist control.
This study consists of a multi-centre (two centres in Korea and two centres in China), randomised, controlled trial with three parallel arms (active acupuncture, sham acupuncture, and waitlist group). The active acupuncture and sham acupuncture groups will receive real or sham acupuncture treatment, respectively, three times per week for a total of 12 sessions over four weeks. Post-treatment follow-up will be performed a month later to complement these 12 acupuncture sessions. Participants in the waitlist group will not receive real or sham acupuncture treatments during this period but will only be required to keep recording their symptoms in a daily diary. After four weeks, the same treatment given to the active acupuncture group will be provided to the waitlist group.
This trial will provide evidence for the effectiveness of acupuncture as a treatment for persistent allergic rhinitis. The primary outcome between groups is a change in the self-reported total nasal symptom score (i.e., nasal obstruction, rhinorrhea, sneezing, and itching) from baseline at the fourth week. Secondary outcome measures include the Rhinitis Quality of Life Questionnaire score and total non-nasal symptom score (i.e., headache, itching, pain, eye-dropping). The quantity of conventional relief medication used during the follow-up period is another secondary outcome measure.
Current Controlled Trials ISRCTN90807007.
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