Acupuncture for allergic rhinitis: a systematic review.
ABSTRACT 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.
SourceAvailable from: Claudia M Witt[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 · 1.88 Impact Factor
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ABSTRACT: Objective Allergic rhinitis (AR) is one of the most common diseases affecting adults. It is the most common chronic disease in children in the United States today and the fifth most common chronic disease in the United States overall. AR is estimated to affect nearly 1 in every 6 Americans and generates $2 to $5 billion in direct health expenditures annually. It can impair quality of life and, through loss of work and school attendance, is responsible for as much as $2 to $4 billion in lost productivity annually. Not surprisingly, myriad diagnostic tests and treatments are used in managing this disorder, yet there is considerable variation in their use. This clinical practice guideline was undertaken to optimize the care of patients with AR by addressing quality improvement opportunities through an evaluation of the available evidence and an assessment of the harm-benefit balance of various diagnostic and management options.Otolaryngology Head and Neck Surgery 02/2015; 152(1 Suppl):S1-S43. DOI:10.1177/0194599814561600 · 1.72 Impact Factor
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ABSTRACT: Rhinitis is a common medical condition and can seriously impact patients' quality of life. The objective of this study was to investigate the association between disease-specific quality of life and use of complementary and alternative medicine (CAM) modalities among Taiwanese rhinitis patients. A cross-sectional survey was undertaken at the outpatient department of otolaryngology in a medical center in Taiwan. Sociodemographic information, disease-specific quality of life (Chinese version of the 31-item Rhinosinusitis Outcome Measure, CRSOM-31), and previous use of CAM modalities for treatment of rhinitis of the patients were ascertained. Factor analysis was performed to reduce the number of CAM modalities. The resulting factors were analyzed for their association with CRSOM-31 score using linear regression analyses. Results from the multiple linear regression analyses indicated that Factor 1 (traditional Chinese medicine), Factor 2 (mind-body modalities), Factor 3 (manipulative-based modalities), female sex, and smoking were significantly associated with a worse disease-specific quality of life. In conclusion, various CAM modalities, female sex, and smoking were independent predictors of a worse disease-specific quality of life in Taiwanese patients with rhinitis.Evidence-based Complementary and Alternative Medicine 10/2014; 2014:958524. DOI:10.1155/2014/958524 · 2.18 Impact Factor