A Double-Blind, Randomized, Placebo-Controlled Trial of Acupuncture for the Treatment of Childhood Persistent Allergic Rhinitis
Kwong Wah Hospital, Hong Kong, 00, Hong Kong PEDIATRICS
(Impact Factor: 5.47).
12/2004; 114(5):1242-7. DOI: 10.1542/peds.2004-0744
To compare active acupuncture with sham acupuncture for the treatment of persistent allergic rhinitis among children.
Subjects with persistent allergic rhinitis were recruited from the pediatric outpatient clinic. They were randomized to receive either active acupuncture or sham acupuncture. Main outcome measures included daily rhinitis scores, symptom-free days, visual analog scale scores for immediate effects of acupuncture, daily relief medication scores, blood eosinophil counts, serum IgE levels, nasal eosinophil counts, patients' and parents' preferences for treatment modalities, and adverse effects.
Eighty-five patients were recruited from the pediatric outpatient clinic at Kwong Wah Hospital, in Hong Kong. Thirteen patients withdrew before randomization; 35 patients (mean age: 11.7 +/- 3.2 years) were randomized to receive active acupuncture for 8 weeks, and 37 patients (mean age: 11 +/- 3.8 years) were randomized to receive sham acupuncture for 8 weeks. Acupuncture was performed twice per week for both groups. Both the assessing pediatricians and the patients were blinded. There were significantly lower daily rhinitis scores and more symptom-free days for the group receiving active acupuncture, during both the treatment and follow-up periods. The visual analog scale scores for immediate improvement after acupuncture were also significantly better for the active acupuncture group. There was no significant difference in the following outcome measures between the active and sham acupuncture groups: daily relief medication scores, blood eosinophil counts, serum IgE levels, and nasal eosinophil counts, except for the IgE levels before and 2 months after acupuncture in the sham acupuncture group. No severe adverse effects were encountered. Numbness, headache, and dizziness were found in both the active and sham acupuncture groups, with no difference in incidence, and the effects were self-limiting.
This study showed that active acupuncture was more effective than sham acupuncture in decreasing the symptom scores for persistent allergic rhinitis and increasing the symptom-free days. No serious adverse effect was identified. A large-scale study is required to confirm the safety of acupuncture for children.
Available from: Raanan Cohen-Kerem
- "c o m / l o c a t e / i j p o r l CAM modalities used in pediatrics encompass a wide range of diverse types of interventions that vary according to the child's age and condition; these may include herbs, homeopathic and nutritional supplements, manual therapies, and mind–body interventions     . Assessment of CAM efficacy in the pediatric population was evaluated in randomized controlled trials in different clinical settings that include homeopathy and various herbs in diarrhea treatment  , hypnotherapy in children with irritable bowel syndrome, acupuncture in relieving persistent allergic rhinitis , herbal treatment in upper respiratory tract infection , otalgia caused by acute otitis media , atopic dermatitis (Chinese medicine) , attention deficit disorder , and other ailments. Potential risks of CAM therapies may include the possibility of toxicity and other side-effects, e.g. "
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Limited data is available about Complementary Alternative Medicine (CAM) use in children attending otolaryngology services. We investigated the pattern of CAM use among children and adolescents attending a pediatric otolaryngology clinic.
A cross-sectional survey. Anonymous questionnaires were administered, prior to doctor's admission, to parents accompanying young patients attending the pediatric otolaryngology clinic. Parents were asked about their general attitude toward CAM and whether they had ever consulted or considered a consultation with a CAM therapist. Subsequently, CAM users were asked to provide details on CAM modalities used and on their overall satisfaction with CAM therapy.
Of 308 questionnaires administered, 294 parents responded (95% response rate). Ninety-four parents (32%) reported considering CAM, or previous or current CAM use. Commonly used CAM treatments were acupuncture (44%), homeopathy (36%), and naturopathy (6.7%). CAM users assessed success rate as being: successful (37%), unsuccessful (24%) or undetermined (39%). Successful treatment was described in terms of cure, improvement and better awareness of the problem being addressed. In most cases parents stated that the primary physician was aware of CAM use by the child (74%).
CAM plays a substantial role among parents of children referred to pediatric otolaryngology consultation. The otolaryngologist awareness of parents’ preference and interest may contribute to decision making regarding pediatric patients’ management. Further investigations regarding CAM are warranted and clinical collaboration with CAM therapists should be considered.
Available from: Hsing-yu Chen
- "Several TCM treatments have been beneficial for allergic rhinitis, and the results of many studies have outlined the possible mechanisms for suppressing allergic reactions     . Nonetheless, the effectiveness of different TCM treatments is still unclear because no large-scale survey on TCM pattern differentiation of allergic rhinitis has yet been done. "
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ABSTRACT: Pattern, or "zheng," differentiation is the essential guide to treatment with traditional Chinese medicine (TCM). However, the considerable variability between TCM patterns complicates evaluations of TCM treatment effectiveness. The aim of this study was to explore and characterize the relationship between patterns and the core patterns of allergic rhinitis. We summarized 23 clinical trials of allergic rhinitis with mention of pattern differentiation; association rule mining was used to analyze TCM patterns of allergic rhinitis. A total of 205 allergic rhinitis patients seen at Chang Gung Memorial Hospital from March to June 2005 were included for comparison. Among the 23 clinical trials evaluated, lung qi deficiency and spleen qi deficiencies were the core patterns of allergic rhinitis, accounting for 29.50% and 28.98% of all patterns, respectively. A higher prevalence of lung or spleen qi deficiency (93.7%) was found in Taiwan. Additionally, patients with lung or spleen qi deficiency were younger (27.99 ± 12.94 versus 58.54 ± 12.96 years) and the severity of nasal stuffiness was higher than among patients with kidney qi deficiency (1.35 ± 0.89 versus 0.62 ± 0.65; P < 0.05). Lung and spleen qi deficiencies are the core patterns of allergic rhinitis and determining the severity of nasal stuffiness is helpful in differentiating the TCM patterns.
Available from: Chun-Chuan Shih
- "The four-agent decoction (i.e., Si Wu Tang) therapy  and other TCM herbal medicine formulas  demonstrate adequate effectiveness in reducing the menstrual pain associated with primary dysmenorrhoea. TCM in Taiwan, as in other countries, is not the principal source of medical care; however, the market for and effectiveness of TCM should not be ignored . Because of the association between age at menarche and body mass index later in life, we adjusted the final model for children's body mass index . "
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ABSTRACT: Traditional Chinese medicine (TCM) utilization is common in Asian countries. Limited studies are available on the socioeconomic status (SES) associated with TCM use among the pediatric population. We report on the association between SES and TCM use among children and adolescents in Taiwan.
A National Health Interview Survey was conducted in Taiwan in 2001 that included 5,971 children and adolescents. We assessed the children's SES using the head of household's education, occupation and income. This information was used to calculate pediatric SES scores, which in turn were divided into quartiles. Children and adolescents who visited TCM in the past month were defined as TCM users.
Compared to children in the second SES quartile, children in the fourth SES quartile had a higher average number of TCM visits (0.12 vs. 0.06 visits, p = 0.027) and higher TCM use prevalence (5.0% vs. 3.6%, p = 0.024) within the past month. The adjusted odds ratio (OR) for TCM use was higher for children in the fourth SES quartile than for those in the first SES quartile (OR 1.49; 95% confidence interval [CI] 1.02-2.17). The corresponding OR was 2.17 for girls (95% CI 1.24-3.78). The highest-SES girls (aged 10-18 years) were most likely to visit TCM practices (OR 2.47; 95% CI 1.25-4.90).
Children and adolescents with high SES were more likely to use TCM and especially girls aged 10-18 years. Our findings point to the high use of complementary and alternative medicine among children and adolescents.
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