Acupuncture for Rhinitis / Hayfever

In a randomised sham controlled trial of 151 individuals (McDonald 2016) acupuncture modulated mucosal immune response in the upper airway in adults with persistent allergic rhinitis. This modulation appears to be associated with down-regulation of allergen specific IgE for house dust mite, which this study is the first to report. Improvements in nasal itch, eye itch, and sneezing after acupuncture are suggestive of down-regulation of transient receptor potential vanilloid 1.

Cao (2014) found in a randomised controlled trial (n=120) that symptoms including nasal itching, nasal blockage, sneezing and rhinorrhoea decreased significantly in three therapy groups: (1) acupuncture on four points, (2) acupuncture plus Loratadine (3) acupuncture/moxibustion/cupping on one point (Dazhui/GV14), with the latter showing the highest improvement. 

A significant improvement in symptoms was also observed by Hauswald (2014) in a randomised study (n=24) comparing acupuncture with Loratadine. The acupuncture group had prolonged improvement 10 weeks after the therapy was stopped while the Loratadine group reversed to baseline symptoms

Earlier studies which included placebo arms showed little if any difference between sham and real acupuncture (Passalacqua 2006; Roberts, 2008). Nevertheless Passalacqua (2006) gives a C as grade of recommendation for acupuncture in allergic rhinitis. 

Lee and colleagues (2009) conclude from their systematic review that the evidence for the effectiveness of acupuncture for the symptomatic treatment or prevention of AR is mixed. While the results for seasonal AR failed to show specific effects of acupuncture, results for perennial AR provide suggestive evidence of the effectiveness of acupuncture.

More recently Brinkhaus and colleaugues (2013) have performed a multicentre randomised controlled study with three groups of patients (n=422); (1) acupuncture plus rescue medication (cetirizine), (2) sham (same points but shallow needle insertion) acupuncture plus rescue medication (3) rescue medication alone. They concluded that acupuncture led to statistically significant improvements in disease-specific quality of life and antihistamine use measures after 8 weeks of treatment compared with rescue medication alone (however, they questioned the clinical significance). 

Another recent multicentre, randomised parallel controlled study (n=238) found that total nasal symptom score (TNSS) was significantly reduced in the active acupuncture group compared with the sham acupuncture group (minimal acupuncture on nonacupuncture points) and the waiting list group, both sham and real acupuncture patients showed significant improvements in Total Nasal Symptom Scores (TTNS) (Choi 2013). 

Ng and colleagues (2004) performed a DBRPCT in 85 children using active and sham acupuncture, respectively and found significantly lower daily rhinitis scores and more symptom-free days in the group with the active treatment. No significant differences were found for daily relief medication scores, blood eosinophil counts, serum IgE levels and nasal eosinophil counts.
 

References:

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