Acupuncture for Rhinitis / HayfeverIn 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.
- Brinkhaus B, Ortiz M, Witt CM, Roll S, Linde K, Pfab F, Niggemann B, Hummelsberger J, Treszl A, Ring J, Zuberbier T, Wegscheider K, Willich SN. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. Ann Intern Med. 2013 Feb 19;158(4):225-34. doi: 10.7326/0003-4819-158-4-201302190-00002.
- Choi SM, Park JE, Li SS, Jung H, Zi M, Kim TH, Jung S, Kim A, Shin M, Sul JU, Hong Z, Jiping Z, Lee S, Liyun H, Kang K, Baoyan L. A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis. Allergy. 2013 Mar;68(3):365-74. doi: 10.1111/all.12053. Epub 2012 Dec 18.
- Cao WZ, Pang WR, Xuan ZD. [Allergic rhinitis treated with acupuncture and the triple-strong stimulation therapy at dazhui (GV 14): a randomized controlled trial]. Zhongguo Zhen Jiu. 2014 Feb;34(2):110-4. [Article in Chinese]
- Hauswald B, Dill C, Boxberger J, Kuhlisch E, Zahnert T, Yarin YM. The effectiveness of acupuncture compared to loratadine in patients allergic to house dust mites. J Allergy (Cairo). 2014;2014:654632. doi: 10.1155/2014/654632. Epub 2014 Jun 5.
- Lee MS, Pittler MH, Shin BC, Kim JI, Ernst E. Acupuncture for allergic rhinitis: a systematic review. Ann Allergy Asthma Immunol. 2009 Apr;102(4):269-79; quiz 279-81, 307. doi: 10.1016/S1081-1206(10)60330-4. Review.
- McDonald JL1, Cripps AW, Smith PK, Smith CA, Xue CC, Golianu B. The anti-inflammatory effects of acupuncture and their relevance to allergic rhinitis: a narrative review and proposed model. Evid Based Complement Alternat Med. 2013;2013:591796. doi: 10.1155/2013/591796. Epub 2013 Feb 14.
- John Leslie McDonald, PhD *; Peter K. Smith, PhD *; Caroline A. Smith, PhD y; Charlie Changli Xue, PhD z; Brenda Golianu, MDx; Allan W. Cripps, PhD *; the Mucosal Immunology Research Group. Effect of acupuncture on house dust mite specific IgE, substance. Ann Allergy Asthma Immunol 116 (2016) 497e505.
P, and symptoms in persistent allergic rhinitis.
- Ng DK, Chow PY, Ming SP, Hong SH, Lau S, Tse D, Kwong WK, Wong MF, Wong WH, Fu YM, Kwok KL, Li H, Ho JC. A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. - Pediatrics - ; 114 (5); 1242-7
- Passalacqua G, Bousquet PJ, Carlsen KH, Kemp J, Lockey RF, Niggemann B, Pawankar R, Price D, Bousquet J. ARIA update: I--Systematic review of complementary and alternative medicine for rhinitis and asthma. J Allergy Clin Immunol. 2006 May;117(5):1054-62. Review.
- Roberts J, Huissoon A, Dretzke J, Wang D, Hyde C. A systematic review of the clinical effectiveness of acupuncture for allergic rhinitis. BMC Complement Altern Med. 2008 Apr 22;8:13. doi: 10.1186/1472-6882-8-13.
- Xue, Charlie Changli; Zhang, Claire Shuiqing; Yang, Angela Weihong; Zhang, Anthony Lin; Li, Yunying; Xia, Jiyan; Da Costa, Cliff; Owe-Young, George; Thien, Francis. Semi-self-administered ear acupressure for persistent allergic rhinitis: a randomised sham-controlled trial. Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 106.2 (Feb 2011): 168-70.
- Zhang CS, Xia J, Zhang AL, Yang AW, Thien F, Li Y, Wu D, Cai J, DaCosta C, Xue CC. Ear acupressure for perennial allergic rhinitis: A multicenter randomized controlled trial. Am J Rhinol Allergy. 2014 Jul-Aug;28(4):e152-7. doi: 10.2500/ajra.2014.28.4081.