Abstract
BackgroundCatgut implantation at acupoints has been used in China to treat allergic rhinitis (AR) for a long time. However, its efficacy and safety in the treatment of AR is controversial due to the poor quality of the clinical trial of this therapy. This study aims to identify whether catgut implantation at acupoints is indeed an effective and safe treatment for patients with persistent or intermittent allergic rhinitis (PER or IAR) by comparing with sham catgut implantation treatment.Methods and designThis study compares real versus sham catgut implantation at acupoints in 242 patients with a history of PER or IAR and with a positive skin prick test (SPT). The trial will be conducted in the Teaching Hospital of Chengdu University of Traditional Chinese Medicine. In the study, patients will be randomly assigned by computer-generated randomization list into two groups and assessed prior to treatment. Then, they will receive two sessions of treatments (once per 2 weeks) for 4 consecutive weeks and have a follow-up phase of 12 weeks. The administration of catgut implantation (or sham-control) at acupoints follows the guidelines for clinical research on acupuncture (WHO Regional Publication, Western Pacific Series No.15, 1995), and is performed double-blindly by a well-trained physician in acupuncture. The main outcome measures include the primary and secondary indicators. Primary indicators are subjective symptoms scores evaluated by visual analogue scales (VAS) and Rhinoconjunctivitis Quality of Life Questionnaires (RQLQ). The secondary indicators are the results of laboratory examinations, such as serum allergen-specific IgE, nasal inflammatory cells counts (mast cells, eosinophils, and T cells) and nitric oxide concentration in nasal excretion. The use of anti-allergic medication will also be recorded as one of the secondary indicators. Furthermore, adverse events will be recorded and analyzed. If any participants withdraw from the trial, intention-to-treat analysis (ITT) and per-protocol (PP) analysis will be performed.DiscussionThe important features of this trial include the randomization procedures, large sample, and a standardized protocol of catgut implantation at acupoints. This trial will be the first study with a high evidence level in China in order to assess the efficacy and safety of catgut implantation at acupoints in treatment of AR following a randomized, double-blind sham-controlled method.Trial registrationChinese Clinical Trial Registry: ChiCTR-TRC-12002191
Highlights
Catgut implantation at acupoints has been used in China to treat allergic rhinitis (AR) for a long time
The important features of this trial include the randomization procedures, large sample, and a standardized protocol of catgut implantation at acupoints. This trial will be the first study with a high evidence level in China in order to assess the efficacy and safety of catgut implantation at acupoints in treatment of AR following a randomized, double-blind sham-controlled method
AR has become a major health problem worldwide. It has been estimated by the ARIA (Allergic Rhinitis and its Impact on Asthma) 2008 document that over 600 million patients from all countries, in all ethnic groups, and of all ages suffer from AR [1]
Summary
Catgut implantation at acupoints has been used in China to treat allergic rhinitis (AR) for a long time. This study aims to identify whether catgut implantation at acupoints is an effective and safe treatment for patients with persistent or intermittent allergic rhinitis (PER or IAR) by comparing with sham catgut implantation treatment. Allergic rhinitis (AR) is an IgE-mediated immune disease triggered by allergens with symptoms of nasal obstruction, itching, watery rhinorrhea, and sneezing. AR has become a major health problem worldwide. It has been estimated by the ARIA (Allergic Rhinitis and its Impact on Asthma) 2008 document that over 600 million patients from all countries, in all ethnic groups, and of all ages suffer from AR [1]. In China, the prevalence of allergic rhinitis has increased to 24.6% in 2007 according to the epidemiological study in 11 major cities in China [2]. The prevalence of asthma in patients with rhinitis could reach up to 40%, and the majority of patients with asthma experience rhinitis symptoms [1]
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