Total Non-nasal Symptom Score Research Articles

Clinical Effect Analysis of Fire-needle Acupuncture at Neiyingxiang Treating Persistent Allergic Rhinitis.

We conducted the first trial to evaluate the effect that fire-needle acupuncture at Neiyingxiang (ExHN 9) in patients with moderate to severe persistent AR. This was a randomized, single-center, sham, and placebo-controlled rial. Patients were kept blinded to their group assignment. All participants were equally assigned to the fire-needle acupuncture (FA) treatment group, sham fire-needle acupuncture (SFA) group, or loratadine group. The trial was designed with an acupuncture intervention once a week for 4 weeks and follow-up 4 weeks. The Total Nasal Symptom Scores (TNSS), Total Non-Nasal Symptom Scores (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), Allergic Rhinitis Control Test (ARCT), and total nasal resistance of 150 Pa were evaluated as outcome measures. A total of 180 participants were enrolled, and 175 participants completed the trials. At 2 and 4 weeks, the TNSS, TNNSS, and RQLQ scores of the FA and loratadine groups were significantly lower than those of the SFA group. At 8 weeks, the scores of loratadine group increased compared with the FA group (Cohen's d >0.80, p < 0.01). The ACRT score of the FA treatment group rose gradually. After treatment, the total nasal resistance of the FA group was significantly decreased and was lower than that of the other two groups (Cohen's d >0.80, p < 0.01). Fire-needle acupuncture at Neiyingxiang (ExHN 9) is effective for improving nasal allergy symptoms and quality of life in patients with moderate and severe persistent AR, and the duration of its effects is long. 2 Laryngoscope, 2024.

Probiotic Lactobacillus plantarum GUANKE effectively alleviates allergic rhinitis symptoms by modulating functions of various cytokines and chemokines.

Currently, the prevalence of allergic rhinitis (AR) remains high and there is a great need to develop better and safer ways to alleviate AR symptoms. The Lactobacillus plantarum GUANKE probiotic was reported as an immunomodulator through maintaining Th1/Th2 balance. This study aimed to determine the efficacy of GUANKE in AR subjects. Adults aged from 18 to 60 years old and previously suffered from AR were recruited and received GUANKE probiotics treatment for 4 weeks. The questionnaires of Total nasal symptom scores (TNSS), total non-nasal symptom score (TNNSS), and rhinitis control assessment test (RCAT) were used to assess the effectiveness before and after treatment. The serum allergen-specific IgE and cytokines were also determined at baseline and after 4 weeks of probiotics administration. The results showed that TNSS and TNNSS were significantly reduced and the RCAT score was significantly increased compared to baseline. The sub-symptom score of rhinorrhea, itching, sneezing, and tearing in each questionnaire also showed significant changes, and the serum IgE level was markedly decreased. We further measured inflammatory-related proteins in serum and found that a total of 20 proteins (6 upregulated and 14 downregulated) were significantly changed compared to baseline, including IL-4, IL-7, IL-20, IL-33, CXCL1, CXCL5, CXCL6, CXCL11, CCL4, CCL23, TGF-alpha, LAP-TGF-beta-1, MMP-1, MMP-10, AXIN1, NT-3, OSM, SCF, CD6, and NRTN. Enrichment analysis showed that these significantly altered proteins were mainly enriched in cytokine and chemokine-related signaling pathways. Taken together, this study demonstrated the Lactobacillus plantarum GUANKE can serve as an effective immunobiotic for the treatment of AR, which is realized through maintaining the Th1/Th2 balance by modulating the functions of various cytokines and chemokines.

Observation of the long-term clinical efficacy of "Fuyang Guben" acupuncture-moxibustion therapy on perennial allergic rhinitis and its effects on the total IgE and IL-4 in the serum

To investigate the long-term clinical efficacy and safety of "Fuyang Guben" (supporting yang and consolidating root) acupuncture-moxibustion therapy on perennial allergic rhinitis (PAR), and to explore its functioning mechanism. The patients with PAR were randomly divided into acupuncture + western medicine group (n=30) and western medicine group (n=30). In the western medicine group, fluticasone propionate nasal spray was administered, one spray in each nostril in one treatment, once a day, for 6 weeks. On the basis of the western medicine group, fuyangguben acupuncture-moxibustion therapy was supplemented. Acupuncture was applied to Shangxing (GV23), Yintang (GV24+), and bilateral Yingxiang (LI20), Shangyingxiang (EX-HN8), Sibai (ST2), Hegu (LI4) and Chize (LU5); warm needling was applied at Dazhui (GV14). The patients of this group received 30 min of acupuncture-moxibustion therapy 3 times weekly during the first 4 weeks and twice a week in the last 2 weeks, totally for 6 weeks. Before treatment, after treatment, in week 10, 18 and 30 of follow-up visits, the reflective total nasal symptom score (rTNSS), the total non-nasal symptom score (TNNSS), the total ophthalmic symptom score (TOSS), and the score of the rhinitis quality of life (RQLQ) scale were compared in the patients of the two groups separately. Using ELISA, the serum concentrations of total immunoglobulin E (IgE) and interleukin-4 (IL-4) were detected before and after treatment. After treatment, the rTNSS, TNNSS, TOSS, as well as RQLQ score were lower in comparison with those before treatment in each group (P<0.05).The rTNSS, TNNSS, TOSS and the score of RQLQ in the week 10, 18 and 30 of follow-up visits were reduced when compared with those before treatment in each group (P<0.05), and these scores in the acupuncture + western medicine group were remarkably lower than those of the western medicine group (P<0.05). After treatment, the serum contents of total IgE and IL-4 were significantly decreased when compared with those before treatment in the acupuncture + western medicine group (P<0.05), and these indicators in the acupuncture + western medicine group were lower than those of the western medicine group (P<0.05). On the base of treatment with fluticasone propionate nasal spray, "Fuyang Guben" acupuncture-moxibustion therapy is safe and effective on PAR, presenting a remarkably long-term efficacy. The functioning mechanism may be related to the down-regulation of total IgE and IL-4 in serum.

Modified acupuncture at sphenopalatine ganglion for allergic rhinitis: a randomized controlled trial

To observe the effect of modified acupuncture at sphenopalatine ganglion for allergic rhinitis (AR).A total of 80 patients with AR were randomly divided into an observation group and a control group, 40 cases in each group. In the observation group, modified acupuncture at sphenopalatine ganglion was given, 30 min each time, 2 times a week and with an interval of 3-4 days. In the control group, budesonide nasal spray was given. Both groups were treated for 4 weeks. The total nasal symptom score (TNSS) and total non-nasal symptom score (TNNSS) were observed before treatment, after first treatment, after last treatment and 4 weeks after treatment; the scores of visual analogue scale (VAS) and rhinoconjunctivitis quality of life questionnaire (RQLQ) were observed before treatment, after last treatment and 4 weeks after treatment; the recurrence condition was evaluated 4 weeks after treatment; the clinical efficacy was evaluated after last treatment in the two groups.Compared with before treatment, the total scores and each score of TNSS, TNNSS scores after first treatment, after last treatment and 4 weeks after treatment were decreased in both groups (P<0.01, P<0.05). After first treatment, the total score, stuffy nose score, itchy nose score of TNSS and TNNSS score in the observation group were lower than the control group (P<0.01, P<0.05). After last treatment, the total score, stuffy nose score, itchy nose score of TNSS in the observation group were lower than the control group (P<0.01). Four weeks after treatment, the total score and each score of TNSS, TNNSS score in the observation group were lower than the control group (P<0.01, P<0.05). Compared with before treatment, the scores of VAS and RQLQ after last treatment and 4 weeks after treatment were decreased in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01). The recurrence rate was 13.5% (5/37) in the observation group, which was lower than 44.8% (13/29) in the control group (P<0.01). The total effective rate was 92.5% (37/40) in the observation group, which was higher than 72.5% (29/40) in the control group (P<0.05).Modified acupuncture at sphenopalatine ganglion could effectively improve symptoms and quality of life in patients with AR, and the recurrence rate is lower.目的：观察改良针刺蝶腭神经节对变应性鼻炎的影响。方法：将80例变应性鼻炎患者随机分为观察组和对照组，每组40例。观察组采用改良针刺蝶腭神经节治疗，每次30 min，每周2次，间隔3~4 d；对照组给予布地奈德鼻喷雾剂喷鼻。两组均连续治疗4周。观察两组患者治疗前、第1次治疗后、末次治疗后及疗程结束后4周鼻症状总分（TNSS）、鼻炎伴随症状总分（TNNSS），治疗前、末次治疗后及疗程结束后4周视觉模拟量表（VAS）、鼻结膜炎生活质量问卷（RQLQ）评分，于疗程结束后4周评估两组复发情况。于末次治疗后评定两组临床疗效。结果：第1次治疗后、末次治疗后和疗程结束后4周，两组患者TNSS总分及各分项评分、TNNSS评分均较治疗前降低（P<0.01，P<0.05）。第1次治疗后，观察组患者TNSS总分及鼻塞、鼻痒评分，TNNSS评分低于对照组（P<0.01，P<0.05）；末次治疗后，观察组患者TNSS总分及鼻塞、鼻痒评分低于对照组（P<0.01）；疗程结束后4周，观察组TNSS总分及各分项评分、TNNSS评分均低于对照组（P<0.01，P<0.05）。末次治疗后和疗程结束后4周，两组患者VAS、RQLQ评分均较治疗前降低（P<0.01），且观察组低于对照组（P<0.01）。观察组复发率为13.5%（5/37），低于对照组的44.8%（13/29，P<0.01）。观察组总有效率为92.5%（37/40），高于对照组的72.5%（29/40，P<0.05）。结论：改良针刺蝶腭神经节能有效缓解变应性鼻炎患者症状、改善生活质量，且复发率低。.

Effects of acupuncture on serum IL-4, IL-6 and IL-10 in patients with allergic rhinitis

To observe and compare the clinical efficacy on allergic rhinitis and the impacts on the expression of serum interleukin-4 (IL-4), interleukin-6 (IL-6) and interleukin-10 (IL-10) between intranasal acupuncture and routine acupuncture. According to the random number table method, 80 patients of allergic rhinitis were divided into an intranasal acupuncture group (40 cases) and a routine acupuncture group (40 cases). In the intranasal acupuncture group, Neiyingxiang (EX-HN9) and Biqiu (Extra) were punctured. In the routine acupuncture group, Yingxiang (LI20, bilateral), Yintang (GV24~+), Shangxing (GV23) and Hegu (LI4, bilateral) were stimulated. In both groups, the treatment was given once daily, for 2 weeks. The total nasal symptom score (TNSS), the total non-nasal symptom score (TNNSS) and rhinoconjunctivitis quality of life questionnaire (RQLQ) score were observed before and after treatment; the contents of IL-4, IL-6 and IL-10 in serum were determined by enzyme linked immunosorbent assay. Compared with the values before the treatment, the scores of TNSS, TNNSS and RQLQ, as well as the contents of serum IL-4 and IL-6 were all decreased after treatment in the two groups (P<0.05), while the content of serum IL-10 was increased (P<0.05). After the treatment, in comparison with the routine acupuncture group, the scores of TNSS, TNNSS and RQLQ, as well as the contents of serum IL-4 and IL-6 were decreased and IL-10 was increased significantly in the intranasal acupuncture group (P<0.05). The total effective rate of the intranasal acupuncture group was 90% (36/40), better than 80% (32/40) of the routine acupuncture group (P<0.05). Intranasal acupuncture can effectively relieve the symptoms of allergic rhinitis, and improve the patient's quality of life, and has a better curative effect than routine acupuncture.

Effect of acupuncture therapy combined with fluticasone propionate in the treatment of persistent allergic rhinitis: study protocol for a randomized controlled trial

BackgroundAllergic rhinitis (AR) is an immunoglobulin E (IgE)-mediated inflammatory response.Persistent allergic rhinitis (PAR) is a subtype of AR, but the treatment of PAR is still a problem. Acupuncture is used as an alternative therapy for AR in clinical practice. The aim of this study is to evaluate the effectiveness of acupuncture therapy combined with fluticasone propionate nasal spray in comparison to fluticasone propionate nasal spray alone in the relief of symptoms for PAR.MethodsThis study is a multicenter, single-blind, randomized controlled trial. A total of 260 eligible patients will be randomly assigned into the treatment group or the control group. The treatment group will receive the nasal fluticasone propionate combined with acupuncture, and the control group will receive fluticasone propionate nasal spray alone for 6 weeks. The primary outcome is the change in the Reflective Total Nasal Symptom Score (rTNSS) from baseline to the end of treatment, and the Total Non Nasal Symptom Score (TNNSS), reflective total ocular symptom score (rTOSS), Rhinitis Quality of Life Questionnaire (RQLQ), use of antiallergic drugs, and the Rhinitis Control Assessment Test (RCAT) are used as secondary outcomes. The participants will be followed up for another 24 weeks after treatment.DiscussionThis clinical trial will be able to provide high level evidence on the acupuncture therapy combined with fluticasone propionate nasal spray in the treatment of PAR.Trial registrationISRCTN Registry, ID: ISRCTN44040506. Registered on 22 July 2020.

The effectiveness of thunder fire moxibustion for treating allergic rhinitis: A protocol for systematic review and meta analysis.

Background:Allergic rhinitis (AR) is a chronic disease, resulting in severe syndromes such as sneezing, itching, nasal blockage, and rhinorrhea. The major medications treating AR cause side effects, while thunder fire moxibustion (TFM) is known as a safe and effective treatment for AR. Thus, this systematic review and meta analysis aims to systematically evaluate the effectiveness and safety of TFM in the treatment of AR.Methods:Nine databases, including Medline, PubMed, Web of Science, Embase, the Cochrane Library, China National Knowledge Infrastructure Database (CNKI), WanFang Database (WF), Chinese Scientific Journal Database (VIP), and Chinese Biomedical Literature Database (CBM) from inception to July 2020 will be searched. In addition, the grey literature and the references of all included literature will be retrieved manually. Reviewers will identify studies, extract data and assess the quality independently. The outcomes of interest include: total nasal symptom score, total non-nasal symptom score, rhinitis quality of life questionnaire, visual analog scale, Laboratory indicators: serum immunoglobulin E, immunoglobulin A, or immunoglobulin G level and adverse events. Randomized clinical trials will be collected, methodological quality will be evaluated using the Cochrane risk-of-bias assessment tool, and the level of evidence will be rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Meta-analysis will be performed using RevMan5.3.0 software.Results:Because the review is ongoing, no results can be reported.Conclusions:The findings from this review will provide reliable evidence for effectiveness and safety of TFM for AR.Ethics and dissemination:Ethical approval requirements are not necessary for this review. This systematic review and meta analysis will be disseminated online and on paper to help guide the clinical practice better.PROSPERO Registration number:CRD42019141113

Effectiveness and safety of indirect moxibustion for the treatment of allergic rhinitis: A protocol for systematic review and meta-analysis of RCTs.

Background:Allergic rhinitis (AR) is a common allergic disorder worldwide. Western medicine is not optimistic about the therapeutic effect of this disease. However, moxibustion can enhance vital energy or immunity through a great number of clinical trials. Thus, the aim of this systematic review and meta-analysis is to systematically evaluate the effectiveness and safety of indirect moxibustion for treating AR.Methods:We will conduct a comprehensive literature search in Medline, PubMed, Web of Science, Embase, the Cochrane Library, China National Knowledge Infrastructure Database, WanFang Database, Chinese Scientific Journal Database, and Chinese Biomedical Literature Database from inception to August 2020 without any language restriction. In addition, we will retrieve the unpublished studies and the references of initially included literature manually. Reviewers will identify studies, extract data, and assess the quality independently. The outcomes of interest include: total effective rate, total nasal symptom score, total non-nasal symptom score, rhinitis quality of life questionnaire, visual analog scale, laboratory indicators (i.e., serum levels of IgE, IgA, or IgG), and adverse events. Randomized clinical trials will be collected, methodological quality will be evaluated using the Cochrane risk-of-bias assessment tool, and the level of evidence will be rated using the Grading of Recommendations, Assessment, Development and Evaluation approach. Meta-analysis will be performed using RevMan 5.3.0 software. The heterogeneity test will be conducted between the studies, and P < .1 and I2 > 50% are the thresholds for the tests. We will utilize the fixed effects model or the random effects model according to the size of heterogeneity.Results:Because the review is ongoing, no results can be reported.Conclusions:The results of this review will provide reliable evidence for effectiveness and safety of indirect moxibustion for treating AR.Ethics and dissemination:Ethical approval is not required for this study. This systematic review and meta-analysis will be disseminated online and on paper to help guide clinicians.PROSPERO Registration number:CRD42019140944.

A Multicenter Randomized Controlled Pilot Trial Testing the Efficacy and Safety of Pterygopalatine Fossa Puncture Using One Acupuncture Needle for Moderate-to-Severe Persistent Allergic Rhinitis.

Objective To compare the efficacy and safety of pterygopalatine fossa puncture using one acupuncture needle inserted through the temporal fossa (intervention) and Chinese verum acupuncture (VA) in patients with moderate-to-severe persistent allergic rhinitis. Methods The patients were randomized to an intervention group receiving pterygopalatine fossa puncture with one acupuncture needle for 4 weeks (once or twice weekly, 4–8 sessions in total, with a second course performed if required) or to a control group receiving individualized VA for 4 weeks (twice weekly, eight sessions in total). Patients were followed up 4 weeks later. Results Ninety-six participants were assigned to intervention (n = 48) or VA (n = 48) or VA (P > 0.05 in all cases). Compared with the VA, the time to onset of effect in the intervention group was shorter and the duration of effectiveness was longer. The mean clinical waiting time was significantly shorter in the intervention group than in the control group (6.640 ± 3.035 min and 31.19 ± 10.216 min, respectively). The total number of sessions in the VA group was 384; 7 episodes of subcutaneous bleeding occurred but did not require treatment. The total number of sessions in the intervention group was 185. Two cases of subcutaneous bleeding (one of local hematoma during the intervention and the other one of bruising in the palpebra inferior on the day after intervention) resolved upon withdrawal from the study. Conclusions Pterygopalatine fossa puncture using one acupuncture needle resulted in a shorter time to onset of effect, a longer duration of effectiveness, and less clinical waiting time when compared with VA. Though the significant differences for TNSS and TNNSS were shown within intervention and VA groups, there were no differences between the two groups. Although the rate of subcutaneous bleeding was low, these adverse events may influence patient compliance. This trial is registered with ISRCTN21980724.

Efficacy of acupuncture at three nasal acupoints plus acupoint application for perennial allergic rhinitis: A multicenter, randomized controlled trial protocol

BackgroundMany studies have shown the potential therapeutic effect of acupuncture on allergic rhinitis. Most of these studies were limited by low-quality evidence. Preliminary experiments showed that the use of acupuncture at three nasal acupoints plus acupoint application (AAP) achieves a more persistent effect in the treatment of perennial allergic rhinitis than acupuncture alone. In this study, a multicenter, single-blind, randomized controlled trial will be performed, in which acupuncture at nonmeridian acupoints and sham AAP will be used as the control group to evaluate the effect of AAP through long-term observation.MethodsThe trial is designed on the basis of the Consolidated Standards of Reporting Trials 2010 guidelines and Standards for Reporting Interventions in Controlled Trials of Acupuncture. A total of 120 participants with perennial allergic rhinitis will be randomly assigned to a treatment or control group. A specially appointed investigator will be in charge of randomization. The participants in the treatment group will be treated with acupuncture at EX-HN3, LI20, and EX-HN8 thrice per week for a total of 12 sessions. In addition, they will undergo AAP at DU14, BL13, EX-BI, and RN22. The participants in the control group will be treated with sham AAP. The primary outcome will be the change in the Total Nasal Symptom Score from baseline to the completion of 4-week treatment. Secondary outcomes include changes in visual analog scale and total non-nasal symptom scores from baseline to the second and fourth weeks of treatment, as well as 1, 3, and 6 months after the completion of treatment. Peripheral blood IL-4, IL-5, IL-6, IL-8, and IL-10 levels will be measured, and any side effects related to treatment will be observed and recorded.DiscussionIt is expected that this randomized clinical trial will provide evidence to determine the effects of AAP compared with acupuncture at nonmeridian acupoints and sham AAP, particularly the long-term effect. These findings will help improve the clinical application of this technique.Trial registrationAcupuncture-Moxibustion Clinical Trial Registry AMCTR-ICR-18000179. Registered on 12 April 2018.

Therapeutic efficacy observation on acupuncture for persistent allergic rhinitis

To observe the clinical effect of acupuncture for persistent allergic rhinitis (PAR). A total of 154 PAR patients were randomized into a treatment group and a control group, 78 cases in the treatment group received acupuncture at meridian points, while 76 cases in the control group received acupuncture at non-meridian points. The treatment was done every other day, 3 times a week for a total 4 weeks. The total nasal symptom score (TNSS), the total non-nasal symptom score (TNNSS) and the rhinoconjunctivitis quality of life questionnaire (RQLQ) were measured before the treatment and after 2 weeks and 4 weeks of treatment, as well as 1 month and 3 months after the treatment to compare the clinical effect between the two groups. After 4 weeks of treatment, the total effective rate in the treatment group was 92.3%, versus 76.3% in the control group, showing a statistically significant difference (P<0.05). Intra-group comparisons of TNSS, TNNSS and RQLQ scores after 4 weeks of treatment showed statistically significant differences (all P<0.05). Between-group comparisons of TNSS, TNNSS and RQLQ score after 4 weeks of treatment and in follow-up visits showed statistically significant differences (all P<0.05). Acupuncture is effective for PAR, and acupuncture at meridian points can produce a better effect than acupuncture at non-meridian points.

Acupuncture–moxibustion therapy of "banking up original qi and consolidating the foundation" for prevention and treatment of seasonal allergic rhinitis: A randomized controlled trial

ObjectiveTo observe the clinical efficacy of acupuncture–moxibustion therapy of "banking up original qi and consolidating the foundation" for prevention and treatment of seasonal allergic rhinitis. MethodsSixty included patients were divided into two groups according to the random number table method with 30 patients in each group. In acupuncture group, warming-needle moxibustion was carried out at Zúsānlĭ (足三里ST 36), and cone moxibustion on Fùzĭ (附子Radix Aconiti Lateralis Praeparata) cake was conducted at Guānyuán (关元CV 4), Qìhăi (气海CV 6) and Dàzhuī (大椎GV 14). The treatment was conducted in May or June (2 months before the onset of rhinitis in this area). The treatment was carried out for once every other day and three times per week. Treatment for 24 times was considered as 1 course of treatment. No intervention treatment was conducted in control group. The score of rhinitis symptom, the visual analogue scale (VAS) score changes of total nasal symptom score (TNSS) and total non-nasal symptom score (TNNSS) of patients in 2015 and in 2016 were observed, and the clinical efficacy of the two groups was compared. Results(1) The score of rhinitis symptom, the VAS score changes of TNSS and TNNSS in acupuncture group in 2016 declined when compared with the results in 2015, which were 4.57 ± 0.82 vs 9.40 ± 1.89, 13.37 ± 4.01 vs 30.80 ± 4.77 and 15.93 ± 6.30 vs 46.13 ± 9.79 (P < 0.001), the results in acupuncture group after treatment were lower than that in control group at same time, which were 4.57 ± 0.82 vs 7.53 ± 2.06, 13.37 ± 4.01 vs 27.17 ± 6.84,15.93 ± 6.30 vs 35.53 ± 11.69(all P < 0.001). According to comparison, there was no obvious difference in the results in control group at the two time points, which were 8.60 ± 2.39 vs 7.53 ± 2.06, 29.63 ± 6.30 vs 27.17 ± 6.84 and 40.90 ± 12.31 vs 35.53 ± 11.69 (all P > 0.05). (2) The total effective rate was 96.7% (29/30) in acupuncture group and 10% (3/30) in control group, and the difference was statistically significant (P < 0.001). ConclusionAcupuncture–moxibustion therapy of "banking up original qi and consolidating the foundation" was effective on prevention and treatment of seasonal allergic rhinitis.

Sphenopalatine ganglion stimulation with acupuncture for perennial allergic rhinitis: a non-randomized traditional Chinese acupuncture (verum acupuncture) controlled pilot trial

Objective To evaluate the efficacy of sphenopalatine ganglion stimulation with acupuncture for moderate-to-severe perennial allergic rhinitis. Methods A total of 50 patients were recruited into a sphenopalatine ganglion stimulation group and a routine acupuncture group according to order of presentation, with 25 in each group. The sphenopalatine ganglion stimulation group received sphenopalatine ganglion stimulation with filiform needle, 1-2 sessions/week for 4 weeks. The routine acupuncture group received traditional acupuncture, with yingxiang (LI 20), yintang (GV29), fengchi (GB20), fengfu (GB16), zusanli (ST36) as the main points, and yingxiang (LI 20), yintang (GV29), fengchi (GB20), fengfu (GB16), zusanli (ST36) as the adjunct points, 1-2 points from both the main and adjunct points in each session, 2 sessions/week for 4 weeks. The nasal symptom score (2004 version), the total nasal symptom score (TNSS) and the total non-nasal symptom score (TNNSS) were used to evaluate symptom improvement. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to assess the patients’ quality of life. The time to symptom alleviation, duration of symptom alleviation in every session and the recurrence duration during 1 month after the treatment were compared between the two groups. Results After the treatment, the score of the nasal symptom score (99.74 ± 31.89 vs. 196.83 ± 31.22; t=-4.912, P=0.001), TNSS (33.63 ± 12.37 vs. 71.82 ± 19.21; t =-3.463, P=0.003), TNNSS (33.63 ± 12.37 vs. 71.82 ± 19.21, t =-3.463, P=0.003) in the sphenopalatine ganglion stimulation were significant lower than those in the routine acupuncture group. Compared with the routine acupuncture group, the time to symptom alleviation was significant shorter (13.85 ± 4.21 min vs. 45.63 ± 7.87 min; t=-1.763, P=0.008), while the duration of symptom alleviation was significant longer (37.92 ± 9.94 h vs. 3.35 ± 1.23 h; t=7.637, P<0.01) after each session in the sphenopalatine ganglion stimulation group. Four weeks after the treatment, RQLQ score in the sphenopalatine ganglion stimulation group was significant lower than that in the routine acupuncture group (8.48 ± 3.71 vs. 37.68 ± 12.46; F=-7.312, P<0.01). The recurrence duration during 1 month after the treatment in the sphenopalatine ganglion stimulation group was significant longer than that in the routine acupuncture group (4.12 ± 2.15 d vs. 23.53 ± 4.63 d; t=-8.879, P=0.003). Conclusion Sphenopalatine Ganglion stimulation is superior to routine acupuncture in treatment of patients with moderate-to-severe perennial allergic rhinitis. Key words: Rhinitis, allergic, perennial; Acupuncture; Ganglia, parasympathetic; Quality of life

Acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate-to-severe allergic rhinitis

Objective To assess the clinical efficacy of acupuncture at the sphenopalatine ganglion for the treatment of patients with moderate to severe allergic rhinitis. Methods 42 cases of moderate to severe allergic rhinitis patients in Otorhinolaryngology clinic of Tongren Hospital between August 2012 to November 2013 were randomized into a treatment group and a control group. The treatment group was treated by acupuncturing sphenopalatine ganglion, once per week, altogether 4 times. The control group was treated by acupuncturing Fengchi (GB20), Baihui (GV20), Yingxiang (GV29), Shangxing (GV23),Taiyang (EX-HN5), Quchi (LI11) and Zusanli (ST36) was used in the control group, 3 times per week for 4 weeks. The changes of the Total Nasal Symptoms Score (TNSS) and the Total Non-Nasal Symptom Score (TNNSS) were evaluated before and after treatment. The Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) was used to evaluate the quality of life. Results One week after treatment, the scores of TNSS, TNNSS and RQLQ in both groups were significantly improved than before the treatment (treatment group: 5.0[4.0, 6.0] vs. 9.0[7.0, 10.0], 1.0[1.0, 1.5] vs. 3.0[3.0, 3.0], 44.0[35.5, 50.0] vs. 60.0[53.5，75.0]; control group: 6.0[5.5, 8.0] vs. 10.0[8.5, 10.1], 2.0[2.0, 3.0] vs. 3.00[3.0, 3.0], 50.0[45.5, 58.0] vs. 43.0[27.0, 48.0]; all P<0.01); the scores of TNSS, TNNSS and RQLQ 1 week after treatment in the treatment group were significantly improved than those in the control group. The scores of TNSS (2.0[1.0, 3.0] vs. 3.0[2.0, 4.5]), TNNSS (1.0[0.0, 1.0] vs. 2.0[2.0, 3.0]) and RQLQ (24.0[19.0, 29.0] vs. 43.0[27.0, 48.5]) 4 week after treatment in the treatment group were significantly improved than those in the control group (all P<0.01). Conclusions Acupuncture at the sphenopalatine ganglion could relieve the symptoms and improve the quality of life in patients with moderate to severe allergic rhinitis, and show more rapid and persistent therapeutic effect. It may be superior to the common acupuncture. Key words: Rhinitis,allergic; Acupuncture; Ganglia, parasympathetic; Quality of life; Treatment outcome

Comparison of clinical effectiveness of acupuncture and a Western drug on allergic rhinitis: study protocol for a randomized controlled trial

ObjectiveTo compare the efficacy of an acupuncture regimen for persistent allergic rhinitis (PER), aimed at improving a patient's mind or Shen in Traditional Chinese Medicine, to that of a second-generation H1-receptor antagonist, cetirizine hydrochloride. MethodsThis multicenter, randomized, controlled clinical trial on PER will be conducted at three institutions in China. The total study period will be 9 weeks. After a 1-week preparatory screening period, 240 eligible participants with PER will be randomized to receive acupuncture or pharmacotherapy (1: 1) for 4 weeks with a 4-week follow-up. The primary outcome will be changes in 7-day average total nasal symptom score. Secondary outcome measures include rhinoconjunctivitis quality of life questionnaire score and total non-nasal symptom score. ResultsThe presence and seriousness of psychological and emotional impairments should be considered in therapeutic programs for allergic rhinitis. No clinical trial for treating allergic rhinitis via acupuncture regulation of psychological and emotional activities has been reported. ConclusionThe findings of the trial will allow us to determine the effects of the mind (Shen)-regulation treatment approach. We will also be able to confirm if the effects of acupuncture are equivalent to those of the conventional drug cetirizine hydrochloride.

A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis

The aim of this study was to evaluate the efficacy and safety of acupuncture in the treatment for allergic rhinitis. This study was a multicenter, randomized, parallel-controlled study. Participants were randomized to either the active acupuncture, sham acupuncture, or waitlist groups. The active and sham acupuncture groups received acupuncture treatment three times per week for 4 weeks. In the sham group, minimal acupuncture at nonacupuncture points was used. The waitlist group did not receive any acupuncture treatment. Of the 238 participants, 97, 94, and 47 individuals were assigned to the active acupuncture, sham acupuncture, and waitlist group, respectively. After the treatment, the difference in the total nasal symptom score (TNSS) was significantly reduced in the active acupuncture group compared with the sham acupuncture (difference: -1.03, 95% confidence interval [CI]: -1.96, -0.09, P = 0.03) and waitlist (difference: -2.49, 95% CI: -3.68, -1.29, P < 0.0001). The active acupuncture group exhibited a significant change in the total non-nasal symptom score (TNNSS) compared with the waitlist (difference: -0.78, 95% CI: -1.22, -0.34, P = 0.0002), but not the sham acupuncture group (difference; 0.15, 95% CI: -0.21, 0.5, P = 0.56). Both active and sham acupuncture treatments resulted in significant improvements in TNSS and TNNSS compared to baseline. Active acupuncture showed a significantly greater effect on symptoms of allergic rhinitis than either sham acupuncture or no active treatment. The symptoms of allergic rhinitis decreased significantly after treatment in the both acupuncture and sham acupuncture groups. Acupuncture appears to be an effective and safe treatment for allergic rhinitis.

Nasal carbon dioxide for the symptomatic treatment of perennial allergic rhinitis

Brief nasal carbon dioxide insufflation has previously been shown to provide rapid relief of the symptoms of allergic rhinitis. To examine the safety and efficacy of nasal carbon dioxide on the symptoms of perennial allergic rhinitis. This was a randomized, double-blind, placebo-controlled, multicenter, in-clinic study that evaluated 2 flow rates (5 or 10 mL/s) and 2 administration durations (10 or 30 seconds per nostril) for nasal carbon dioxide vs placebo. Study participants rated their symptoms in clinic for 4 hours after administration and then through 24 hours outside the clinic. A total of 348 symptomatic patients with a minimum 2-year history of perennial allergic rhinitis requiring pharmacotherapy were randomized and treated. The mean change in total nasal symptom score from baseline at 30 minutes (the primary end point) showed greater improvement in the nasal carbon dioxide-treated groups compared with placebo. This change was statistically significant in the group treated with 10 mL/s for 10 seconds per nostril: -4.69 carbon dioxide vs -2.00 placebo (P = .03). The effect of a single dose lasted approximately 4 to 6 hours. The mean change from baseline at 30 minutes in total nonnasal symptom score was also statistically significant (-4.06 carbon dioxide vs -2.25 placebo, P = .029) for this group. The most common adverse events were nasal discomfort, lacrimation, and headache. The study provides further evidence that nasal carbon dioxide is a potentially efficacious treatment for the symptoms of allergic rhinitis.

Acupuncture for persistent allergic rhinitis: a multi-centre, randomised, controlled trial protocol

BackgroundAllergic rhinitis is one of the most common health complaints worldwide. Complementary and alternative medical approaches have been employed to relieve allergic rhinitis symptoms and to avoid the side effects of conventional medication. Acupuncture has been widely used to treat patients with allergic rhinitis, but the available evidence of its effectiveness is insufficient. Our objective is to evaluate the effectiveness of acupuncture in patients in Korea and China with persistent allergic rhinitis compared to sham acupuncture treatment or waitlist control.MethodsThis study consists of a multi-centre (two centres in Korea and two centres in China), randomised, controlled trial with three parallel arms (active acupuncture, sham acupuncture, and waitlist group). The active acupuncture and sham acupuncture groups will receive real or sham acupuncture treatment, respectively, three times per week for a total of 12 sessions over four weeks. Post-treatment follow-up will be performed a month later to complement these 12 acupuncture sessions. Participants in the waitlist group will not receive real or sham acupuncture treatments during this period but will only be required to keep recording their symptoms in a daily diary. After four weeks, the same treatment given to the active acupuncture group will be provided to the waitlist group.DiscussionThis trial will provide evidence for the effectiveness of acupuncture as a treatment for persistent allergic rhinitis. The primary outcome between groups is a change in the self-reported total nasal symptom score (i.e., nasal obstruction, rhinorrhea, sneezing, and itching) from baseline at the fourth week. Secondary outcome measures include the Rhinitis Quality of Life Questionnaire score and total non-nasal symptom score (i.e., headache, itching, pain, eye-dropping). The quantity of conventional relief medication used during the follow-up period is another secondary outcome measure.Trial registrationCurrent Controlled Trials ISRCTN90807007

Efficacy of mometasone furoate nasal spray in the treatment of allergic rhinitis. Meta‐analysis of randomized, double‐blind, placebo‐controlled, clinical trials

Several randomized, double-blind, placebo-controlled clinical trials have demonstrated the efficacy of mometasone furoate nasal spray (MFNS) in the treatment of allergic rhinitis (AR) thus allowing for a meta-analysis to determine the overall treatment effect. A comprehensive search of the MEDLINE, LILACS, SCOPUS, and the Cochrane Library databases up to 31 October, 2007 was carried out. Randomized, double-blind, placebo-controlled, clinical trials evaluating the efficacy of MFNS in patients with AR compared to placebo were included. Total nasal symptom scores (TNSS), individual nasal symptoms, total non-nasal symptom scores (TNNSS) and nasal airflow were analysed as the standardized mean difference (SMD). Meta-analysis was performed with the random or the fixed effect models depending on heterogeneity, by using revman 5 software. Sixteen of the 113 identified articles met the inclusion criteria. For MFNS efficacy on TNSS, 2998 participants were analysed: 1534 received MFNS and 1464 placebo. Mometasone furoate nasal spray was associated with a significant reduction in TNSS (SMD -0.49, 95% CI: -0.60 to -0.38; P < 0.00001; I(2) = 50.1%). A significant effect on SMD for nasal stuffiness/congestion (-0.41; 95% CI: -0.56 to -0.27), rhinorrhoea (-0.44; 95% CI: -0.66 to -0.21), sneezing (-0.40; 95% CI: -0.57 to -0.23) and nasal itching (-0.39; 95% CI: -0.53 to -0.25) was also demonstrated. Mometasone furoate nasal spray treated subjects also showed a significant reduction in TNNSS (-0.30; 95% CI: -0.43 to -0.18). The proportion of patients with adverse events was similar for MFNS and placebo (0.99; 95% CI: 0.81-1.20; P = 0.91). This meta-analysis provides a level Ia evidence for the efficacy of MFSN in the treatment of AR vs placebo. Adverse events frequency was similar in both groups.