Treatment Of Allergic Rhinitis In Children Research Articles

Clinical practice guidelines for the treatment of allergic rhinitis in children with traditional Chinese medicine.

Allergic rhinitis (AR) is one of the most common allergic diseases in children and it can lead to physical and mental health problems. Traditional Chinese medicine (TCM) plays an important role in understanding the phenotypes and treatment of AR. However, there are currently no normative clinical practice guidelines (CPGs) for the treatment of AR in children. The study aimed to develop an evidence-based CPG for the treatment of AR in children with TCM. Systematic literature research, expert questionnaire, and clinical evaluation after three rounds of surveys were adopted to form recommendations for treating children with AR using the Delphi method. Depending on the clinical manifestations, we finally recommended two decoctions with two Chinese patent medicines for an acute attack of AR and two decoctions for a chronic period of AR. For the acute attack of AR in children, Xinyi Qingfei decoction, Wenfei Zhiliu decoction, Xinqin granules, and Xinyi Biyan pills were suggested, whereas for the chronic period of AR, Buzhong Yiqi and Jingui Shenqi decoctions were recommended. The four external treatment methods suggested for the prevention and care of AR were body acupuncture, moxibustion, auricular point pressing, and acupoint application. The recommended levels of the suggested TCM strategies ranged from Grade B to D, indicating the weakness of the recommendations. TCM has the potential to offer new insights into phenotypes and the management of AR worldwide; however, more high-quality clinical studies are needed to improve the quality of evidence.

Clinical acupuncture therapy for children with allergic rhinitis: A protocol for systematic review and meta analysis.

Background:Allergic rhinitis (AR) in children has become a common clinical allergic disease, the incidence of which is increasing in pediatric. The side effects of the drug cause parents to worry about the health of their child. However, a large number of current clinical studies have shown that acupuncture therapy is effective in treating children with AR. Therefore, this systematic review aims to explore the safety and effectiveness of acupuncture in the treatment of AR in children.Methods:We will conduct a comprehensive literature search in Medline, PubMed, Cochrane Database of Systematic Reviews, Embase, Chinese Biomedical Literatures Database (CBM), China National Knowledge Infrastructure (CNKI), Wang Fang Database (WF), Chinese Scientific Journal Database (VIP) from inception to November 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; the total nasal symptom score; Rhinitis quality of life questionnaire (RQLQ); Visual Analog Scale (VAS); Laboratory inspection indicators: the level of IgE, IL6, IL10 or TNF-α; Recurrence rate; 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 5.4.0 software. The heterogeneity test will be conducted between the studies, 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:The results of this systematic review will provide a synthesis of current evidence of AR in children. We will report this result shortly.Conclusion:This study will explore whether or not acupuncture therapy can be used as one of the non drug therapies to prevent or treat allergic rhinitis in children.Trial registration number:INPLASY2020110053.

Topical intranasal corticosteroids and growth velocity in children: a meta-analysis.

There is no consensus regarding the effects on growth velocity of intranasal topical corticosteroid (ITC) use in children. The objective of this study was to determine whether ITC use reduces growth velocity in children with allergic rhinitis (AR). A literature search of the National Center for Biotechnology Information PubMed, EMBASE, SCOPUS, and Cochrane databases from January 1, 1988 to October 7, 2013. The study selection was composed of randomized clinical trials investigating ITC for treatment of AR in children (age <18 years of age) with appropriate controls. Studies must have included interval change in growth as an outcome. Two authors independently extracted data and assessed study quality. Eligible studies were pooled using a random-effects approach. Eight studies with 755 participants from 3 countries provided data for the meta-analysis (knemometry, n =342 participants; stadiometry, n =413 participants). Study duration ranged from 2 to 4 weeks for trials evaluating knemometry outcomes, and 12 months for trials evaluating stadiometry outcomes. Age of participants ranged from 3 to 12 years. The pooled standardized mean difference showed that among studies using knemometry, mean growth was statistically significantly lower among children using ITC vs placebo (-.223 mm/week; 95% confidence interval [CI], -0.429 to -0.017; p < 0.034).The pooled standardized mean difference showed that among studies using stadiometry, there was no significant growth difference among children using ITC vs placebo (-0.053 cm/year; 95% CI, -0.491 to 0.385; p = 0.813). The limitations of this study were the difficulty in predicting longer-term or catch-up growth in children. Meta-analytic pooling of trials suggest that short-term ITC for the treatment of AR in children may decrease short-term growth velocity using knemometry; however, the effect on longer-term growth velocity as measured by stadiometry is unclear.

CLINICAL EFFICIENCY AND ANTI-INFLAMMATORY ACTIVITYOF THERAPY IN CHILDREN WITH PERENNIAL ALLERGICRHINITIS

Background. Intranasal corticosteroids and nonsedating antihistamines are the drug classes most often prescribed to treat allergic rhinitis (AR). Treatment guidelines recommend a combination of these agents for moderate to severe AR. Objective: To compare the efficacy of mometasone furoate (MF) nasal spray plus desloratadine (DL) with that of monotherapy with the individual agents in 6-16 years old patients with perennial AR. Methods. A prospective, randomized, open label, parallel group study of the efficiency of MF nasal spray plus DL and of monotherapy with MF or DL in children with persistent allergic rhinitis aged 6-16 in a 12week period was conducted. The efficacy of therapy was evaluated by level of markers of an allergic inflammation, indicators of a bronchial hyperresponsiveness and by dynamics of clinical symptoms. Results. Combined therapy (DL+MF) restores balance of cytokines: increase the Тh1 activity and decrease the Т2 activity. Combined therapy found to be effective in the majority of AR patients. Сnclusion. Combined therapy with MF and DL in the treatment of perennial AR in children has clinical advan60

Update on Allergic Rhinitis

1. Todd A. Mahr, MD* 2. Ketan Sheth, MD, MBA† 1. *Clinical Professor of Pediatrics, University of Wisconsin Medical School, Department of Pediatric Allergy/Immunology, Gundersen Clinic, La Crosse, Wisc 2. †Assistant Clinical Professor of Pediatrics, Indiana University School of Medicine, Lafayette Allergy & Asthma Clinic, Lafayette, Ind After completing this article, readers should be able to: 1. Recognize the various signs and symptoms of allergic rhinitis (AR) in children. 2. Understand the impact of AR on pediatric patients. 3. Discuss the treatment of AR in children. 4. Describe the systemic effects of antihistamines in infants and young children. 5. Understand the roles of topical and oral corticosteroids in the treatment of AR. Allergic rhinitis (AR) is the most common chronic disease in children, affecting up to 40%. However, the disease frequently is overlooked and undertreated because it often is mistaken for recurrent upper respiratory tract infections in children who cannot adequately communicate the impact of their symptoms. AR generally is not considered to be a life-threatening disease, yet it is one of the major reasons for visits to pediatricians. In 1998, the Joint Task Force on Practice Parameters in Allergy, Asthma, and Immunology defined rhinitis as “inflammation of the membrane lining the nose, characterized by nasal congestion, rhinorrhea, sneezing, itching of the nose and/or postnasal drainage.” AR is a hypersensitivity reaction to specific allergens occurring in sensitized patients that is mediated by immunoglobulin (Ig)E antibodies and results in inflammation. Traditionally, AR is classified as seasonal or perennial and as either mild, moderate, or severe. Mild AR involves no sleep interruption, no impairment of daily activities, and no troublesome symptoms. Moderate-to-severe AR involves one or more of those factors. A newer classification system specifies that AR be characterized as intermittent or persistent. Intermittent disease involves symptoms for fewer than 4 days per week or for a duration of fewer than 4 weeks. Persistent disease involves symptoms that occur more than 4 days per week and are present for longer than 4 weeks (Bousquet, 2001). Because approximately 50 million Americans have AR, almost all primary care physicians encounter the disease. In one study, 42% …