Efficacy of Acupuncture at the Sphenopalatine Ganglion in the Treatment of Persistent Allergic Rhinitis.

Objective: The aim of this research was to explore the hypothesis that acupuncture at the sphenopalatine ganglion (SPG), a new a new method of acupuncture, would be more efficacious and safe than traditional acupuncture in the treatment of persistent allergic rhinitis (PAR). Materials and Methods: For this study, 120 patients with PAR were randomly assigned to SPG acupuncture, traditional acupuncture (Yingxiang [LI 20], Hegu [LI 4], and Yintang [Ex-HN 3]), or drug treatment (budesonide nasal spray). Efficacy was assessed by using single symptoms, including sneezing, rhinorrhea, nasal obstruction and nasal itch, a total nasal symptoms score (TNSS), and a Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) before treatment, the day treatment ended, and 4-, 8-, 12-weeks later, respectively. Results: Four weeks after treatment ended, the effectiveness rate in the SPG-acupuncture group was superior to that of the traditional-acupuncture group (P = 0.033) but was still lower than that of the drug-treatment group (P = 0.039), with mean effectiveness rates of 69.70%, 44.44%, and 71.43%, respectively. However, these rates gradually decreased in each group during weeks 8 through 16. Moreover, statistically significant improvements in TNSS', and reductions in nasal congestion and sneezing symptoms were observed in the SPG-acupuncture group, compared with those in the traditional-acupuncture group as early as the day treatment ended and this continued throughout the observation period (P < 0.05). However, the improvement did not continue for sneezing, during weeks 8 through weeks 12 after treatment ended. The RQLQ of the SPG-acupuncture group was lower than that of the traditional-acupuncture group at week 12; however, there were no differences at weeks 8 and 16. Conclusions: The data generated by this study confirmed that acupuncture at the SPG alleviated the symptoms of PAR rapidly and safely, especially nasal obstruction, and improved the patients' life quality. These results were worthy of clinical promotion.

Barrier Protection Measures for the Management of Allergic Rhinitis: A Systematic Review and Meta-analysis.

BACKGROUND: Pharmacotherapy for allergic rhinitis (AR) still remains unsatisfying regarding its effect and safety. Barrier protection measures may be a good choice for the patients with AR. OBJECTIVE: To assess the efficacy and safety of barrier protection measures in the treatment of AR. METHODS: We selected relevant randomized controlled trials published between January 1, 1990, and February 20, 2019, by searching Embase, PubMed, Cochrane, Web of Knowledge, and ClinicalTrials.gov. The primary outcome for this analysis was rhinitis symptom scores, overall quality of life, nasal peak inspiratory flow (NPIF), and adverse events. Differences were expressed as weighted mean difference (WMD) with 95% confidence intervals (CIs) for continuous outcomes. Statistical heterogeneity across trials was assessed with the statistic (P < .1) and the I2 statistic. RESULTS: Fifteen RCTs (with data for 1154 participants) satisfied our inclusion criteria. The types of barrier protection measures comprised cellulose, pollen blocker cream, microemulsion, and nasal filter. To reduce the potential risk of bias and heterogeneity, we carried out subgroup analysis according to different types of barrier protection measures (cellulose: WMD = -2.18, 95% CI, -3.01 to -1.35, P < .00001; pollen blocker cream: WMD = -4.55, 95% CI, -6.10 to -3.00, P < .00001; microemulsion: WMD = -0.22, 95% CI, -0.42 to -0.03, P = .03). Findings from our meta-analysis show that, compared with placebo, barrier protection measures can yield improved symptomatic control for AR, with no increase in adverse events. Furthermore, barrier protection measures can improve the quality of life and NPIF. CONCLUSION: Although further studies are still needed, our findings clearly lend support to barrier protection measures as a safe and efficacious option for the treatment of AR patients.

Treatment of persistent allergic rhinitis via acupuncture at the sphenopalatine acupoint: a randomized controlled trial.

BACKGROUND: Allergic rhinitis is a common respiratory disease. Acupuncture is used to treat it in traditional Chinese medicine, and generally, the L120, ST2 and ST36 acupoints are selected in clinical practice. We report a new method of acupuncture at the sphenopalatine acupoint (SPA) for treatment of persistent allergic rhinitis (PAR). The effect of this treatment was investigated using two different needling depths. The efficacy of this treatment was associated with accurate stimulation of the sphenopalatine ganglion (SPG). METHODS/DESIGN: A total of 61 patients diagnosed with PAR were randomly allocated to either the acupuncture or the sham acupuncture group. The difference between the groups was the needle depth when acupuncture was administered, which was 50 mm and 20 mm. Alteration in total nasal symptom score (TNSS) was the primary outcome. Quality of life, medication dosages and adverse events were secondary outcomes, measured using the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Confidence assessment was performed to evaluate data from the treatment and follow-up periods. RESULTS: Results were: (1) average TNSS in the treatment group was significantly lower than in the control group at week 4 (median and 25th and 75th percentiles were 5.00 (4.00, 7.00) and 8.00 (7.00, 10.00), respectively (P < 0.001)). However, scores in the two groups were not significantly different at week 12; (2) quality of life (RQLQ) was significantly improved at week 2 in the treatment group compared to the control group (scores of 35.47 ± 8.20 and 45.48 ± 8.84; P < 0.001); (3) during the follow-up period, the medication dosage in the treatment group was much lower than in the control group (3.64 ± 1.45 and 6.14 ± 2.34; P < 0.05); and (4) no adverse events were observed in either group during treatment. CONCLUSIONS: This pilot study revealed a profound effect of acupuncture at the SPA on prevention of PAR development. The TNSS in the treatment group (needle depth 50 mm), was significantly lower than in the control group (needle depth of only 20 mm). Our result demonstrates that performing acupuncture directly at the SPA to stimulate the SPG is an effective method to treat PAR. TRIAL REGISTRATION: Acupuncture Clinical Trial Registry, AMCTR-OOR-16000014 and Chinese Clinical Trial Register, ChiCTR-IOR-16009211 . Registered on 1 September 1 2016.