Ear Acupressure for Allergic Rhinitis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified. OBJECTIVE: To evaluate the effects and safety of EAP in AR patients. DESIGN: Systematic review of published studies. METHODS: A total of 24 English and Chinese databases (PubMed, EMBASE (Excerpta Medical Database), Cochrane Central Register of Controlled Trials, CINAHL, Informit, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences), ProQuest, AMED, Blackwell Synergy, PsycINFO, Panteleimon, AcuBriefs, KoreaMed, IndMed, Ingenta, mRCT, ISI Web of Knowledge, ERIC, VIP Information (http://www.cqvip.com), China National Knowledge Infrastructure (http://www.cnki.net), Cochrane Library, Chinese Cochrane Centre Controlled Trials Register Platform, and Wanfang Chinese Digital Periodical and Conference Database) were searched from their respective inceptions to August 2020 to collect randomized controlled trials of ear acupressure for allergic rhinitis. We performed literature inclusion, data extraction, and trial quality evaluations. Methodological quality was assessed according to the Cochrane Handbook. Revman5.3 was used for all analyses. RESULTS: A total of 203 trials were identified and eleven studies involved 1094 participants aged 3-70 years. EAP was better than control group interventions in terms of effectiveness (risk ratio (RR): 0.51; 95% confidence interval (CI): 0.36-0.70; P < 0.0001). EAP was superior to sham EAP in terms of improvement of the total nasal symptom score (RR: -0.50; 95% CI: -0.96-0.05; P = 0.03), sneezing score (RR: -0.36; 95% CI: -0.59-0.12; P = 0.003), global QoL score (RR: 0.42; 95% CI: 0.04-0.08; P = 0.03), and eye symptom score (RR: -0.36; 95% CI: -0.67-0.05; P = 0.02). CONCLUSIONS: Despite the positive results, it is premature to confirm the efficacy of EAP for treating AR. More high-quality studies are needed to confirm safety and efficacy.

Yu ping feng san for pediatric allergic rhinitis: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: The potential treatment effects and safety of Yu ping feng san (YPFS) for pediatric allergic rhinitis (PAR) patients have yet to be studied systematically. OBJECTIVES: To assess the effects and safety of YPFS for treat pediatric patients, allergic rhinitis. METHODS: We systematically searched PubMed, EMBASE (Excerpta Medical Database), Cochrane library, Chinese Cochrane Centre's Controlled Trials Register platform, Wanfang Chinese Digital Periodical and Conference Database, China National Knowledge Infrastructure Database, and VIP Chinese Science, from inception dates to November 1, 2019. Randomized controlled trials (RCTs) were included. The risk of bias in the trials was assessed in accordance with the Cochrane Handbook, version 5.1.0. RevMan 5.3 software was used to perform a meta-analysis. Grading of Recommendations Assessment, Development and Evaluation methodology was applied to evaluate the evidence quality for each outcome. The quality of evidence for each outcome measurement was low for 4 outcomes and very low for 5 outcomes. RESULTS: A total of 10 RCTs involving 1069 participants (3-15 years old) fulfilled the inclusion criteria. After exclusion, 8 RCTs were pooled for efficacy assessment. The overall efficacy evaluation result did not show benefit for the experimental group (relative risk 0.32, CI 95% 0.24-0.45; P = .98;) Investigation of variation of serum IgA, immunoglobulin E, IgG in three studies in 2 groups returned no statistical significance. YPFS gave relatively better safety (relative risk 0.29, CI 95% 0.14-0.58; P = .0005; Fig. S8, http://links.lww.com/MD/F751) and lower recurrence rates than did Western medical therapy. CONCLUSIONS: Current evidence cannot support the routine use of YPFS for treatment of PAR. This may be due to poor-quality study-design limitations of the included YPFS studies. Our data showed that the use of YPFS for PAR is relatively safe compared to Western medical therapy, but a conclusion could not be drawn because only 5 studies were analyzed. Every study suffered from some methodological limitation. Therefore, further large, rigorously-designed studies are necessary to determine conclusively the utility of YPFS in PAR.

Healthy lifestyle consultation based on traditional Chinese medicine versus routine patient education in the treatment of idiopathic sudden sensorineural hearing loss after failure of systemic therapy: study protocol for a clinical randomised trial.

BACKGROUND: Idiopathic sudden sensorineural hearing loss (ISSNHL) is a major cause of deafness. Despite the advances in systemic therapy, some cases of ISSNHL are untreated, because the exact ISSNHL aetiology is unclear. Traditional Chinese medicine (TCM) has been used to treat diseases for thousands of years and is popular and widely practiced in Asia. TCM includes guidance on a healthy lifestyle. In recent decades, the relationship between lifestyle and disease has been emphasised; an unhealthy lifestyle may lead to illnesses. Thus, this study aims to compare the efficacy of lifestyle modification based on TCM with the usual consultation of ISSNHL after failure of a 2-week systemic therapy to provide a scientific basis for clinical decisions. METHODS: This study is a clinical randomised trial that involves 56 patients diagnosed with ISSNHL but who have had incomplete recovery after initial management (at least 2 weeks of routine Western medical treatment). The study is performed in accordance with the sudden hearing loss clinical guideline of the American Academy of Otolaryngology-Head and Neck Surgery, published in 2012. Participants are randomly distributed into two groups: the healthy lifestyle modification group based on TCM and the control group (1:1 ratio). Patient follow-up lasts for 3 months. The primary outcome measure is the effective rate of hearing improvement, which is defined as the proportion of patients with at least 15 dB of improvement in the average thresholds of hearing loss frequency. The secondary outcome measures are improvements in word recognition score, Tinnitus Handicap Inventory and visual analogue scale for ear blockage and dizziness. Assessments are made at baseline and after lifestyle modification for 1 and 3 months. DISCUSSION: The efficacy of healthy lifestyle modification based on a TCM programme for patients with ISSNHL with incomplete recovery after failure of initial systemic therapy is determined in this trial. Positive results will provide clinical evidence on the effects of a TCM-based healthy lifestyle, which could be recommended as salvage therapy for patients with ISSNHL. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-INR-17011459. Registered on 22 May 2017.

Patient education in sudden sensorineural hearing loss: Knowledge, attitude/belief, and practice findings among otolaryngologists and otologists in China.

OBJECTIVE: To examine patient education knowledge, attitude/belief, and practices (KABP) among specialists who manage sudden sensorineural hearing loss (SSNHL). METHODS: A cross-sectional study design was employed wherein semi-structured interviews were conducted at a 2017 otorhinolaryngology meeting. In this survey, we asked the respondents about their perspectives regarding the imparting of SSNHL patient education. RESULTS: The sample consisted of 84 physicians from 23 cities in Sichuan province. Three quarters of the respondents felt SSNHL patient education was necessary. Notably, 67.9% of the respondents believed that patient education could improve treatment. Half of the respondents provided culturally tailored education (based on US guidelines) inclusive of traditional Chinese medicine (TCM) notions of lifestyle adjustments. Internet platforms were an emerging preference for education delivery mode. Only 47.4% of participants reported being satisfied with their current patient education offerings, and these activities were regarded as needing improvement. CONCLUSION: This study captured the perspectives of otorhinolaryngologists and otologists in China regarding the imparting of SSNHL patient education. The results of this survey should support Chinese physician's implementation of SSNHL patient education. PRACTICE IMPLICATIONS: Findings obtained with the present survey may be employed to support the importance of SSNHL patient education in China.

Ma-Huang-Fu-Zi-Xi-Xin Decoction for Allergic Rhinitis: A Systematic Review.

BACKGROUND: The treatment effects and safety of Ma-Huang-Fu-Zi-Xi-Xin decoction for patients with allergic rhinitis have yet to be clarified. OBJECTIVES: The aim of this study is to evaluate the effects and safety of Ma-Huang-Fu-Zi-Xi-Xin decoction in patients with allergic rhinitis. METHODS: We searched PubMed, EMBASE (Excerpta Medical Database), Cochrane Library, Chinese Cochrane Centre's Controlled Trials Register Platform, Wanfang Chinese Digital Periodical and Conference Database, China National Knowledge Infrastructure (CNKI) Database, and VIP Chinese Science and Technique Journals Database to collect randomized controlled trials of Ma-Huang-Fu-Zi-Xi-Xin decoction (MHFZXXD) for allergic rhinitis (AR) prior to May 8, 2017. RevMan 5.3 software was used to conduct a meta-analysis. GRADE methodology was applied to evaluate the evidence quality for each outcome. RESULTS: Six randomized controlled trials (RCTs) involving 576 participants (10-78 years old) were included. A meta-analysis revealed that the overall effect of MHFZXXD for AR was not better than western medical treatment (RR: 0.41; 95% CI: 0.26-0.65; P = 0.0001) for all included studies. However, the evidence quality of these western medical intervention studies was low or very low due to a high risk of bias, small sample sizes, and poor-quality design.

Development of a Highly Specific Fluorescence Immunoassay for Detection of Diisobutyl Phthalate in Edible Oil Samples.

The diisobutyl phthalate (DiBP) hapten containing an amino group was synthesized successfully, and the polyclonal antibody against 4-amino phthalate-bovine serum albumin (BSA) was developed. On the basis of the polyclonal antibody, a rapid and sensitive indirect competitive fluorescence immunoassay (icFIA) has been established to detect DiBP in edible oil samples for the first time. Under the optimized conditions, the quantitative working range of the icFIA was from 10.47 to 357.06 ng/mL (R(2) = 0.991), exhibiting a detection limit of 5.82 ng/mL. In this assay, the specific results showed that other similar phthalates did not significantly interfere with the analysis, with the cross-reactivity less than 1.5%, except for that of DiBAP. Thereafter, DiBP contamination in edible oil samples was detected by icFIA, with the recovery being from 79 to 103%. Furthermore, the reliability of icFIA was validated by gas chromatography-mass spectrometry (GC-MS). Therefore, the developed icFIA is suitable for monitoring DiBP in some edible oil samples.