Acupuncture in Patients With Seasonal Allergic Rhinitis: A Randomized Trial

Ann Intern Med. 2013 Feb 19;158(4):225-34. doi: 10.7326/0003-4819-158-4-201302190-00002.

Abstract

Chinese translation

Background: Acupuncture is frequently used to treat seasonal allergic rhinitis (SAR) despite limited scientific evidence.

Objective: To evaluate the effects of acupuncture in patients with SAR.

Design: Randomized, controlled multicenter trial. (ClinicalTrials.gov: NCT00610584)

Setting: 46 specialized physicians in 6 hospital clinics and 32 private outpatient clinics.

Patients: 422 persons with SAR and IgE sensitization to birch and grass pollen.

Intervention: Acupuncture plus rescue medication (RM) (cetirizine) (n = 212), sham acupuncture plus RM (n = 102), or RM alone (n = 108). Twelve treatments were provided over 8 weeks in the first year.

Measurements: Changes in the Rhinitis Quality of Life Questionnaire (RQLQ) overall score and the RM score (RMS) from baseline to weeks 7 and 8 and week 16 in the first year and week 8 in the second year after randomization, with predefined noninferiority margins of -0.5 point (RQLQ) and -1.5 points (RMS).

Results: Compared with sham acupuncture and with RM, acupuncture was associated with improvement in RQLQ score (sham vs. acupuncture mean difference, 0.5 point [97.5% CI, 0.2 to 0.8 point; P < 0.001]; RM vs. acupuncture mean difference, 0.7 point [97.5% CI, 0.4 to 1.0 point; P < 0.001]) and RMS (sham vs. acupuncture mean difference, 1.1 points [97.5% CI, 0.4 to 1.9 points; P < 0.001]; RM vs. acupuncture mean difference, 1.5 points [97.5% CI, 0.8 to 2.2 points; P < 0.001]). There were no differences after 16 weeks in the first year. After the 8-week follow-up phase in the second year, small improvements favoring real acupuncture over the sham procedure were noted (RQLQ mean difference, 0.3 point [95% CI, 0.03 to 0.6 point; P = 0.032]; RMS mean difference, 1.0 point [95% CI, 0.2 to 1.9 points; P = 0.018]).

Limitation: The study was not powered to detect rare adverse events, and the RQLQ and RMS values were low at baseline.

Conclusion: Acupuncture led to statistically significant improvements in disease-specific quality of life and antihistamine use measures after 8 weeks of treatment compared with sham acupuncture and with RM alone, but the improvements may not be clinically significant.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acupuncture Therapy*
  • Betula
  • Cetirizine / therapeutic use
  • Female
  • Histamine H1 Antagonists / therapeutic use
  • Humans
  • Immunoglobulin E / immunology
  • Male
  • Poaceae
  • Pollen / immunology
  • Quality of Life
  • Rhinitis, Allergic, Seasonal / drug therapy
  • Rhinitis, Allergic, Seasonal / immunology
  • Rhinitis, Allergic, Seasonal / therapy*
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Histamine H1 Antagonists
  • Immunoglobulin E
  • Cetirizine

Associated data

  • ClinicalTrials.gov/NCT00610584