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

Anat Rec (Hoboken). 2021 Nov;304(11):2592-2604. doi: 10.1002/ar.24718. Epub 2021 Jul 29.

Abstract

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.

过敏性鼻炎是儿童最常见的疾病之一,对儿童的身心健康产生一定的负面影响。中医药在儿童过敏性鼻炎的辨证分型及治疗中起着重要作用, 但目前尚缺乏规范的临床实践指南。本研究旨在制定儿童过敏性鼻炎的循证性中医药临床实践指南, 采用了系统的文献研究、专家问卷调查以及三轮调查后的临床评价, 并运用德尔菲法形成了儿童过敏性鼻炎的中医药推荐疗法。根据不同的临床表现, 我们最终推荐了“辛夷清肺饮、温肺止流丹”两种复方结合“辛芩颗粒、辛夷鼻炎丸”两种中成药来治疗急性期儿童过敏性鼻炎;对于慢性期儿童过敏性鼻炎, 我们推荐了补中益气汤和金匮肾气丸;同时本研究提出“体针、艾灸、耳穴、穴位贴敷”等四种外治法可用于儿童过敏性鼻炎的预防与调护。以上治疗方案的推荐等级从B级到D级不等, 总体推荐力度较弱。因此, 本研究认为中医药辨证论治儿童过敏性鼻炎具有较大的潜力, 可为本病诊疗提供新的见解, 但仍然需更多高质量的临床研究来提高证据的质量。.

Keywords: allergic rhinitis; children; clinical practice guidelines; traditional Chinese medicine; 中医药; 临床指南; 儿童; 过敏性鼻炎.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acupuncture Therapy*
  • Humans
  • Medicine, Chinese Traditional / methods
  • Practice Guidelines as Topic
  • Rhinitis, Allergic* / drug therapy