Objectives: To evaluate the efficacy and safety of intranasal acupuncture for allergic rhinitis (AR).
Methods: Randomized controlled trials on intranasal acupuncture for AR were searched in China National Knowledge Infrastructure, Wanfang Data Knowledge Service platform, VIP Database, PubMed, Web of Science, Embase, and The Cochrane Library from their inception to October 2024. The basic information, evaluation of the therapeutic efficacy, related scales, and laboratory indexes were screened and extracted by 2 independent reviewers. The scales included the Total Nasal Symptom Score (TNSS), the Total Nasal Symptom and Sneezing Score (TNNSS), Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). Laboratory indicators focused on serum total IgE and serum interleukin-4 (IL-4) contents. Meta-analysis was conducted using RevMan software and Stata software.
Results: A total of 19 randomized controlled trials involving 1 482 participants were included. The Meta-analysis indicated that, compared with conventional western medicines and nasal-external acupuncture, the intranasal acupuncture group achieved greater reductions in TNSS [MD=-1.67, 95% CI (-2.30, -1.04), P<0.000 01], RQLQ score [MD=-3.14, 95% CI(-4.16, -2.12), P<0.000 01], and TNNSS [MD=-0.52, 95% CI (-0.67, -0.36), P<0.000 01] from baseline to post-treatment, and greater decreases in serum IgE [SMD=-1.17, 95% CI (-1.46, -0.87), P=0.000 01] and IL-4 [SMD=-1.14, 95% CI (-1.80, -0.49), P=0.000 6] levels. Adverse events were mainly mild epistaxis and localized pain.
Conclusions: Intranasal acupuncture appears superior to nasal-external acupuncture and western medicines in reducing nasal symptom severity and improving life quality in AR, with no obvious adverse events reported. However, because the existing studies generally have small sample sizes, limited methodological rigor in randomized designs, and substantial heterogeneity across studies, the reliability of the findings is limited. Therefore, large-sample, multicenter, randomized controlled clinical trials are needed to improve the quality level of the evidence.
目的: 评估鼻内针治疗变应性鼻炎（AR）的疗效及安全性。方法: 检索建库至2024年10月中国知网、万方数据知识服务平台、维普数据库、PubMed、Web of Science、Embase、The Cochrane Library数据库关于鼻内针治疗AR的随机对照临床研究，由2名独立研究者筛选并提取文献基本信息、疗效评价、相关量表和实验室指标，其中相关量表包括鼻部症状（TNSS）、鼻结膜炎生存质量调查问卷（RQLQ）、鼻炎伴随症状（TNNSS）评分，实验室指标以血清免疫球蛋白E（IgE）和血清白细胞介素4（IL-4）水平为主。所有纳入研究应用RevMan软件和Stata软件进行Meta分析。结果: 共纳入19篇临床研究文献，涉及1 482名参与者。Meta分析结果显示，相较于西药及鼻外局部针刺，鼻内针组TNSS总分[MD=-1.67，95% CI （-2.30，-1.04），P<0.000 01]、RQLQ总分[MD=-3.14，95%CI（-4.16，-2.12），P<0.000 01]及TNNSS总分[MD=-0.52，95%CI（-0.67，-0.36），P<0.000 01]降低更明显，血清IgE[SMD=-1.17，95%CI（-1.46，-0.87），P=0.000 01]、IL-4水平[SMD=-1.14，95%CI（-1.80，-0.49），P=0.000 6]亦明显降低。不良反应以轻度鼻出血和疼痛为主。结论: 鼻内针刺在降低鼻部症状严重程度和改善患者生活质量的大多数方面优于鼻外局部针刺及西药，且无明显不良反应。但由于现有研究样本量普遍较小、随机化设计严谨性较低。研究之间异质性较大，导致结果可靠性偏低，仍需开展大样本、多中心、随机对照临床试验以提高证据质量等级。.
Keywords: Allergic rhinitis; Clinical efficacy; Intranasal acupuncture; Meta-analysis; Randomized controlled trial.