Allergic Rhinitis – Basics

Like Sinusitis, Rhinitis is a chronic condition characterized by congestion, sneezing, stuffiness and runny nose. It can be allergy-related (allergic rhinitis) or have another cause (non-allergic rhinitis). In people with allergic rhinitis, symptoms are caused by the immune system’s reaction to certain allergens in the air. Generally, these allergens are otherwise harmless and can include pollen, pet dander, dust, grass and others. Non-allergic rhinitis usually presents in adults, and can be the cause of exposure to a strong irritant—such as pollution or smoke—or certain medications.

Treatments for this condition are similar for sinusitis

Allergic Rhinitis – Diagnostic Patterns

The Chinese Medicine treatment of rhinitis generally involves arriving at the appropriate TCM diagnosis or pattern. This pattern within the individual is what treatment is based on not the general condition. The following patterns may represent the underlying contributing factors for the development of rhinitis: Lung Dampness-Phlegm Heat, Lung Wind Invasion-Wind Cold, Lung Wind Invasion-Wind Heat and Spleen Qi Deficiency

Commonly  used points: LI4 Hegu, UB4 Chuanzu

commonly used formula: Chuan Xiong Cha Tiao San, Xin Yi Wan, Yu Ping Feng Wan, Gui Zhi Tang Wan

Research

Acupuncture could be a safe and valid treatment for allergic rhinitis; Moderate quality evidence (Feng 2015 – SR of 13 RCTs)(1)

High quality evidence of efficacy and effectiveness (Taw 2015 – SR of 2 large multi-centre RCTs, 3 acupuncture vs medication RCTs and 1 cost-effectiveness study)(2)

OHNSF clinical practice guideline: Option 5: Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with AR who are interested in nonpharmacologic therapy; Aggregate evidence quality – Grade B (Seidman 2015)(3)

Acupuncture is cost-effective for allergic rhinitis (Kim 2012, Witt 2010)(4, 5)

SAR – Acupuncture significantly superior to rescue medication in QALY gained, but may cost more short term (Reinhold 2013)(6, 7)

References

1.Feng S, Han M, Fan Y, Yang G, Liao Z, Liao W, et al. Acupuncture for the treatment of allergic rhinitis: a systematic review and meta-analysis. Am J Rhinol Allergy. 2015 Jan-Feb;29(1):57-62.

2. Taw MB, Reddy WD, Omole FS, Seidman MD. Acupuncture and allergic rhinitis. Curr Opin Otolaryngol Head Neck Surg. 2015 Jun;23(3):216-20.

3. Seidman MD, Gurgel RK, Lin SY, Schwartz SR, Baroody FM, Bonner JR, et al. Clinical practice guideline: Allergic rhinitis. Otolaryngol Head Neck Surg. 2015 Feb;152(1 Suppl):S1-43.

4. Witt CM, Brinkhaus B. Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis – An overview about previous and ongoing studies. Auton Neurosci. 2010 Oct 28;157(1-2):42-5.

5. Kim SY, Lee H, Chae Y, Park HJ, Lee H. A systematic review of cost-effectiveness analyses alongside randomised controlled trials of acupuncture. Acupunct Med. 2012 Dec;30(4):273-85.

6. Reinhold T, Roll S, Willich SN, Ortiz M, Witt CM, Brinkhaus B. Cost-effectiveness for acupuncture in seasonal allergic rhinitis: economic results of the ACUSAR trial. Ann Allergy Asthma Immunol. 2013 Jul;111(1):56-63.

7. Reinhold T, Brinkhaus B, Willich SN, Witt C. Acupuncture in patients suffering from allergic asthma: is it worth additional costs? J Altern Complement Med. 2014 Mar;20(3):169-77.