Background: In this study, we attempted to assess the efficacy and safety of acupuncture for allergic rhinitis, and to test the robustness of the estimated effects.
Methods: The Cochrane methodology standard was followed to conduct this systematic review. Randomized controlled trials (RCTs) comparing acupuncture with other therapies for allergic rhinitis were included. Furthermore, trial sequential analysis was conducted to test the robustness of pooled results. Thirty trials with 4413 participants were included.
Results: Acupuncture improved the nasal symptoms on Total Nasal Symptom Score (TNSS) and quality of life measured by Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) in adults with allergic rhinitis, compared to acupuncture with no intervention. Acupuncture was also shown to be more effective than sham acupuncture for nasal symptom (RQLQ subscale, n = 489, MD – 0.60, 95% CI – 1.16 to – 0.04) and quality of life (RQLQ, n = 248, – 8.47 95% CI – 14.91, – 2.03).
No clear difference was observed between acupuncture and cetirizine or loratadine. Interestingly, trial sequential analysis (TSA) failed to confirm the aforementioned results. The effect of acupuncture for children/adolescents with allergic rhinitis remains unclear due to insufficient data. The performance bias and attrition bias are serious in most studies that were included. Selection bias may also have affected the quality of the evidence.
Conclusion: Acupuncture may have an advantage over no intervention and sham acupuncture in improving nasal symptoms and quality of life for adults with allergic rhinitis. The effect of acupuncture and cetirizine or loratadine for allergic rhinitis may be similar.