A systematic review of the clinical effectiveness of acupuncture for allergic rhinitis.
BACKGROUND
Allergies cause a considerable burden to both sufferers and the National Health Service. There is growing interest in acupuncture as a treatment for a range of conditions. Since acupuncture may modulate the immune system it could be a useful treatment for allergic rhinitis (AR) sufferers. We therefore assessed the evidence for the clinical effectiveness of acupuncture in patients with AR by performing a systematic review of the literature.


METHODS
Searches (to 2007) were conducted in all major databases for randomised controlled trials (RCTs) evaluating the clinical effectiveness of acupuncture in the treatment of AR. No limits were placed on language. Studies were included if they compared acupuncture to a sham or inactive acupuncture treatment (placebo) with or without standard care. Meta-analysis was performed where feasible.


RESULTS
Seven relevant RCTs were included after screening and application of inclusion and exclusion criteria. The trials were generally of poor quality as assessed by a modified Jadad scale, with the exception of two studies which scored highly. A wide variety of outcomes was measured but most assessed symptom severity on a visual analogue scale. A meta-analysis failed to show any summary benefits of acupuncture treatment for symptom severity scores or serum IgE measures which could not have been accounted for by chance alone. Acupuncture was not associated with any additional adverse events in the trials.


CONCLUSIONS
There is currently insufficient evidence to support or refute the use of acupuncture in patients with AR. A large well conducted RCT, which overcomes identified methodological problems in the existing RCTs, would be required to resolve this question.
Roberts
Jonathan
J
West Midlands Health Technology Assessment Collaboration, Department of Public Health and Epidemiology, University of Birmingham, UK. jonathan.roberts@hpa.org.uk
Huissoon
Aarnoud
A
Dretzke
Janine
J
Wang
Dechao
D
Hyde
Christopher
C
D015669:Acupuncture Points; D015670:Acupuncture Therapy / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D010147:Pain Measurement / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012221:Rhinitis, Allergic, Perennial / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome