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Category Archives: Hay Fever & Allergic Rhinitis
Chinese medicine has long recognised hay fever and perennial allergic rhinitis. Hay fever is simply a sub-category of allergic rhinitis, in which the allergen is pollen and therefore symptoms are seasonal. In perennial allergic rhinitis, symptoms are present year round, and can be driven by such irritants as house dust or mould spores. Acupuncture for hay fever is ideally given before the onset of the season, during the preceding autumn and winter. This is considered to be the time when we can emphasise addressing the root of the disease. Once the season has commenced, treatment inevitably has to lean more towards treatment of the manifestation ie your symptoms. Many people though do not seek out an acupuncturist until the season is underway, but there is still a great deal treatment can offer then.
You can continue to use antihistamines if you wish, and if you find you need them to a diminishing extent, then that is one indicator of progress.
Turning to perennial allergic rhinitis, then because there is less seasonal variation, we treat the root and manifestation with equal emphasis. I use the expression “less seasonal variation” because some patients will feel worse in autumn with the increase in mould spores. Others might feel better in summer when they can be outdoors, away from house dust or other domestic allergens.
If you would like to explore treatment for either of these conditions, you are welcome to call me. My usual approach is to suggest a fixed number of sessions, after which we stop and review progress. Meanwhile, you will find below the results of some recent research into these conditions.
Authors of a German study looking at acupuncture for hayfever have concluded that patients can significantly reduce their use of antihistamines whilst also improving their symptoms. At the start of the pollen season, 414 patients aged 16 to 45 were randomised into three groups: acupuncture plus cetirizine, sham acupuncture plus cetirizine, and cetirizine alone. The acupuncture group received 12 sessions over the eight week intervention period. All participants documented their medication use before and during the trial.
The results showed that eight weeks of true acupuncture was associated with significantly fewer days of antihistamine use, compared with the sham acupuncture and cetirizine alone groups. Also in contrast to the other two groups, the acupuncture patients did not need to increase the number of days on which they used antihistamines, as the pollen season moved from onset to peak. Approximately 38% of the acupuncture group used no antihistamines at all, compared to 16% in the group in which antihistamines only were permitted.
The authors state that acupuncture is relatively safe, and common side effects are bleeding and haematoma caused by the needles. In contrast, antihistamines like cetirizine commonly cause fatigue, dizziness, headaches, sleepiness and sore throat. They reduce patients’ quality of life, and affect daily life and activities. Clinical guidelines strongly recommend antihistamines however, and acupuncture is listed as a supplementary option. These results encourage consideration of the need for a stronger position of acupuncture in those guidelines, as a valuable, additional treatment option.
(Impact of acupuncture on antihistamine use in patients suffering seasonal allergic rhinitis: secondary analysis of results from a randomised controlled trial. Acupuncture in Medicine, 10 February 2018.)
Australian researchers have found that acupuncture may help allergic rhinitis by modulating the body’s immune response to house dust mites. They randomised 151 individuals with persistent allergic rhinitis, to receive real, sham or no acupuncture. The intervention groups had sessions twice-weekly for eight weeks. Various cytokines, pro-inflammatory neuropeptides and immunoglobulins were measured in saliva or plasma from baseline to follow-up at four weeks.
Statistically-significant reductions in total IgE and allergen-specific IgE for house dust mite, were observed only in the real acupuncture group. Nasal obstruction, nasal itch, sneezing, runny nose, eye itch and sleep all improved significantly in the real acupuncture group, and continued to improve up to the follow-up at four weeks. The authors report that the results suggest modulation of expression, sensitivity and/or activation of a cellular receptor which plays a central role in our allergic inflammatory response. They conclude that acupuncture is a safe and effective treatment modality for patients with allergic rhinitis.
(Effect of acupuncture on house dust mite specific IgE, substance P, and symptoms in persistent allergic rhinitis. Annals of Allergy Asthma & Immunology, June 2016.)
The effects of acupuncture are comparable to those of medication in patients with moderate to severe allergic rhinitis, Chinese researchers have found. In the study, 76 patients received either acupuncture, or budesonide nasal spray (a steroid) plus cetirizine (antihistamine) tablets for a total of eight weeks.
Scores for specific symptoms, including sneezing, runny nose, stuffy nose and nasal itching, as well as total symptom scores, decreased in both groups with no sigificant difference between the two. This persisted at 12 week follow-up. The authors conclude acupuncture has a comparable effect to the medication treatment on patients with moderate to severe allergic rhinitis, and it is safe with no severe adverse effects.
(Acupuncture for moderate to severe allergic rhinitis: A non-randomized controlled trial. Chinese Journal of Integrative Medicine, July 2016.)
In addition to the developments reported in my earlier posts on this page, further evidence supporting the use of acupuncture for hay fever, has emerged from researchers in Australia.
The study randomly allocated 175 patients with seasonal allergic rhinitis and confirmed as allergic to rye grass pollen, to receive either true acupuncture or sham acupuncture. The latter consisted of needling superficially at non-acupuncture points. Twelve sessions were given over four weeks during the pollen season in Melbourne. True acupuncture was significantly better at reducing symptom severity, namely sneezing and itchiness, and improving quality of life.
(Acupuncture for seasonal allergic rhinitis: a randomized controlled trial. Annals of Allergy, Asthma & Immunology, June 2015.)