Traditional 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 the time when we can address the root of the disease. Once the season has commenced, treatment inevitably has to lean more towards the manifestation ie your symptoms. Many people though do not seek out an acupuncturist until the season is underway, but we can still provide relief.
You can continue using antihistamines if you wish. If you need them to a diminishing extent, then that is one indicator of progress.
Perennial Allergic Rhinitis
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” carefully because some patients will feel worse in autumn with the increase in mould spores, in nature or in the home. Others might feel better in summer when they can be outdoors, down at the coast say, and away from house dust or other domestic allergens.
If you would like to explore acupuncture 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, a resource you may find interesting is the University of Worcester’s pollen calendar for southwest England: it might help you pinpoint which species you are reacting to.
Below you can read the results of some of the research which has been undertaken into acupuncture for allergic rhinitis. The trials vary in quality, but systematic reviews and randomised controlled trials are generally considered to provide the highest quality evidence. If you would like to read more about evidence quality, I would refer you to the British Acupuncture Council’s description of the evidence pyramid.
A study conducted in Hong Kong has demonstrated acupuncture can bring relief to the main symptoms of allergic rhinitis. In a three-armed trial, 96 patients aged 18 to 65, were randomly assigned to receive either acupuncture, acupuncture plus herbal moxibustion, or a place on a waiting list control group. Acupuncture was given three times a week for four weeks, making 12 sessions in total. All groups received advice on a healthy lifestyle, diet and exercise.
Compared to the waiting list group, both treatment groups showed statistically significant improvements in symptom and quality of life scores. There were no significant differences between them, suggesting no additional benefit from moxibustion. No adverse events from acupuncture were reported.
(Acupuncture and herbal moxibustion for the treatment of ‘BiQiu’ (allergic rhinitis symptoms) in a Hong Kong Chinese medicine clinic: a randomized controlled trial. Chinese Medicine, 8 November 2019.)
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.)