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      Acupuncture for Hayfever, Sinus Congestion and Allergic Rhinitis

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      Allergic Rhinitis is a condition when study in depth, was rated as ‘effective’ in the Australian DVA review (2010) and ‘unclear’ in the USVA Evidence map of acupuncture (2014) (1, 2).

      Clinical practice guidelines for allergic rhinitis published by the Otolaryngology Head Neck Surgery Foundation in 2015 included acupuncture as Option five: Clinicians may offer acupuncture, or refer to a clinician who can offer acupuncture, for patients with Allergic Rhinitis who are interested in non-pharmacological therapy (Aggregate evidence quality - Grade B) (3, 4).

      Allergic rhinitis has similar symptoms commonly associated with hay fever and is a worldwide health concern due to an immediate inflammatory response in the nasal mucosa. Worldwide estimates suspect hay allergic rhinitis affects 18% of 15-34 year olds and 10% of 35-54 year olds (5). Causes are usually triggered by an inhaled allergen or can also occur from non-allergic triggers. Allergic Rhinitis can be classified as intermittent or persistent based on the frequency and severity of your symptoms. 

      Presenting symptoms include:

      • Nasal congestion or;
      • Profuse watery nasal discharge.
      • Sneezing.
      • Itchy nose or eyes.
      • Sinus pain, pressure or headaches.

      Causes of Hay Fever or Allergic Rhinitis:

      Seasonal factors (9):

      • Pollens from grass, flowers, trees or weeds (known as hay fever).

      Perennial factors (9):

      • Inhaled antigens derived from;
      • House dust.
      • Fungus spores.
      • Animals.

      Non allergic triggers from cold air, dry atmosphere, perfumes and chemicals can still trigger a response in up to 87% of allergic rhinitis patients (5). Some people with allergic rhinitis or hay fever may also have asthma. Results suggest that better control of allergic rhinitis has been shown to result in better asthma control (6). Emerging evidence is also recognising that untreated allergic rhinitis may also increase a higher risk of developing asthma (6).

      How can Acupuncture Help your Hay Fever or Allergic Rhinitis?

      McDonald et al. (4, 10) conducted a study between patients who received acupuncture, sham acupuncture or no treatment. The results revealed a significant reduction in IgE in patients who received Acupuncture opposed to sham or no acupuncture. IgE is an antibody produced by the body’s immune system in response to a perceived threat i.e. a allergic reaction (7).

      Patients who received Acupuncture, resulted marked improvements in (8):

      • Nasal obstruction.
      • Runny nose.
      • Nasal itch.
      • Sneezing.
      • Itchy eyes.
      • Unrefreshed sleep.

      These marked improvements continued over the course of 12 weeks of treatment and patient symptoms continued to improve once the course of treatment ended (8).

      Acupuncture is recognised by the World Health Organisation (WHO) as a safe and effective natural option to help assist with the frequency and severity of symptoms for hay fever and/or allergic rhinitis without any associated side effects like drowsiness. Chinese Medicine is generally considered to be safe, but occasionally (as with other health treatments) may be associated with possible adverse reactions in individual cases. 

      Whether you suffer from hay fever once a year or if you are a chronic sufferer for a couple months of the year, with the continuation of emerging evidence,  Acupuncture appears to be an excellent option to help manage the severity of symptoms in conjunction with your current treatment regime.

      Research: 

      • A systematic review of 13 randomised controlled trials concluded that acupuncture could be a safe and valid treatment option for allergic rhinitis (moderate quality evidence) (11).
      • Another systematic review (which included two large multi-centre randomised controlled trials, three comparisons of acupuncture versus medication and one cost-effectiveness study) concluded that there is high quality evidence (12). 
      • Acupuncture could be a safe and valid treatment for allergic rhinitis; Moderate quality evidence (Feng 2015 - SR of 13 RCTs) (11). 

      References:

          1. Biotext. Alternative therapies and Department of Veterans' Affairs Gold and White Card arrangements. In: Australian Government Department of Veterans' Affairs, editor: Australian Government Department of Veterans' Affairs; 2010.
          2. Hempel S, Taylor SL, Solloway MR, Miake-Lye IM, Beroes JM, Shanman R, et al. VA Evidence-based Synthesis.
          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. McDonald J, Janz S, 2017, ‘The Acupuncture Evidence Project: A Comparative Literature Review (Revised edition). Brisbance: Australian Acupuncture and Chinese Medicine Association Ltd; 2017. http://www.acupunctrue.org.au.
          5. McDonald, JL, Cripps, AW, Smith, PK, Smith, CA, Xue, CC & Golianu, B 2013, ‘The anti-inflammatory effects of acupuncture and their relevance to allergic rhinitis: a narrative review and proposed model.’, Evidence-based complementary and alternative medicine : eCAM, vol. 2013, p. 591796, <http://www.hindawi.com>.
          6. https://www.allergy.org.au/patients/allergic-rhinitis-hay-fever-and-sinusitis/allergic-rhinitis-or-hay-fever.
          7. https://labtestsonline.org/understanding/analytes/total-ige/tab/test/.
          8. McDonald, J.L., Cripps, A.W., Smith, P.K., Smith, C.A., Xue, C.C. &Golianu, B. (2016) Effect of acupuncture on house dust mite specific IgE, substance P, and symptoms in persistent allergic rhinitis Annals of Allergy, Asthma & Immunology (Article in Press).
          9. Colledge, N, Walker, B & Ralston, S 2010, Davidson’s Principles & Practice of Medicine, 21st edn, Churchill Livingstone Elsevier, Edinburgh.
          10. McDonald, JL, Cripps, AW, Cripps, PK 2015, 'Mediators, Receptors, and Signalling Pathways in the Anti-Inflammatory and Antihyperalgesic Effects of Acupuncture, Evidence-Based Complementary and Alternative Medicine, pp. 1-10, <http://www.hindawi.com>.
          11.  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.

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

       

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