Department of Traditional Chinese Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Int Forum Allergy Rhinol. 2024 Sep;14(9):1488-1500. doi: 10.1002/alr.23414. Epub 2024 Jul 17.
Acupuncture has been shown for the treatment of allergic rhinitis in previous studies. Nevertheless, relevant evidence was lacked for paediatric patients with allergic rhinitis. We aim to validate the efficacy of acupuncture for allergic rhinitis in children by meta-analysis and trial sequence analysis.
Comprehensive search of eight databases were conducted until August 27, 2023. Randomized controlled trials comparing acupuncture alone or in combination with drugs versus medication in children with AR were included. The primary outcome was total nasal symptom score (TNSS). The secondary outcomes were serum immunoglobulin E levels, and relapse rates.
Thirteen studies involving 1186 participants were included. In results, acupuncture group (AC group) versus medication group (Med group) shows no significant difference in the treatment of AR in children (risk ratio [RR] = 1.10, 95% CI = 0.97 to 1.24, p = 0.13), while TSA suggested the included sample size did not exceed required information size (RIS). Significant differences were found between the AC + Med group versus the Med group (RR = 1.29, 95% CI = 1.17 to 1.42, p < 0.00001), with sufficient sample size. Results in serum IgE after treatment which favored the Med group (MD = 51.94, 95% CI [22.24, 81.65], p = 0.0006). In terms of relapse rate, The AC group had a lower relapse rate than the Med group (RR = 0.40, 95% CI = 0.26-0.63, p < 0.0001).
Acupuncture is an efficacious treatment for allergic rhinitis in children, but this conclusion might be limited by the generally low quality of evidence. TSA suggested additional high-quality trials with larger sample sizes and longer treatment durations were needed.
既往研究表明针刺治疗变应性鼻炎有效，但儿童变应性鼻炎的相关证据尚缺乏。本研究旨在通过荟萃分析和试验序贯分析评估针刺治疗儿童变应性鼻炎的疗效。
系统检索 2023 年 8 月 27 日前收录针刺治疗儿童变应性鼻炎的随机对照试验（RCT），比较针刺与药物及药物联合针刺治疗儿童变应性鼻炎的疗效，主要结局指标为总鼻症状评分（TNSS），次要结局指标为血清免疫球蛋白 E（IgE）水平和复发率。
共纳入 13 项研究 1186 例患者，针刺组与药物组比较，儿童变应性鼻炎的疗效差异无统计学意义（RR=1.10，95%CI=0.971.24，P=0.13），序贯分析提示纳入样本量未达到所需信息量（RIS）；针刺联合药物组与药物组比较，儿童变应性鼻炎的疗效差异有统计学意义（RR=1.29，95%CI=1.171.42，P<0.00001），且具有足够的样本量；治疗后两组血清 IgE 水平差异有统计学意义，药物组优于针刺组（MD=51.94，95%CI=[22.24，81.65]，P=0.0006）；针刺组复发率低于药物组（RR=0.40，95%CI=0.26~0.63，P<0.0001）。
针刺治疗儿童变应性鼻炎有效，但由于证据质量普遍较低，该结论可能受到限制。序贯分析提示需要进一步开展高质量、大样本、长疗程的 RCT 研究。
