A novel and alternative therapy for persistent allergic rhinitis via intranasal acupuncture: a randomized controlled trial
Authors: Liu Li-li , Gong Zheng , Tang Lei , Yan Zhan-feng 
Published: January 2023

Abstract
Background
Acupuncture is used to treat allergic rhinitis (AR) in traditional Chinese medicine, and the ST2 and ST36 acupoints are generally selected in clinical practice. We report a new intranasal acupuncture method at the Neiyingxiang (EX-HN9) and Biqiu points for the treatment of persistent AR (PAR). Here, the efficacy and safety of this method were evaluated.

Methods
A total of 120 patients diagnosed with PAR were randomly allocated (2:1 ratio) to intranasal acupuncture or Western medicine groups, the basic principle of random grouping is SAS random grouping method. The applicator held a nasal endoscope and a 0.30 × 75 mm filiform needle in their left and right hands, respectively. When aiming at the Neiyingxiang or Biqiu point, the applicator quickly inserted the needle to a 20-mm depth as parallel as possible to the inferior turbinate or middle turbinate, without special reinforcing and reducing techniques (the needle remained for 20 min). The intranasal acupuncture groups received acupuncture treatment three times per week for 2 weeks. The Western medicine group was treated with budesonide nasal spray (two sprays/nostril, twice/day) and loratadine (one tablet/night) for 2 weeks. Visual analog scale (VAS) scores were the primary outcome. Quality of life, medication dosages and adverse events were secondary outcomes measured using the Rhinoconjunctivitis Quality-of-Life Questionnaire (RQLQ). Confidence assessments were performed to evaluate data from the treatment and follow-up periods.

Results
The results were as follows: (1) VAS and RQLQ scores were significantly lower in the intranasal acupuncture group than in the Western medicine group on day 1 (i.e., first treatment) (P < 0.05; 95% CI − 13.1 to − 9.6 VAS points) (P < 0.05; 95% CI − 20.27 to − 12.28 RQLQ points). Overall symptoms (95% CI − 2.86 to − 1.86 points), nasal obstruction (95% CI − 6.33 to − 5.36 points), olfactory function (95% CI − 2.91 to − 1.75 points), sleep (95% CI − 5.05 to − 3.57 points), actual problems (95% CI − 2.03 to − 0.06 points), nasal symptoms (95% CI − 6.62 to − 4.5 points), and emotional problems (95% CI − 5.05 to − 3.5 points) were significantly improved. (2) VAS and RQLQ scores in the two groups were significantly improved at week 2; however, there were no significant group differences in the VAS (P > 0.05; 95% CI − 1.21 to − 1.38 points) and RQLQ (P > 0.05; 95% CI − 0.33 to − 3.46 points) scores. Olfactory function symptoms were significantly improved (95% CI − 1.58 to − 0.21 points). (3) During the follow-up period, there was a significant difference between the two groups (P < 0.05) with higher RQLQ and VAS scores in the intranasal acupuncture group than in the Western medicine group. VAS scores on rhinobyon symptoms, nasal itch, rhinorrhea and olfactory function and RQLQ scores for activities, non-nasal/eye symptoms, actual problems, nasal symptoms, and eye symptoms were significantly improved. (4) No adverse events were observed in either group during treatment.

Conclusions
Intranasal acupuncture has good efficacy and safety in the treatment of PAR. Moreover, VAS and RQLQ scores were much lower in the intranasal acupuncture group than in the Western medicine group, and acupuncture had an immediate impact, especially for improving nasal congestion, olfactory function and sleep.