| Objective1.Using systematic review and Meta-analysis methods,evaluate the efficacy and safety of acupuncture combined with traditional Chinese medicine decoction in the treatment of allergic rhinitis.2.Randomized controlled trials were used to observe the clinical efficacy and safety of Jin’s three-needles therapy combined with XiaoQingLong decoction in improving the symptoms of allergic rhinitis,so as to provide new ideas and methods for clinical treatment of allergic rhinitis.Methods1.Systematic review and Meta-analysisAccording to the Cochrane Systematic Review Handbook,the inclusion and exclusion criteria and literature search strategy were formulated,and Chinese and English randomized controlled trials on‘acupuncture combined with traditional Chinese medicine for allergic rhinitis’ were searched comprehensively in various databases,including SinoMed,CNKI,WanFang,VIP,Embase,PubMed,Cochrane Library,the search period is from the database established to December 31,2022.The included subjects were patients with allergic rhinitis who met the diagnosis.The intervention measures chosen for the treatment group were ordinary acupuncture combined with oral administration of traditional Chinese medicine decoction;the intervention measures for the control group were conventional western medicine treatment,the same acupuncture or traditional Chinese medicine as the treatment group,and sham acupuncture combined with sham Chinese medicine.After the obtained literatures were screened strictly according to the inclusion and exclusion criteria,the quality of the included literatures was evaluated,and the relevant data of the included literatures were quantitatively analyzed using RevMan5.4.1 software.The total effective rate of treatment,total nasal symptom score(TNSS),rhinoconjunctivitis quality of life questionnaire(RQLQ),total serum IgE,and adverse event rate were used to evaluate the treatment of allergic rhinitis with acupuncture combined with traditional Chinese medicine of effectiveness and safety.Analysis was performed using a fixed-effects model or a random-effects model according to between-study heterogeneity,and forest plots were used to represent the results.Dichotomous variables are expressed by relative risk(RR),continuous variables are expressed by mean difference(MD)or standard mean difference(SMD),and the confidence interval is set to(95%Cl).2.Clinical trial102 subjects who met the diagnosis of allergic rhinitis and lung qi deficiency and cold syndrome were included in this study.The subjects came from the Department of Traditional Chinese Medicine of the Second People’s Hospital of Futian District,Shenzhen and the Shenzhen JinCao Traditional Chinese Medicine Center.The recruitment time was January 2022 to December 2022.Subjects are screened,meet the diagnostic criteria and various inclusion and exclusion criteria,and sign the‘Informed Consent’ before they can participate in this clinical research.Using the random number table method,the subjects were divided into 3 groups according to the ratio of 1:1:1,namely treatment group(acupuncture and medicine group),acupuncture group,and traditional Chinese medicine group,with 34 people in each group.Due to the particularity of acupuncture and traditional Chinese medicine treatment,the evaluator blind method was adopted in this study.Acupuncture group,ordinary filiform acupuncture was used,with three needles on the nose(Yintang,both sides Shangyingxiang,and both sides Yingxiang),three needles on the back(bilateral Dazhu,both sides of damper,and both sides of Feishu),Needle retention for 30 minutes.Once a day,5 days of treatment,2 days off,2 weeks as a course of treatment,2 courses of treatment.The Chinese medicine group took XiaoQingLong Decoction for treatment,and the prescription was:Ephedra 9g,Baishao 9g,Guizhi 9g,Asarum 6g,dried ginger 9g,roasted licorice 9g,Schisandra chinensis 12g,Pinellia chinensis 12g,one dose of traditional Chinese medicine per day,boil 400ml for each dose(2 bags of 200ml),and take it warm after half an hour in the morning and lunch.Two weeks is a course of treatment,and two courses of treatment are taken.The treatment of the acupuncture and traditional Chinese medicine group is a combination of the acupuncture group and the traditional Chinese medicine group,and the treatment method,medication method and course of treatment are the same.Before treatment,the basic information of subjects in each group was evaluated,and there was no significant difference in gender,age,and course of disease,which were comparable.The curative effect was evaluated by Total Nasal Symptom Score(TNSS),Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ),Chinese Medicine Scale score and total effective rate of treatment.Results1.After screening,a total of 39 articles(38 in Chinese and 1 in English)were included in the systematic review and Meta-analysis.1.1 Total effective rate.A total of 36 literatures reported the total effective rate.The results showed that the total effective rate of the acupuncture combined with traditional Chinese medicine group was better than that of the control group[RR=1.21.95%CI(1.18,1.25),Z=13.42,P<0.00001].Subgroup analysis found that the total effective rate of acupuncture combined with traditional Chinese medicine group was higher than that of acupuncture alone[RR=1.19,95%CI(1.11,1.28),Z=4.78,P<0.00001],and traditional Chinese medicine alone[RR=1.19,9.5%CI(1.14.1.24),Z=8.46,P<0.00001]and conventional western medicine group[RR=1.24,9.5%CI(1.14,1.34),Z=5.04,P<0.00001].1.2 Total Nasal Symptom Score(TNSS).A total of 7 articles evaluated TNSS,and the results showed that the improvement of TNSS in the acupuncture combined with traditional Chinese medicine group was better than that in the control group[MD=-1.87,95%CI(-2.33,1.41),Z=7.98,P<0.00001].Subgroup analysis found that the acupuncture combined with traditional Chinese medicine group had no significant difference in improving the TNSS compared with the acupuncture group[MD=-1.68,95%CI(-3.40,0.05),Z=1.91,P=0.06];compared with the traditional Chinese medicine group[MD=-1.96,95%CI(-2.65,-1.27),Z=5.59,P<0.00001]and conventional western medicine group[MD=-1.78,95%CI(-2.29,1.26),Z=6.76,P<0.00001],the difference was statistically significant.It is suggested that the improvement of TNSS in the acupuncture combined with traditional Chinese medicine group is significantly better than that in the traditional Chinese medicine group and the conventional western medicine group.The difference with the acupuncture group is not obvious enough,suggesting that the acupuncture group may be more effective in improving the TNSS than the traditional Chinese medicine group and the conventional western medicine group.1.3 Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ).A total of 8 articles evaluated the RQLQ,and the results showed that the improvement of RQLQ scores in the acupuncture combined with traditional Chinese medicine group was better than that in the control group[SMD=-1.26,95%CI(-1.73,-0.80),Z=5.35,P<0.00001].Subgroup analysis found that acupuncture combined with traditional Chinese medicine group improved RQLQ compared with acupuncture group[SMD=-1.31,95%CI(-2.09,-0.53),Z=3.27,P=0.001],Chinese medicine group[SMD=-1.38,95%CI(-2.28,-0.47),Z-2.98,P=0.003]and conventional western medicine group[SMD=-1.3 7,95%CI(-2.68,-0.05),Z=2.03,P=0.04],both had significant difference,which was statistically significant.Suggesting that the acupuncture combined with traditional Chinese medicine group improved the RQLQ better than the acupuncture group,the Chinese medicine group and the conventional western medicine group.It may be that conventional western medicine is more effective in improving RQLQ than acupuncture alone and traditional Chinese medicine alone.1.4 Serum total IgE.A total of 7 documents evaluated IgE,and the results showed that the improvement of IgE level in the acupuncture combined with traditional Chinese medicine group was better than that in the control group[SMD=-0.79.95%CI(-1.28,-0.30),Z=3.18,P=0.001<0.05].Subgroup analysis found that the acupuncture combined with traditional Chinese medicine group improved IgE levels compared with the acupuncture group alone[SMD=-0.61,95%CI(-1.27,0.05).Z=1.80,P=0.07]and the conventional western medicine group[SMD=-1.29,95%CI(-2.88,0.31),Z=1.58,P=0.11]the difference was not statistically significant,compared with the traditional Chinese medicine group[SMD=-0.60,95%CI(0.92.-0.28),Z=3.66,P=0.0002].The difference was statistically significant,suggesting that the acupuncture combined with traditional Chinese medicine group had no significant difference in improving serum total IgE compared with the acupuncture alone group and the conventional western medicine group.It may be that the conventional western medicine group improved the serum total IgE level,which was significantly more effective than the acupuncture group and the traditional Chinese medicine group.1.5 Incidence rate of adverse events.There was no significant difference in the incidence of adverse events between the acupuncture combined with traditional Chinese medicine group and the control group[RR=0.70,95%CI(0.42,1.17),Z=1.36,P=0.17].Subgroup analysis found that there was no statistically significant difference between acupuncture combined with traditional Chinese medicine group and acupuncture alone/Chinese medicine alone group[RR=0.84,95%CI(0.46,1.51),Z=0.59,P=0.56]There was a statistically significant difference between groups[RR=0.21,95%CI(0.09,0.48),Z=3.71,P=0.0002<0.05].It suggested that the incidence of adverse events in the acupuncture combined with traditional Chinese medicine group was not significantly different from that in the acupuncture combined with traditional Chinese medicine alone group,while the incidence of adverse events in the conventional western medicine group was higher than that in the acupuncture combined with traditional Chinese medicine group.2.A total of 102 AR patients with lung qi deficiency and cold type who met the criteria were recruited in this clinical study,with 34 subjects in each group.Among them,2 cases were terminated in the treatment group,1 case was terminated in the acupuncture group,1 case dropped out,and 2 cases were terminated in the traditional Chinese medicine group.Finally,96 subjects were included in the statistics,including 32 cases in the acupuncture group and 32 cases in the traditional Chinese medicine group.There were 32 cases in the medicine group.The general data of the three groups of patients were comparable.2.1 Total effective rate.96 subjects were finally included in the statistics of this clinical study,including 32 cases in the treatment group(Jin’s three-needles therapy combined with XiaoQingLong decoction);32 cases in the acupuncture group(acupuncture alone);32 cases in the Chinese medicine group(Chinese medicine treatment alone).In the treatment group,24 patients were markedly effective,7 patients were effective,and 1 patients was ineffective,with a total effective rate of 96.875%.In the acupuncture group,8 patients were markedly effective,18 patients were effective,and 6 patients were ineffective,with a total effective rate of 81.25%.In the Chinese medicine group.12 patients were markedly effective,15 patients were effective,5 patients were ineffective,and the total effective rate was 84.375%.The total effective rate of the treatment group was higher than that of the acupuncture group and the traditional Chinese medicine group(P<0.05):However,there was no significant difference in the total effective rate between the acupuncture group and the traditional Chinese medicine group(P>0.05).2.2 Total Nasal Symptom Score(TNSS).The TNSS of the three groups showed a downward trend before treatment,2 weeks after treatment,and 4 weeks after treatment,and the difference was statistically significant(P<0.05);Compared with the difference between the TNSS level after 2 weeks of treatment and before treatment,the curative effect of the treatment group was better than that of the acupuncture group and the traditional Chinese medicine group(P<0.05),but there was no significant difference between the acupuncture group and the traditional Chinese medicine group(P>0.05);Comparing the difference between the TNSS level after 4 weeks of treatment and before treatment.the curative effect of the treatment group was better than that of the acupuncture group and the Chinese medicine group(P<0.05),but there was no significant difference between the acupuncture group and the Chinese medicine group(P>0.05).2.3 Rhinoconjunctivitis Quality of Life Questionnaire(RQLQ).The improvement of RQLQ in the three groups showed a downward trend before treatment,2 weeks after treatment,and 4 weeks after treatment,and the difference was statistically significant(P<0.05);Comparing the difference between the RQLQ level after 2 weeks of treatment and before treatment,the curative effect of the treatment group was better than that of the acupuncture group and the Chinese medicine group(P<0.05),and the difference between the acupuncture group and the Chinese medicine group was not significant(P>0.05);Comparing the difference between the RQLQ level after 4 weeks of treatment and before treatment,the curative effect of the treatment group was better than that of the acupuncture group and the Chinese medicine group(P<0.05),but there was no significant difference between the acupuncture group and the Chinese medicine group(P>0.05).2.4 Chinese medicine scale scores.There was a statistically significant difference in the improvement of TCM scale scores in the three groups before treatment compared with after treatment(P<0.05).Comparing the differences between the three groups after treatment and before treatment,the curative effect of the treatment group was better than that of the acupuncture group and the traditional Chinese medicine group(P<0.05),but there was no significant difference between the acupuncture group and the traditional Chinese medicine group(P>0.05).2.5 Adverse events.There were no serious adverse events in the three groups of patients.During the treatment,1 case of nausea after taking medicine,1 case of dry mouth after taking the medicine,and 1 case of local skin bruise after acupuncture in the acupuncture and medicine group;1 case of acupuncture pain and 1 case of local skin bruise after acupuncture in the acupuncture group;In the traditional Chinese medicine group,2 cases of dry mouth and 1 case of constipation occurred.Conclusion1.The total effective rate of acupuncture combined with traditional Chinese medicine in the treatment of allergic rhinitis is better than that of acupuncture alone,traditional Chinese medicine alone and conventional western medicine.In addition to improving nasal symptoms,it can also play a positive role in the quality of life of patients.In terms of objective indicators,acupuncture combined with traditional Chinese medicine can also improve total serum IgE levels in AR patients.In addition,the method of acupuncture combined with traditional Chinese medicine has good safety.The quality of the included literature is low,and more high-quality clinical studies are needed to further confirm the results of this study.2.Jin’s three-needles therapy combined with XiaoQingLong decoction,Jin’s threeneedles therapy,and XiaoQingLong decoction all have good curative effects on allergic rhinitis,and the curative effect of the treatment group is better than that of the acupuncture group and the traditional Chinese medicine group.The curative effect is similar;the treatment of the three groups can significantly improve the nasal symptoms(TNSS),the quality of life(RQLQ)and the state of the syndrome of deficiency and cold of lung qi(Chinese medicine scale scores)of AR patients;The treatment of the three groups has good safety. |
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