Evaluation Of The Treatment Of Allergic Rhinitis By Acupuncture And Papillary Ganglion

[Background]There exit many side effects in the treatment of allergic rhinitis (AR) with conventional western medicine. Moreover, a substantial number of patients have uncontrolled symptoms during treatment and require a personalized approach.The safe and effective personalized treatment approach has been paid more attention. Therefore patients turn to Traditional Chinese Medicine, more and more patients receive acupuncture and Chinese medicine in the treatment. The technique’the Sphenopalatine Ganglion Stimulation with Acupuncture’uti lized as the main treatment of allergic rhinitis has been performed in the clinic for many years. Abundant clinical cases were reported with significant efficacy in many articles addressed this technique, most of them were about summarizing the clinical experience. Lacking objective control study and evidence-based support, it will make this simple and effective technique difficult to promote.[Objectives]This research will adopt the method of evidence-based medicine to evaluate the superiority of’the Sphenopalatine Ganglion Stimulation with Acupuncture’ as main treatment of AR compared to conventional western medicine or traditional verum acupuncture, and provide scientific basis for clinical study.[Data and Methods]The eligibity criteria was developed based-on Participants, Interventions, Comparisons and Outcomes. Searched for English articles by keywords through the Cochrane Library (-Jan 2015), PubMed (1980-Jan 2015), ProQuest (-Jan 2015) and Chinese articles through CNKI (1979-Jan 2015)、 Chinese Biological Medicine database (CBM) (1978-Jan 2015)、 WanFang (1978-Jan 2015) and VIP database (1989-Jan 2015). Handsearched TCM-related journals 《Chinese Acupuncture & Moxibustion》, 《Shanghai Journal of Acupuncture and Moxibustion》, 《ZHENCI YANJIU》, 《Journal of Clinical Acupuncture and Moxibustion》, 《Chinese Journal of Integrated Traditional and Western Medicine》and 《Chinese Journal of Otorhinolaryngology in Integrative Medicine》 (Jan 2014-Jan 2015) for comprehensive and entire collection of articles.To identify other source of registered trials from Chinese Clinical Trial Registry (ChiCTR)、ISRCTN、 ClinicalTrials.gov and The Cochrane Central Register of Controlled Trials (CENTRAL).Articles Screening Steps: ①Removing Duplicates; ①Overview Titles and Abstracts (1st Screening); ③Full-Text Review(2nd Screening). Data Extract ion Steps: ①Making Data Extraction Tables; ②Extrating Data from included studies.Appraisal of Methodological Quality: ①Jadad Scale;②Risk of Bias Tool (referred to the Cochrane Handbook for Systematic Reviews of Interventions)Outcomes were synthesized and analyzed via Meta-Analysis by RevMan version 5.3 and R version 3.2.0. After comprehensive analysis, the GRADEpro3.6 software was used to present the GRADE evidence quality rating.[Results]9 studies were identified including 1 unpublished. The result of Meta-ana lysis showed that (1)’the Sphenopalatine Ganglion Stimulation with Acupuncture’ as the main treatment of AR compared to conventional western medicine showed that①Total response rate:the synthesis of adjusted OR= 1.99 with 95%CI [1.06, 3.72], the difference was significant statistically; ②Change of total symptom score:the synthesis of MD is 0.69 with 95%CI [-0.56,1.93], no statistical significant difference; ③Change of IgE:the synthesis of SMD=-0.07,95%CI [-0.97, 0.83], no statistical significant difference (2)’the Sphenopalatine Ganglion Stimulation with Acupuncture’as the main treatment of AR compared to conventional acupuncture showed that ①Total response rate:the synthesis of adjusted OR isl.36 with 95%CI[0.57,3.24], no statistical significant difference; ②Change of total symptom score:the synthesis of MD is 0.06 with 95%CI [-0.56, 0.68], no statistical significant difference; ③Change Score of RQLQ:the synthesis of MD is 7.40 with 95%CI[2.36,12.45], the difference was significant statistically.[Conclusions]Based on the results, we might conclude that the main treatment on AR by’the Sphenopalatine Ganglion Stimulation with Acupuncture’is more effective on alleviating symptoms and improving the quality of life than that only by western medicine or only by traditional verum acupuncture.However only 9 studies which most assessed lower quality in methodology were included in the review and the possible clinical heterogeneity among studies existed, we should be aware of the limitation of the syntheses of outcomes via Meta-Analysis and treat the results prudently.