| 1BackgroundThe incidence of allergic rhinit is (short for AR) is high around the world, and is increasing for the last several years. The symptoms are recurrent and hard to be cured completely. AR has many complications such as asthma, nasal polyps, sinusitis and so on. AR is a common disease and becomes a global problem of health. There are many treatments including drug therapy, specific immunotherapy, surgery, and omalizumab. However, there are still some patients of moderate or severe AR who cannot be cured. In recent years, acupuncture and moxibustion becomes more widely used for AR. The efficacy is satisfactory.2ObjectiveThe objective of this study is to observe the clinical efficacy, the onset time and duration of the treatment called acupuncture plus moxibustion above ginger, and to optimize the project of acupuncture and moxibustion for AR.3MethodsThis was a randomized, parallelgroup study.60cases of AR patients treated in acupuncture clinics of Guang’anrmen Hospital, China Academy of Chinese Medical Sciences were selected as sample. All patients met the diagnostic criterion of "Diagnostic and treatment guidelines for al lergic rhinit is"(2009update) written out by Otolaryngology-Head and Neck Surgery Branch of China Medical Association. Case inclusion criterion:1)those who meet the diagnostic criterion for AR;2)AR had been documented by a recognized skin prick test of at least++reaction for one kind of allergen;3)age older than18years, younger than60years;4) signed informed consent, voluntary participants. This study also had an exclusion criterion.60patients were divided into three equal groups, each group had20cases. The three groups accapted three different kinds of treatments. One was acupuncture plus moxibustion above ginger, one was single acupuncture, and another was loratadine. There were no differences for age, gender, course of disease, type and degree among groups. The patients in the first group accepted the treatment with acupuncture plus moxibustion above ginger on the acpoint Dazhui (DU14) and acupuncture on other points such as Chize(LU5), Lieque(LU7), Hegu(LI4), Quchi (LI11), reducing technique should be applied at LU5, kept the needle for20minutes, three times a week,12times in all for4weeks. Single acpuncture group only accepted acpuncture on the same points with the same techniques to the first group, kept the needle for20minutes, three times a week,12times in all for4weeks. Drug group took10mg loratadine once a day, for4weeks. The symptom scores, TNSS+TNNSS scores, and RQLQ scores were evaluated before and after the treatments. During the treatments, patients except the drug group wrote down scores of the TNSS+TNNSS scale on the diary cards at eight different times which were hour1, hour8, hour24, hour48, after the first cure and the twelfth cure. Six months later, the patients would be called for finding out the situations of the symptoms.4ResultsIn the study, two patients had not finished the treatment. One felt dizzy at the first treat, and stopped the treatment. The other patient was so busy that he could not finish it. So there were58patients who had finished the treatment completely. The dropout rate was3.3%, less than15%, meeting the statistical requirements. Compared to the scores evaluated before the treatment, the symptom scores, the TNSS+TNNSS scores and the RQLQ scores evaluated after the treatment of the three groups had apparent reductions (P<0.01). However, among the three groups, the symptom scores after the treatment had no differences with each other(P>0.05), and this situations were the same to the TNSS+TNNSS scores and the RQLQ scores. The TNSS+TNNSS scores evaluated at the different eight times on the diary cards of the patients who accepted the acupuncture were less than the scores before the treatment(P<0.01). However, there was no differences between the two groups (P>0.05). In the single acupuncture group, the TNSS+TNNSS scores at hour8after the twelfth treat were more than those at hour1(P<0.05). And the scores at hour24and hour48after the twelfth treat were obviously more than those at hour1(P<0.01). For the TNSS+TNNSS scores, the change from the situation before the treatment was assessed, with a decrease in scores denoting reduction in symptoms. Analyses were performed for both the percentage change and the absolute change from the scores before the treatment. In the group of acupuncture plus moxibustion above ginger, there were no differences for both the percentage change and the absolute change among the different four times after the first treat or the twelfth treat (P>0.05). In the group of single acupuncture, there were no differences for the absolute change among the different four times after the first treat (P>0.05), however, mean percent reductions at the hour48were smal ler than the hour1(P<0.05). In the same group, mean absolute decrease at the hour24and the hour48were less than the hour1after the twelfth treat (P<0.05),and mean percentage reductions at the hour8, the hour24and the hour48were smaller than the hour1after the twelfth treat (P<0.05). At the hour24after the twelfth treat, mean absolute decrease of the single acupuncture was less than that of the acupuncture plus moxibustion above ginger (P<0.05). Assessment of effects of therapy on individual symptoms revealed statistically significant greater reductions with the three groups after the treatment versus that before the treatment. The scores of Nasal congestion with the group of acupuncture plus moxibustion were less than that with the group of drug(P<0.017)at the end of the study. The scores of itchy and watery eyes with the group of single acupuncture were more than that with the group of drug(P<0.017)after the treatment. In the drug group, mean absolute decrease of itchy and watery eyes was greater than that of the other symptoms (P<0.05).5DiscussionIn the58cases,81.0%-83.3%of the patients had moderate or severe AR,16.7%-19.0%of the patients had mild AR. According to the results, the three groups had similar efficacy with each other for the symptoms of AR. The three therapies also could improve the quality of life. The onset of action of acupuncture plus moxibustion above ginger was evident by hour1, and the same to the single acupuncture. The durations of two therapies were both48hours. ARIA pointed out that the onset of action of H1antihistamines was within1hour after the dose, and the duration of the drug could last24hours. So the onset of action of the three therapies was similar. And the two kinds of acupuncture therapies had longer durations than that of the H1antihistamines. So the acupuncture therapies could treat patients every other day. The scores of the TNSS+TNNSS scale at the different8times which belonged to the group of acupuncture and moxibustion were similar with each other, so the therapy had a stable and lasting efficacy. However, the scores of the single acupuncture group at hour8, hour24, hour48were more than hour1after the twelfth treat. So the efficacy of the single acupuncture was not stable and lasting enough. The study also showed that the therapy of acupuncture plus moxibustion above ginger had a better efficacy for nasal congestion than that of loratadine. But the therapy of single acupuncture had a worse efficacy for itchy and watery eyes than that of loratadine. So the therapy of acupuncture plus moxibustion above ginger can be used in clinic to cure AR instead of loratadine, and get the same efficacy with loratadine. It can also be used with loratadine together to make a better efficacy for nasal congestion.6ConclusionThree therapies were all effective for AR. Those therapies could not only relieve the main symptoms but also improve the quality of life. The onsets of action of the three therapies were within1hour. After the first treat, two kinds of acupuncture therapies had the similar duration of48hours, however, after the twelfth treat, the duration of the single acupuncture therapy became shorter than the other one. So the therapy of acupuncture plus moxibustion above ginger had a more stable and lasting efficacy than the therapy of single acupuncture. The individual symptom scores showed that the therapy of acupuncture plus moxibustion above ginger had a better efficacy for nasal congestion than that of loratadine. The therapy of single acupuncture had a worse efficacy for itchy and watery eyes than that of loratadine. |
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