Acupuncture for persistent allergic rhinitis: a randomised, sham-controlled trial

Charlie C L Xue, Xuedong An, Thomas P Cheung, Cliff Da Costa, George B Lenon, Frank C Thien and David F Story
Med J Aust 2007; 187 (6): 337-341.


Objective: To investigate the effectiveness and safety of acupuncture in persistent allergic rhinitis (PAR)

Design: Randomised, single-blind, sham-controlled trial conducted from May 2004 to February 2005.

Participants and intervention: 80 patients with PAR (age, 16–70 years) were randomly assigned to receive real or sham acupuncture. After a 1-week baseline period, participants were treated twice weekly for 8 weeks and followed up for another 12 weeks.

Main outcome measures: Nasal obstruction, sneezing, rhinorrhoea and nasal itch were each self-assessed daily on a 5-point scale, and scores were aggregated weekly. The sum of the symptom scores (total nasal symptom score, TNSS) was also determined. A secondary outcome was use of PAR relief medication.

Results: After 8 weeks’ treatment, the weekly mean difference in TNSS from baseline was greater with real (17.2; 95% CI, 24.6 to 9.8) than with sham acupuncture (4.2; 95% CI, 11.0 to 2.7) (P = 0.01). The decrease in individual symptom score was also greater with real acupuncture for rhinorrhoea (P < 0.01) but not the other symptoms. At the end of follow-up, the greater difference in TNSS from baseline in the real acupuncture group was still apparent: real, 21.0 (95% CI, 29.1 to 12.9) versus sham, 2.3 (95% CI, 10.2 to 5.6) (P = 0.001). Moreover, the differences from baseline in all four individual symptom scores were greater for the real than for the sham group (P < 0.05). Real and sham acupuncture were both well tolerated.

Conclusion: Our findings suggest that acupuncture is effective in the symptomatic treatment of PAR.

Trial registration: Australian Government Therapeutic Goods Administration CTN 034/2004.

  • Charlie C L Xue1
  • Xuedong An1
  • Thomas P Cheung1
  • Cliff Da Costa2
  • George B Lenon1
  • Frank C Thien3
  • David F Story4

  • 1 Division of Chinese Medicine, School of Health Sciences, World Health Organization Collaborating Centre for Traditional Medicine, RMIT University, Melbourne, VIC.
  • 2 School of Mathematical and Geospatial Sciences, RMIT University, Melbourne, VIC.
  • 3 Department of Allergy, Immunology and Respiratory Medicine, The Alfred Hospital and Monash University, Melbourne, VIC.
  • 4 School of Health Sciences, RMIT University, Melbourne, VIC.



We gratefully acknowledge RMIT University for financial support of the study, Dr Vincent Dinh for medical assessment of participants, Professor Xun Chuan Ji for specialist nasal assessments, staff of the RMIT Chinese Medicine Research Group for their assistance in the conduct of this trial, and Dr Lin Zhang for assistance in proof reading and constructive comments during preparation of the manuscript.

Competing interests:

None identified.

  • 1. Bauchau V, Durham SR. Epidemiological characterization of the intermittent and persistent types of allergic rhinitis. Allergy 2005; 60: 350-353.
  • 2. Australian Bureau of Statistics. National Health Survey: summary of results 2004–2005. Canberra: ABS, 2006. (ABS Cat. No. 4364.0.)
  • 3. Douglass JA, O’Hehir RE. 1. Diagnosis, treatment and prevention of allergic disease: the basics. Med J Aust 2006; 185: 228-233. <MJA full text>
  • 4. Plaut M, Valentine MD. Clinical practice. Allergic rhinitis. N Engl J Med 2005; 353: 1934-1944.
  • 5. Bousquet J, Van Cauwenberge P, Khaltaev N. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001; 108 (5 Suppl): S147-S334.
  • 6. Leger D, Annesi-Maesano I, Carat F, et al. Allergic rhinitis and its consequences on quality of sleep: an unexplored area. Arch Intern Med 2006; 166: 1744-1748.
  • 7. Leynaert B, Neukirch C, Kony S, et al. Association between asthma and rhinitis according to atopic sensitization in a population-based study. J Allergy Clin Immunol 2004; 113: 86-93.
  • 8. Fineman SM. The burden of allergic rhinitis: beyond dollars and cents. Ann Allergy Asthma Immunol 2002; 88 (4 Suppl 1): 2-7.
  • 9. Walls RS, Heddle RJ, Tang ML, et al. Optimising the management of allergic rhinitis: an Australian perspective. Med J Aust 2005; 182: 28-33. <MJA full text>
  • 10. Schafer T, Riehle A, Wichmann HE, Ring J. Alternative medicine in allergies — prevalence, patterns of use, and costs. Allergy 2002; 57: 694-700.
  • 11. Xue CC, Thien FC, Zhang JJ, et al. Treatment for seasonal allergic rhinitis by Chinese herbal medicine: a randomized placebo controlled trial. Altern Ther Health Med 2003; 9: 80-87.
  • 12. Hu G, Walls RS, Bass D, et al. The Chinese herbal formulation biminne in management of perennial allergic rhinitis: a randomized, double-blind, placebo-controlled, 12-week clinical trial. Ann Allergy Asthma Immunol 2002; 88: 478-487.
  • 13. Xue CC, English R, Zhang JJ, et al. Effect of acupuncture in the treatment of seasonal allergic rhinitis: a randomized controlled clinical trial. Am J Chin Med 2002; 30: 1-11.
  • 14. Ng DK, Chow PY, Ming SP, et al. A double-blind, randomized, placebo-controlled trial of acupuncture for the treatment of childhood persistent allergic rhinitis. Pediatrics 2004; 114: 1242-1247.
  • 15. Qiu ML. Chinese acupuncture and moxibustion. London: Longman Group UK, 1993.
  • 16. Prenner BM, Chervinsky P, Hampel FC Jr, et al. Double-strength beclomethasone dipropionate (84 micrograms/spray) aqueous nasal spray in the treatment of seasonal allergic rhinitis. J Allergy Clin Immunol 1996; 98: 302-308.
  • 17. Brinkhaus B, Hummelsberger J, Kohnen R, et al. Acupuncture and Chinese herbal medicine in the treatment of patients with seasonal allergic rhinitis: a randomized-controlled clinical trial. Allergy 2004; 59: 953-960.
  • 18. Joos S, Schott C, Zou H, et al. Immunomodulatory effects of acupuncture in the treatment of allergic asthma: a randomized controlled study. J Altern Complement Med 2000; 6: 519-525.
  • 19. Petti FB, Liguori A, Ippoliti F. Study on cytokines IL-2, IL-6, IL-10 in patients of chronic allergic rhinitis treated with acupuncture. J Tradit Chin Med 2002; 22: 104-111.
  • 20. Dawidson I, Angmar-Mansson B, Blom M, et al. Sensory stimulation (acupuncture) increases the release of calcitonin gene-related peptide in the saliva of xerostomia sufferers. Neuropeptides 1999; 33: 244-250.
  • 21. Birch S. Clinical research on acupuncture. Part 2. Controlled clinical trials, an overview of their methods. J Altern Complement Med 2004; 10: 481-498.
  • 22. Streitberger K, Kleinhenz J. Introducing a placebo needle into acupuncture research. Lancet 1998; 352: 364-365.
  • 23. Kaptchuk TJ, Stason WB, Davis RB, et al. Sham device v inert pill: randomised controlled trial of two placebo treatments. BMJ 2006; 332: 391-397.
  • 24. Dincer F, Linde K. Sham interventions in randomized clinical trials of acupuncture — a review. Complement Ther Med 2003; 11: 235-242.
  • 25. MacPherson H, Thomas K, Walters S, Fitter M. The York acupuncture safety study: prospective survey of 34 000 treatments by traditional acupuncturists. BMJ 2001; 323: 486-487.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Responses are now closed for this article.