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

To the Editor: Xue and colleagues reported an interesting randomised, single-blind trial of acupuncture for persistent allergic rhinitis (PAR) and concluded that acupuncture is an effective treatment for this condition.1 I am not entirely sure that this is true. The authors state that “once needling sensation (known as de-qi) was obtained, the needles were manipulated . . .”. In the sham group they inserted needles at non-acupuncture points where, according to acupuncture theory, no de-qi can be elicited. Thus the intervention patients were experiencing de-qi, and the control patients were not. This means that neither the patients nor the therapist were blinded. Consequently, the difference in outcome between the two groups could be unrelated to acupuncture itself, and caused by patient expectation, therapist expectation or both.