Seasonal Allergies Relieved With Chinese Herbs and Acupuncture

Often referred to as “hay fever,” allergic rhinitis can be caused by a variety of relatively
harmless substances, ranging from pollen and dust to animal dander. The most common
form of allergic rhinitis is seasonal allergic rhinitis, which typically occurs at the same
time each year when certain plants are in bloom. Other people can be afflicted with
perennial allergic rhinitis (which may occur at any given time of the year) or occupational
allergic rhinitis (which is caused by an allergic reaction to substances in the workplace,
such as chemicals or grains). All told, between 10 percent and 20 percent of the general
population is believed to have some form of allergic rhinitis, with direct and indirect
health care costs totaling between $4.5 and $7.7 billion per year in the U.S. alone.
1
In China, acupuncture and herbal remedies have been used to combat symptoms similar
to allergic rhinitis successfully for centuries. Previous research has shown, for instance,
that Chinese herbal medicine can treat atopic dermatitis, while acupuncture has been
proven effective in relieving the symptoms a number of allergic conditions. However,
few studies have examined the combined use of acupuncture and Chinese herbal
remedies in the treatment of allergic rhinitis.
A study in the September 2004 issue of Allergy has concluded that a combination of
Chinese herbs and weekly acupuncture sessions may be more effective than a placebo at
relieving the symptoms of seasonal allergic rhinitis. The authors of the study also suggest
that future research be conducted to investigate the effectiveness of an acupuncture­herb
combination in the treatment of other conditions.
2
In the study, a total of 52 patients between the ages of 20 and 58, all diagnosed with
seasonal allergic rhinitis, were randomly assigned to a traditional Chinese medicine group
or a control group. In the TCM group, patients received a standardized 20­minute
acupuncture treatment once a week for six weeks, with points on the Large Intestine,
Gallbladder, Lung and Liver meridians stimulated. Additional points were selected based
on each patient’s individual symptoms. All of the patients were treated while in a supine
position. After the needles were inserted, they were manipulated to obtain de qi. The
needles were manipulated again 10 minutes after the start of treatment.
Along with acupuncture, TCM patients received a basic herbal formula (consisting of
schizonepeta, chrysanthemum, cassia seed, plantago seed and tribulus), which they were
instructed to take as a decoction three times per day, parallel to acupuncture treatment. In
addition to the basic formula, every patient received a second formula tailored to the
patient’s individual TCM diagnosis.
In the control group, patients were given acupuncture at standardized non­acupuncture
points distant from meridians, and were treated superficially with needles smaller than
those used on the TCM patients. The needles were not manipulated, and the same points
were needled at each acupuncture session. Control patients also received a non­specificherbal formula comprised of coix seed, licorice, poria, hops, oryza, barley, hawthorn
fruit, and medicated leaven.
To measure the effect of each therapy, patients used a visual analogue scale to rate the
severity of hay fever suffered during the previous week on a 10­point scale, and an
assessment­of­change scale to measure any changes in symptoms. Patients also filled out
an allergic rhinitis questionnaire to rate the severity of symptoms, and a pair of quality­
of­life surveys. In addition, patients were asked to document the number of anti­allergy
drugs taken for one week.
Patient Surveys Find Favorable Results for Acupuncture/Herb Combination
At the start of the study, visual analogue scores for each group were nearly identical (4.1
for the TCM group, 4.2 for the control group). By the end of the study period, however,
the severity of hay fever was “significantly less pronounced in the TCM group” than in
the control patients, and instances of remission (represented by a 0 or 1 on the visual
analogue scale) occurred twice as often in TCM patients compared to patients in the
control group.
Similar results were seen in the assessment­of­change scores and the rhinitis
questionnaire. Improvement on the assessment­of­change score was observed in 85
percent of the TCM patients versus only 40 percent of control patients. An analysis of the
rhinitis questionnaire, meanwhile, found that TCM patients experienced improvements in
allergy symptoms in the eyes and nose, higher levels of physical activity, and an
improved psychological condition compared to patients in the control group.
Intake of anti­allergy drugs also dropped dramatically among TCM patients. According
to the researchers, “the permitted drug intake for allergic rhinitis symptoms decreased
substantially, from 7.7 to 3.4 points in the TCM group, whereas we found only a slight
decrease in the control group (7.7­6.0).”
The acupuncture­herb combination appeared to be well­tolerated by patients in both
groups. Two patients in the TCM group complained of pain due to needle insertion, as
did one patient in the control group. A second control patient complained of hematoma,
while a third suffered from paresthesia in one arm, which persisted for 7 days. Five
patients (two TCM, three control) complained that the herbal decoction either tasted
bitter or made them feel nauseous. However, none of the patients experienced “severe or
serious adverse events” that would have caused them to leave the trial.
Limitations and Conclusions
The scientists noted that their study methods contained some restrictions that might have
impacted the quality of their research. For instance, they stated that one of the
questionnaires used in the study may have been “methodologically inefficient” because
of the potential for low patient compliance. In addition, the acupuncture­herb therapyused in the trial lasted only 6 weeks; other studies have indicated that longer treatment
times and more individualized therapies have resulted in better patient outcomes.
3,4
After taking the limitations into account, the authors suggested that the combination of
acupuncture and an herbal decoction, tailored to the patient and administered according
to the diagnostic principles of traditional Chinese medicine, could be effective in treating
mild­to­moderate forms of seasonal allergic rhinitis. As they noted in the study’s
conclusion:
“We could show that this treatment was efficacious in improving global severity rating
and in affecting disease­related quality of life parameters after 6 weeks of treatment when
compared with sham needling plus a non­specific herbal formulation … Taking into
account the above­mentioned limitations of the study, we conclude that acupuncture plus
Chinese herbal formulations may offer relief in patients with seasonal allergic rhinitis.
Our findings support further investigations of acupuncture and Chinese herbal medicine
in this and other diseases.”